How flexible is an unconscious body

March 30, 2021 2:46 AM

How flexible is an unconscious body under anaesthetic?

I watched a video on relaxation, and the person giving the lesson said that people under anaesthetic are very flexible.

She said you can put the legs of even an older person with stiff joints right over their head and that people are so flexible when anaesthetised that doctors and nurses have to be careful when moving them.

I'd like to hear from anyone with substantial direct experience of the truth or otherwise of this statement.

posted by Quillcards to Science & Nature (8 answers total)

I had ACL surgery, and in one of our post-op appointments my surgeon said that immediately after my surgery while I was still under anesthesia he could bend my knee to full flexion/range of motion. Even though once awake I could barely bend it and the first weeks of physical therapy were centered on lots of painful manipulation to try to get back to full range of motion. (Of course some of the reduced range of motion was post-op swelling and scar tissue.) It was weird because it felt like it wasn't physically possible to move the joint more than I was, like there was something physically in the way, yet he did seem to be saying that our muscles (?) tense up to protect the "injured" joint and reduce range of motion beyond any actual physical structure, fluid, or tissue that might be preventing movement.

I was under anesthesia so obviously I can't confirm truly first hand but I don't see why my ortho would lie about it.
posted by misskaz at 4:46 AM on March 30, 2021

My experience is similar to misskaz's. I had a terrible case of adhesive capsulitis (frozen shoulder) that had limited the range of motion of my arm to just a few inches for almost a year. My planned surgery involved freeing the adhesions surgically and then putting the arm through the full range of motion under anesthesia. The surgeon totally dismissed my question about whether that would result in pulled or torn muscles, saying that since I was under anesthesia I wouldn't be guarding against pain and the muscles would be able to stretch, despite having been basically immobilized for so long. My surgical report notes the degrees of range that he was able to put my arm through in the various planes, but it has taken a good five months of physical therapy to be get that same range while conscious.
posted by HotToddy at 6:07 AM on March 30, 2021 [1 favorite]

I am not an expert, but I believe that the term is flaccid paralysis, and since there are no inhibitory reflexes present, flexibility is maximized.
posted by OHenryPacey at 7:03 AM on March 30, 2021

There is a worst-case scenario for joint surgery rehab whereby if the regular physical therapy isn't working, and they ascertain that the problem is too much scar tissue locking things up, they give you a SECOND procedure where they put you under general anesthesia and then your doctor manually forces your joint to bend to the full range of motion. The theory is that your joint is actually okay to bend, but the scar tissue is gumming it up, and brute force is the only thing that would rip things free which would hurt.

Disclaimer: I am not a doctor, I am just a patient recovering from a broken knee who Googled that once after a particularly bleak physical therapy session and had screaming paranoia about it for two weeks after.
posted by EmpressCallipygos at 7:11 AM on March 30, 2021 [1 favorite]

Best answer: From my ample experience positioning patients for surgery this year: while everyone is more flexible under anesthesia, not everyone is extremely flexible. Some extremely stiff old folks become merely moderately stiff instead.
posted by ocherdraco at 7:35 AM on March 30, 2021 [5 favorites]

Response by poster: Thank you all. That's a good range of experiences - from the patient and the point of view of the person making the movements on a patient.

Case closed :-)
posted by Quillcards at 9:55 AM on March 30, 2021

I actually have supporting knowledge from my physical therapist (who I just saw today and asked about this). She said that part of the reason why this might happen is that when you're awake, you sort of subconsciously resist against making any movements if they hurt (i.e., if it hurts when you bend your knee all the way and your therapist is trying to do that, you are subconsciously tensing up against her to stop yourself). And when you're knocked out, you don't know it's happening, so you aren't fighting her.

....Not that I'm speaking from experience or anything.... (cough)
posted by EmpressCallipygos at 11:35 AM on March 30, 2021

She said that part of the reason why this might happen is that when you're awake, you sort of subconsciously resist against making any movements if they hurt
So I hurt my back recently, and it felt like the pain was coming from my back muscles being contracted and stuck there. A friend loaned me a book called Somatics, and it speaks to exactly this issue: at some point, after injury or because of repetitive stress or whatever, we might actually forget how to relax some of our muscles: "His gentle program for the mind and body proves once and for all that so many problems we accept as inevitable over time -- chronic stiffness, bad back, chronic pain, fatigue, and, at times, even high blood pressure -- need never occur if we maintain conscious control of nerve and muscle, replacing Sensory-Motor Amnesia with Sensory-Motor Awareness."

It sounds a bit woo, but it makes total sense, and aligns with this issue here. Sometimes our muscles are more flexible but we've forgotten how to relax them.
posted by bluedaisy at 12:08 PM on March 30, 2021 [1 favorite]