Contracture: Symptoms, Causes, Diagnosis, Treatment and Prevention — What You Need to Know
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Quick Answer: A contracture is a structural change in your soft and connective tissues — skin, muscles, joints, tendons and ligaments — that makes them stiffen, tighten and shorten, losing their normal elasticity and range of motion. It is a form of scarring: fibrosis gradually replaces healthy tissue with denser, more rigid tissue that cannot stretch. The leading cause is immobilization (not moving a body part after injury, surgery, or during illness), alongside burns and other wounds, poor blood flow, neuromuscular disorders, and some conditions present at birth. Early treatment — physical therapy, stretching with braces and splints, heat, and sometimes surgery — works best before a contracture becomes fixed.
What Is a Contracture, in Plain Language?
Contractures are structural changes to your soft and connective tissues that cause them to stiffen, tighten and contract. Tissues affected by contracture lose their former elasticity and range of motion.
Contracture is a type of scarring in these tissues. It is easiest to see when it affects your skin. For example, people with significant burn injuries develop areas of skin that are shrunken and constricted.
In other tissues, like your muscles or ligaments, scarring is called fibrosis. It is the process of gradually replacing parts of these tissues with a denser, tougher, more fibrous and more rigid type of tissue.
Rigid tissue loses its capacity to stretch and move, leading to disability. It can also shrink or shorten. This can lead to deformities as the contracture pulls other tissues around to it into abnormal formations.
TL;DR — The Short Version
A contracture is stiffening and shortening of soft tissues caused by scarring (fibrosis). It most often affects skin, muscles, joints and tendons. The leading cause is lack of movement — immobilization after injury, surgery, or illness — but burns, wounds, poor blood flow, neuromuscular conditions, and some birth conditions can also cause it. A permanent contracture can reduce mobility, cause chronic pain, and make daily tasks harder. The best treatment is prevention through movement and physical therapy, and early-stage contractures are far easier to reverse than long-standing ones.
"Contractures can happen all too easily when you're recovering from another condition. And they can take a long time to fix. It takes commitment and diligence with physical therapy to undo the damage." — the reviewed medical source on contracture
When Should You Seek Evaluation for a Contracture?
Contracture is not usually an emergency, but timing matters enormously. The sooner a contracture is addressed, the better the outlook.
Situation | Why it matters |
You have a new injury, surgery, burn, or illness that limits your movement | Immobilization is the leading cause of soft tissue contractures — prevention starts immediately |
You have been hospitalized or in a cast for several weeks | You are at risk of contracture during and after immobilization |
You notice stiffness, tightness, or reduced range of motion in a muscle or joint | Recent contractures are milder and easier to reverse |
You have a condition such as stroke, cerebral palsy, or a neuromuscular disorder | These conditions can immobilize or over-contract muscles |
A permanent bend or deformity is developing in a limb | A flexion deformity can become fixed and harder to treat |
You have a chronic condition that can cause contractures | Ongoing physical therapy may be needed to prevent them |
If you or someone you care for is recovering from an injury, surgery, or illness that limits movement, ask your healthcare team about a physical therapy plan early — before stiffness sets in.
How Does a Contracture Develop?
Contracture is a type of scarring or fibrosis in your tissues. It usually happens when the tissues try to repair themselves after injury or after wasting away from disuse. Sometimes, it is present at birth.
Think of it as the body's repair process overcorrecting. Healthy soft tissue is elastic — it stretches and rebounds. When tissue is repeatedly damaged, starved of blood flow, or simply not used, the repair process replaces it with tissue that is denser, tougher, and more rigid.
Rigid tissue cannot stretch. Over time it can also shrink or shorten, pulling on the surrounding tissues. That pulling is what produces the permanent bends and deformities seen in advanced contractures.
What Are the Types of Contracture?
Different types of contractures can affect different tissues or parts of your body. Healthcare providers use a variety of different names to describe them.
The four broad types
Type | What it affects | Key note |
Scar contracture | Skin, after a wound has healed and scarring is complete | Can lead to other contracture types if it prevents tissues or joints from moving normally |
Muscle contracture | One muscle or a related group of muscles | Can lead to other contractures, such as joint contractures |
Joint contracture (capsular contracture) | The joint capsule — connective tissues enclosing the bones in a joint | When the capsule stiffens, the bones in the joint can't move |
Arthrogenic contracture | Capsular contractures that originate from the joint | Easily affects connected muscles, just as a muscle contracture can affect the joint |
Specific contractures with their own names
Several specific contractures are recognized by name, depending on location and cause.
