A Physiotherapist’s Complete System for Rebuilding Reaching After Stroke
Hey Fam!
Welcome back, and thank you for being a Paid member!
This week’s full guide dives deeply into how reaching works, what typically breaks down after a stroke, and the safest, most effective ways to retrain your shoulder, elbow, wrist and fingers — all in a realistic, home-based system.
This is the same progression I use clinically with my patients.
Before we begin, do check out this video for more details in an audio and visual format:
🔍 1. Why Reaching Feels Awkward After a Stroke
Reaching is more complex than it looks.
It requires coordination between large muscles (shoulder + elbow) and fine muscles (wrist + fingers).
When any link in this chain weakens, the whole movement becomes inefficient.
Here’s how each phase normally works:
A. Transport Phase — shoulder + elbow movement
This phase moves the hand toward the target.
After stroke, typical challenges include:
Arm feels heavy
Shoulder retracts instead of protracts
Trunk leans excessively
Elbow doesn’t extend smoothly
The root cause is usually weakness in shoulder flexors, protractors, and elbow extensors.
B. Pre-Shaping Phase — wrist + finger preparation
Your hand naturally begins to open or shape itself based on the object.
Post-stroke challenges:
Hand stays closed due to flexor tightness
Wrist collapses downward
Fingers open too slowly
This is directly related to weak wrist extensors and finger extensors, which are essential for shaping the hand before grasping.
