Clinically reviewed by What is stroke rehabilitation
A stroke happens when the blood supply to part of the brain is blocked by a clot, or when a vessel in the brain bleeds. Brain cells in that area stop working within minutes, and the parts of the body they controlled lose power, feeling or coordination.
In Urdu it is falij, and people also call it dimagh ka doura. The weakness usually appears on the opposite side of the body to the damaged side of the brain.
Rehabilitation is not about repairing the damaged area. It is about training the rest of the brain to take over that work, which it genuinely can do.
Symptoms you might have
- Sudden weakness of the face, arm or leg on one side: the sign that matters most
- Sudden difficulty speaking, or understanding what is said
- Sudden loss of vision, double vision, or severe unsteadiness
- Afterwards: a weak arm and leg, loss of feeling, and poor balance
- Stiffness developing over weeks, pulling the elbow, wrist, fingers and ankle into fixed positions
- Shoulder pain on the weak side
- Coughing on food or water, and difficulty swallowing
- Low mood and tiredness, which are very common and worth telling the doctor about
Why it happens
- High blood pressure, the single biggest cause, and often undiagnosed until the stroke
- Diabetes, particularly when it has been poorly controlled for years
- Smoking, and the use of chewing tobacco
- High cholesterol and an irregular heartbeat
- A previous stroke, or a brief warning stroke where symptoms came and went within a day
- Being overweight and inactive
- Stopping blood pressure or blood thinning medicine once you feel well, which is a common and avoidable reason for a second stroke
When you should see a physiotherapist
A stroke is an emergency. Go to the hospital immediately, even if the symptoms are mild or already seem to be improving. Clot treatment only works within the first few hours, and time lost cannot be recovered later.
Rehabilitation should start as soon as the doctors say the person is stable, often within the first few days, beginning with positioning, movement and sitting up. Early rehabilitation gives better results than waiting until everyone is home and settled.
Go back to the hospital for any new weakness, new speech difficulty, a severe headache, vomiting or drowsiness. A second stroke is a real risk in the first weeks.
Dr. Zahra sees stroke patients at home while travelling is difficult, then at the clinic once walking is safe enough.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Stroke rehabilitation is repetition. The brain builds new pathways by practising the movement you want back, many times, correctly. Everything else exists to make that practice possible.
- Positioning and turning from the first days, which prevents pressure sores, chest infection and stiffness
- Daily movement of every joint on the weak side, the most important thing for preventing contractures
- Spasticity management: sustained stretch, positioning, splinting of the hand and ankle, and strengthening the muscles that oppose the tight ones. Medicines and injections for severe tone are a doctor's decision
- Shoulder protection. A weak shoulder can slip partly out of its socket because the muscles cannot hold it. That means support when sitting, never lifting the person by that arm, and work for the shoulder blade muscles
- Sitting balance, then standing, then stepping, in that order, with gait retraining and an ankle splint where the foot drops
- Task-specific hand practice, repeating real tasks rather than general exercises
- Electrotherapy to weak muscles and TENS for shoulder or limb pain, where the assessment supports it
- Family training in transfers, positioning, and how to assist without doing everything for the person
The medicines that prevent a second stroke matter as much as the rehabilitation does, and they are the doctor's side of the work.
Exercises, and what to avoid
What helps
- Sitting balance practice without back support, then reaching outside your base
- Standing up from a chair repeatedly, the most useful single exercise for getting walking back
- Using the weak hand in real tasks, even badly, instead of doing everything with the good hand
- Short practice sessions several times a day rather than one long one
What to avoid
- Pulling on the weak arm during transfers, which is how shoulders get damaged
- Overhead pulleys, and forced overhead stretching of the weak arm
- Letting the weak hand stay clenched. A hand splint and daily opening prevent a fixed fist
- Doing everything for the person. It is kind, and it slows recovery more than almost anything else
What you can do at home
Change position every two hours in the early weeks, and check the tailbone, hips and heels each time.
Support the weak arm on a pillow or a table when sitting, and never pull on it.
Set the room up so the person has to look and reach towards the weak side.
Practise in short bursts several times a day. Twenty minutes four times beats eighty minutes once.
Keep the blood pressure, sugar and cholesterol medicines going exactly as prescribed, even once the person feels better. This is how a second stroke is prevented.
If the person coughs on food or water, tell the doctor before continuing.
How long it takes
Most recovery happens in the first three months. It continues more slowly to six months, and real gains are still possible up to twelve or eighteen months.
After that, neurological recovery usually plateaus. People hear that word as nothing more can be done, and that is wrong. What stops changing is the nerve recovery. Strength, balance, walking distance and independence keep improving with training, and go backwards if training stops.
Walking returns for most people who could walk before the stroke, usually within three to six months, often with a stick or an ankle splint. Useful hand function is less predictable.
Starting early, practising daily and preventing contractures are what move the outcome.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
فالج میں دماغ کے ایک حصے کو خون نہیں پہنچتا، اور جسم کی دوسری طرف کمزور ہو جاتی ہے۔
بحالی کا اصل اصول بار بار مشق ہے۔ دماغ نئی راہ بناتا ہے جب آپ وہی حرکت صحیح طریقے سے بار بار دہراتے ہیں۔
شروع کے تین مہینے سب سے اہم ہیں، لیکن ایک سال تک بہتری ہوتی رہتی ہے۔ جب نس کی بہتری رک جائے تب بھی طاقت، توازن اور چلنے کی صلاحیت ورزش سے بڑھتی رہتی ہے۔
کمزور بازو سے مریض کو کبھی نہ کھینچیں، کندھا متاثر ہوتا ہے۔ ہاتھ کو مشت بند ہونے نہ دیں۔ ہر دو گھنٹے کروٹ بدلیں۔
بلڈ دباؤ اور شوگر کی دوا برابر جاری رکھیں۔ دوبارہ فالج سے بچنے کا سب سے بڑا طریقہ یہی ہے۔
Roman Urdu
Falij mein dimagh ke ek hissay ko khoon nahi pohnchta, aur jism ki doosri taraf kamzor ho jati hai.
Rehabilitation ka asal usool bar bar mashq hai. Dimagh nai raah banata hai jab aap wohi harkat sahi tareeqe se bar bar dohrate hain.
Shuru ke teen mahine sab se ahem hain, lekin ek saal tak behtari hoti rehti hai. Jab nas ki behtari ruk jaye tab bhi taqat, balance aur chalne ki salahiyat warzish se barhti rehti hai.
Kamzor bazu se marize ko kabhi na khenchen, kandha mutasir hota hai. Haath ko musht band hone na den. Har do ghante karwat badlen.
Blood pressure aur sugar ki dawa barabar jari rakhen. Dobara falij se bachne ka sab se bara tareeqa yehi hai.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
How long does recovery after a stroke take?
When should physiotherapy start after a stroke?
Can a paralysed arm recover after a stroke?
Do you do home visits for stroke patients?
Why does the weak shoulder hurt so much?
Further reading from the NHS
Stroke rehabilitation can include physiotherapy for movement as part of a wider recovery plan. NHS: recovery after stroke
Related conditions
- Carpal tunnel syndrome treatment
- Bell's palsy treatment and exercises
- Sciatica treatment and exercises
- Diabetic neuropathy treatment
- Numbness and tingling in the hands and feet