Name | What it is |
Amyoplasia | A birth defect involving multiple contractures in a child's limbs |
Arthrogryposis | A general term for a child born with multiple contractures; a feature of many genetic disorders, including muscular dystrophy and Edwards syndrome (see our guide to arthrogryposis) |
Clubfoot | A congenital contracture of the foot's tendons that causes the foot to turn inward; can involve the calf muscle |
Dupuytren's contracture | A genetic disorder that contracts the soft tissues of the hands, gradually turning fingers inward toward the palm |
Elbow contracture (stiff elbow) | A contracture of the elbow joint capsule |
Equinus contracture | A contracture of the ankle joint or its attached muscles that makes it impossible to bring the foot to a neutral, right-angle position |
Flexion contracture | A joint contracted in a bent position that can no longer be straightened; most often affects the limbs |
Frozen shoulder (adhesive capsulitis) | A contracture of the shoulder joint capsule |
Volkmann contracture | A hand contracture causing inward flexion of the fingers and wrist, making the hand look like a claw |
What Are the Signs and Symptoms of a Contracture?
Symptoms of contractures can include the following.
Symptom | What to notice |
Visibly thickened, tightened scar tissue | The skin or tissue looks tighter and firmer than before |
Stiffness in muscles, joints, or other soft tissues | Movement feels restricted or "frozen" |
Musculoskeletal pain in your soft tissues | Aching related to the stiffened tissue |
Reduced range of motion and overall mobility | You cannot move the joint or limb through its full range |
Muscle atrophy | Loss of muscle mass from disuse |
Gait disorders | Abnormalities in the way you walk |
Flexion deformities | A permanent bend, especially in the limbs |
What Causes a Contracture?
Contracture is a type of scarring or fibrosis in your tissues. It usually happens when the tissues try to repair themselves after injury or after wasting away from disuse. Sometimes, it is present at birth.
Cause | How it leads to contracture |
Wounding | Injuries that cause significant tissue loss — burns, infected wounds, or surgery — can cause a contraction scar on your skin or in soft tissues |
Ischemia (poor blood flow) | Not enough blood flow causes chronic inflammation, followed by scarring; it can happen suddenly or gradually; lack of movement is one cause |
Immobilization | Lack of movement is the leading cause of soft tissue contractures; body parts may be immobilized by injury, physical disability, or a neurological condition |
Neuromuscular disorders | Conditions like stroke and cerebral palsy affect communication between brain and muscles, immobilizing them or over-contracting them (hypertonia) |
Inherited connective tissue diseases | Conditions affecting how connective tissues develop, such as congenital myopathy, can cause overly contracted or overly lax muscles (hypotonia) |
Birth defects | Some babies are born with contractures that do not seem to relate to any disease or obvious cause; they may result from genetic mutations or a lack of movement in the uterus |
What Complications Can Contractures Cause?
A permanent contracture can severely inhibit your quality of life. It can affect your mobility and independence, and you may find it harder to carry out the functions of your daily life without assistance.
Contractures can also contribute to chronic pain, and they can snowball — affecting other muscles and joints connected to them. The less you are able to move, the more your tissues may start to contract.
How Is a Contracture Diagnosed?
If you have a preexisting injury or condition that can lead to contracture, your healthcare provider will be on the lookout for it. They can diagnose it with a physical exam that checks your range of motion.
Your provider might want to take images of your connective and soft tissues to learn more about what might be contributing to your contracture. They might take X-rays, an ultrasound, or an MRI.
Diagnostic step | What it involves |
Physical exam | Checking your range of motion to detect stiffness, shortening, and fixed positions |
X-rays | Imaging of the affected tissues and joints |
Ultrasound | Imaging of connective and soft tissues |
MRI | Detailed imaging of soft tissues to see what contributes to the contracture |
What Is the Best Treatment for a Contracture?
The best treatment for contracture is prevention, and in many cases, it is preventable. If you are currently immobilized or have a condition that leads to contracture, physical therapy can often help prevent it.
If you do develop a contracture, it is best to treat it earlier on. Recent contractures tend to be milder and easier to reverse, while more advanced contractures may not respond to nonsurgical treatments.
Treatments to fix a contracture include conservative, orthopedic therapies and surgeries. It is also important to treat any underlying conditions that may be causing or contributing to your contracture.
Nonsurgical treatments
Treatment | How it helps |
Static and dynamic stretching | Braces, casts, and splints hold contracted tissues in a position that provides gradual, continuous stretching |
Heat therapy | Therapeutic heat helps soft tissues relax and stretch — especially with chronic hypertonia or spasticity — and promotes circulation |
Physical therapy | Passive and active exercises improve flexibility and range of motion, and help prevent muscle atrophy from lack of movement |
Myofascial release therapy | Hands-on massage targeting the fascia, the connective tissue underlying your muscles; can help prevent and treat contractures |
Injections | Intra-articular (in the joint) and soft tissue injections can release contractures; Botox can help tissues relax, and collagenase injections can break up fibrosis |
Anti-inflammatory treatments | Anti-inflammatory drugs and low-level laser therapy (infrared light) reduce inflammation and help prevent fibrosis after immobilization |
Surgical treatments
Surgery is typically considered for contractures that are more advanced or fixed.
