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Hand and Arm Thermoplastic Splinting 

Thermoplastic Wrist Hand Splint

Upper limb splinting following a stroke can offer several benefits, which are supported by research and clinical practice.

These benefits include:


    1.    Prevention of Contractures:

    •    Contractures are permanent shortenings of muscles or tendons that can limit joint mobility. Splinting helps maintain muscle length and joint alignment, thereby preventing or reducing the risk of contractures  .

    2.    Reduction of Spasticity:

    •    Spasticity is a common post-stroke condition where muscles are continuously contracted. Splinting can help manage spasticity by positioning the limb in a way that reduces muscle overactivity, which can lead to improved limb function and comfort  .

    3.    Improvement of Functional Use:

    •    By stabilizing and supporting the affected limb, splints can enhance the functional use of the upper extremity. This support can assist in performing daily activities, promoting greater independence and quality of life  .

    4.    Pain Reduction:

    •    Post-stroke shoulder pain is a frequent issue. Proper splinting can help alleviate pain by providing support and preventing improper positioning and movement, which might otherwise lead to discomfort and pain  .

    5.    Facilitation of Motor Recovery:

    •    Splinting can aid in motor recovery by maintaining appropriate limb alignment and positioning, which can help retrain neural pathways and support rehabilitation exercises aimed at improving motor function

The Shoulder

The shoulder joint capsule is a fluid-filled sac that surrounds the joint and helps it to stay lubricated and move around freely. It is formed by several ligaments that help to make the shoulder joint more stable. 

Anatomy of the Shoulder_edited.jpg

What is Hydrodilation

The hydrodilation is a mixture of saline, anti-inflammatories and local anaesthetic that is injected directly into the shoulder capsule. It works by stretching the shoulder capsule, creating more space for movement. The anti-inflammatories should reduce pain for a few weeks or months to give you a window where you can work with your therapist to improve the mobility and strengthen the muscles around it. 


Hydrodilation is a relatively low risk procedure, with a 70% success rate at improving range of motion, and a 90% success rate at improving pain. 


We have developed a pathway for our patients to be seen and treated in a timely manner by a trusted, skilled and experienced Radiologist Dr Demitrios Tzias at New Malden Diagnostic Centre. 

You could be seen within days or weeks, and the radiologist will assess your shoulder with guidance and background information from your therapist. They will likely perform an ultrasound to confirm the diagnosis of frozen shoulder, and if appropriate, the hydrodilation can be done there and then at the same appointment. 


You can start moving and stretching the shoulder straight away, and it is best to do these stretches every waking hour under the guidance of your therapist. You may expect to see your physiotherapist 2-3 times a week for the first month after injection for more hands-on manual therapy to continue stretching the joint as well as lots of stretching and strengthening exercises to continue working on it at home. It is important to push the shoulders into tolerable amounts of pain to gain the most benefit, and your therapist will help you to gain an understanding of your pain. 


For more information about the Hydrodilation Procedure 

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