You've come through the initial recovery from a stroke. You and your doctor are now assessing the movement in the affected side. This can be a frustrating time as you realize what you've lost. But with physiotherapy on your arm and hand, you may get back much of the functionality. Here is what to expect as you start physical therapy after your stroke.

Putting Back the Puzzle Pieces

Patience will be your greatest asset as you start therapy. There were many pieces affected by the stroke, and each one must be retrained to make you feel whole again. Arm and leg muscles, facial muscles, and perhaps some of your memory and cognitive abilities have been affected. Slowly, you'll work with the orthopedist and physiotherapist to regain some of those missing elements.

Arm and Hand Therapy

Strokes affect one side of the body, so you'll have one "good" arm and hand. People will adapt to doing their daily activities with the unaffected side and ignore the injured side. The disuse of the affected side causes muscles to contract and joints to stiffen. Eventually, the arm and hand may contract tightly together making them useless to you. Part of your physical therapy is to get the affected side involved in daily activities to keep the muscles limber and working for you.

Muscle Stretching

Your therapist will begin by doing stretching exercises on your arm and hand muscles. They will also show you how to do them yourself at home. This will prevent the muscles from contracting when not in use. You'll use your unaffected arm and hand to work the other side. Some of the exercises include:

• Pulling the fingers straight out and bending them back and forth.
• Moving each finger and joint through its normal range of motion.
• Bending and rotating the wrist through it normal movement.
• Extending the elbow until your arm is straight.

Daily Activity and Exercises

Another segment of therapy is to get the affected arm and hand involved in tasks you do every day. The therapist will show you how to use your hand to help with tasks around the house. As with all of the exercises, you'll start out slowly and work up to the maximum capabilities you have in your hand. These functional exercises may include:

• Using a drawer handle to open and close a drawer.
• Carrying a shopping bag across the room with a small object in it.
• Squeezing a toothpaste tube.
• Turning a door knob.

These activities coordinate your brain, nerves and muscles to retrain your arm and hand so that it can be of use to you with your daily tasks. Physiotherapy will be very effective for you if you are able to stick with it patiently.