Surgery | What it involves |
Tenotomy (tendon lengthening) | Small cuts or holes in the tendon release tension; as the tendon repairs itself, it can grow back longer |
Tendon transfer | The contracted tendon is removed and replaced with another tendon from a donor or elsewhere in your body |
Arthroplasty | For joint capsule contractures, surgery releases or replaces parts of the joint capsule, or in some cases the whole joint |
Fasciotomy | For contractures affecting the fascia, such as Dupuytren's contracture, surgeons cut holes in the fascia to release it or remove pieces of scar tissue |
Z-plasty | Zig-zag cuts in the tissue release tension; the Z pattern encourages the tissue to repair itself without shrinking |
Plastic surgery | For scar contractures, a surgeon may remove scarred tissue and replace it with a skin graft or skin flap from a donor or elsewhere on your body |
What Is the Prognosis for Contracture?
Contractures respond best to treatment when they are not yet too advanced and fixed. Healthcare providers caring for people at risk of contractures can take steps to prevent or minimize them.
Recent contractures often respond to conservative treatments. More advanced contractures may benefit from surgery. Some contractures may not be treatable or may not fully resolve with surgery.
"For people with certain chronic and congenital conditions, some contracture is inevitable. But early interventions can make a big difference in how much they affect you and how disabling they become." — the reviewed medical source on contracture
How Can You Prevent a Contracture?
The most common cause of contracture is immobilization. If you are hospitalized for a severe injury, surgery, or disease, or you have to wear a cast for several weeks, you are at risk of contracture.
Healthcare providers go to great lengths to prevent contractures while you are in their care. But they need your help. It is very important to follow through with your physical therapy during your recovery.
Exercising in a state of disease, disability, or injury can be uncomfortable and difficult. In some cases, you might need help to complete your exercises, or you might need someone to remind and motivate you.
If you or someone you care for has a chronic condition that can cause contractures, you or they might need ongoing physical therapy to prevent them. Quality lifetime care is important in these cases.
Prevention step | Why it helps |
Follow through with physical therapy during recovery | Keeps tissues moving while they heal, before stiffness sets in |
Ask about movement plans during hospitalization or casting | Immobilization is the leading cause; early movement reduces risk |
Get help and reminders for exercises when needed | Motivation and assistance make consistent movement realistic |
Commit to ongoing physical therapy for chronic conditions | Quality lifetime care can prevent or minimize long-term contractures |
Treat underlying conditions | Addressing the cause (neurological, vascular, congenital) helps prevent recurrence |
The Bottom Line
A contracture is stiffening, tightening, and shortening of soft tissue caused by scarring — and the most common trigger is simply not moving. Burns, wounds, poor blood flow, neuromuscular disorders, and some birth conditions can also cause it. Once a contracture becomes fixed, it can permanently limit range of motion, cause chronic pain, and reduce independence. The good news is that contracture is preventable in many cases, and recent contractures respond well to stretching, splinting, heat, and physical therapy. If you or someone you care for faces a period of immobilization — after injury, surgery, or during illness — the single most important step is to start and follow through with a movement and physical therapy plan early, while stiffness is still reversible.
Take action today: if you are recovering from an injury, surgery, or illness that limits your movement, ask your healthcare team about a physical therapy plan now. If you are noticing new stiffness, tightness, or a developing bend in a limb, schedule an evaluation — early treatment makes all the difference.
Frequently Asked Questions
What is a contracture?
A contracture is a structural change in your soft and connective tissues — skin, muscles, joints, tendons, ligaments — that causes them to stiffen, tighten and contract, losing their elasticity and range of motion.
Is a contracture a type of scar?
Yes. It is a form of scarring. In skin it appears as shrunken, constricted scar tissue; in muscles and ligaments the scarring process is called fibrosis, which replaces healthy tissue with denser, tougher, more rigid tissue.
What is the leading cause of contracture?
Immobilization — lack of movement. Body parts may be immobilized by injury, physical disability, or a neurological condition, and that disuse is the leading cause of soft tissue contractures.
Can burns cause contractures?
Yes. Injuries that cause significant tissue loss, such as burns, infected wounds, or surgery, can cause a contraction scar on your skin or in your soft tissues.
Can poor blood flow cause contracture?
Yes. Ischemia — not enough blood flow to your tissues — causes chronic inflammation followed by scarring. It can happen suddenly or gradually, and lack of movement is one of its causes.
