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This article refers to orthopedic contractures, i.e., permanent shortening of muscles, tendons, and/or ligaments. For short-term contraction of muscles, including the normal action and function of muscles, see Muscle contraction. For non-orthopedic types of contractures, see the “See Also” section below.
A muscle contracture is a permanent shortening of a muscle or joint. It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy.
Contractures are essentially muscles or tendons that have remained too tight for too long, thus becoming shorter. Once they occur, it is often argued that they cannot be stretched or exercised away (they must be released with orthopedic surgery). Most of the physical therapy, occupational therapy, and other exercise regimens targeted towards people with spasticity focuses on trying to prevent contractures from happening in the first place. However, research on sustained traction of connective tissue in approaches such as adaptive yoga has demonstrated that contracture can be reduced, at the same time that tendency toward spasticity is addressed.
Contractures can also be due to ischemia, as in Volkmann’s contracture.
Excessive matrix metalloproteinase and myofibroblast accumulation in the wound margins can result in contracture.

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