Can stroke or cerebral palsy cause contractures?
Yes. Neuromuscular disorders affect communication between your brain and muscles. This can immobilize the muscles or cause them to over-contract (hypertonia).
Can contractures be present at birth?
Yes. Some babies are born with contractures that do not seem to relate to any disease or obvious cause — possibly from genetic mutations or a lack of movement in the uterus. Birth defects such as amyoplasia, arthrogryposis, and clubfoot involve congenital contractures.
What is the difference between a joint contracture and an arthrogenic contracture?
A joint contracture (capsular contracture) affects the connective tissues enclosing the bones in a joint. An arthrogenic contracture is a capsular contracture that originates from the joint itself — and can easily spread to connected muscles, just as a muscle contracture can affect the joint.
What does Dupuytren's contracture do?
Dupuytren's contracture is a genetic disorder that contracts the soft tissues in your hands, making your finger or fingers gradually turn inward toward your palm. Fasciotomy surgery may benefit it.
What is Volkmann contracture?
It is a hand contracture that causes an inward flexion of your fingers and wrist, making your hand look like a claw.
What is a flexion contracture?
A type of joint contracture in which the joint is contracted in a bent position and can no longer be straightened. It most often affects the limbs.
What are the symptoms of a contracture?
Symptoms include visibly thickened, tightened scar tissue; stiffness in muscles, joints, or soft tissues; musculoskeletal pain; reduced range of motion and mobility; muscle atrophy (loss of muscle mass); gait disorders (abnormal walking); and flexion deformities (a permanent bend), especially in the limbs.
What complications can a contracture cause?
A permanent contracture can severely inhibit your quality of life, affect mobility and independence, contribute to chronic pain, and snowball into other muscles and joints — the less you can move, the more your tissues may contract.
How is a contracture diagnosed?
With a physical exam that checks your range of motion, and sometimes imaging — X-rays, ultrasound, or MRI — of your connective and soft tissues to learn what may be contributing.
What is the best treatment for contracture?
Prevention is the best treatment, and in many cases contracture is preventable through physical therapy. For existing contractures, treating them early gives the best results.
Can stretching and splints fix a contracture?
Static and dynamic stretching with braces, casts, and splints can hold contracted tissues in a position that provides gradual, continuous stretching — a core conservative treatment.
Does heat therapy help contractures?
Therapeutic heat applied to soft tissues can help them relax and stretch, especially if you have chronic hypertonia or spasticity, and it also helps promote circulation.
What role does physical therapy play?
Passive and active exercises improve flexibility and range of motion in contracted muscles and joints, and help prevent muscle atrophy from lack of movement.
What are myofascial release therapy and collagenase injections?
Myofascial release is a hands-on massage technique focused on the fascia, the connective tissue underlying your muscles, which can help prevent and treat contractures. Collagenase injections can help break up fibrosis, while Botox can help tissues relax.
When is surgery needed for a contracture?
More advanced contractures may not respond to nonsurgical treatments. Surgical options include tenotomy (tendon lengthening), tendon transfer, arthroplasty, fasciotomy, Z-plasty, and plastic surgery with skin grafts or flaps — depending on the tissues involved.
What is tenotomy?
Also called tendon lengthening, tenotomy makes small cuts or holes in your tendon to release tension. As the tendon repairs itself, it can grow back longer.
Can a contracture be cured completely?
It depends. Recent contractures often respond to conservative treatments, and advanced contractures may benefit from surgery. But some contractures may not be treatable or may not fully resolve with surgery.
How can I prevent a contracture after surgery or injury?
Follow through with your physical therapy during recovery. If you are hospitalized or wearing a cast for several weeks, you are at risk — movement plans started early make a big difference.
Do I need ongoing therapy for a chronic condition?
If you or someone you care for has a chronic condition that can cause contractures, ongoing physical therapy may be needed to prevent them. Quality lifetime care is important in these cases.
How can I help someone who finds exercise uncomfortable or difficult?
In some cases they might need help completing their exercises, or someone to remind and motivate them. Support makes consistent movement — the key to prevention — much more achievable.
Related Reading
External References
For deeper reading, consult authoritative references including AAPM&R — Contractures, StatPearls — Scar Contractures, AAPM&R — Prevention and Management of Limb Contractures in Neuromuscular Diseases, and National Organization for Rare Disorders — Arthrogryposis.
Sources
Medical review source on contracture — overview, symptoms, causes, diagnosis, treatment, prognosis, and prevention page (medically reviewed; last updated December 29, 2024). Cleveland Clinic — Contracture
Medical disclaimer: This article is for general informational purposes only and does not constitute medical advice. It is not a substitute for professional medical diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking care because of information read here. If you think you may have a medical emergency, call your doctor or emergency services immediately.
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