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"The Plateau Myth" in Stroke Recovery

Updated: Jun 25, 2022

"Recovery is not a straight line. There are ups and downs and a plateau may occur, but that doesn’t mean recovery stops!"

"You've reached a plateau," or "This is the most progress you'll make" are phrases too many stroke survivors have heard. These statements can be extremely discouraging and misleading if you don't truly understand the trajectory of stroke recovery.

If you think about it, immediately after your stroke is when you are at your worst. You may have been disoriented, paralyzed, or unable to eat or speak. You typically make the most rapid progress within the first few weeks or months. This is also where spontaneous recovery takes shape ("spontaneous" meaning without you even trying!). After that, progress naturally begins to slow down. The changes in our brain are not as drastic as they were initially.

It's during this "slowing down" phase that people often become hopeless and convinced that they're stuck where they are forever. Doctors may tell them that "this is as good as it's going to get." While plateaus do happen, being stuck for good is far from the truth. Unfortunately, things may really not get better if you adopt that mindset.

The brain can and will continue to change and improve if you work at it. It’s just not as easy as it was early on. Stroke survivors keep improving even years after their stroke. You have to set a goal, break it down into steps, and work on it daily. You may not see progress right away, but if you stay consistent and maintain your hope and motivation, you’ll start to see change again!

*Infographic above from Constant Therapy

There are ways to get unstuck and create new neural connections!

6 ways to get unstuck:

  1. Set new goals: if you've been working on the same thing for awhile, switch it up a little...and get specific while you're at it!

  2. Join a social network or support group: Support groups can help in so many ways: friendship, inspiration, and exercises. It helps to know you’re not alone in stroke recovery.

  3. Sign up for a research study: GSU has an Aphasia & Motor Speech Disorders lab that is regularly conducting research studies (see current studies below!). You can get the latest treatments by being part of a study. *It may not always work, or you may be part of a control/placebo group, but it feels good to help others and you may just luck out with a great new treatment!

  4. Try a new therapist: Starting therapy with a new clinician can bring fresh eyes and a new bag of tricks to help you reach your goals.

  5. Try a new activity: Using your mental and physical abilities in fun new ways can reap benefits in other areas of your life. Maybe you'd like to pick up jewelry making- practicing your fine motor skills in this way may also help with a functional goal like buttoning your shirt independently!

  6. Don't get discouraged: "Hope is the most powerful drug there is, so do everything you can to hold onto it." Everyone recovers at different rates. Try not to compare yourself with others or with how things use to be.

Healing your brain and literally rewiring it, is hard work. It doesn't always happen quickly, but you can always make progress!


Atlanta Speech & Wellness is the only speech therapy private practice in Atlanta that specializes solely in adult neurological rehabilitation. Our expertise is in brain injury, including stroke, TBI, concussions, and neurodegenerative disorders such as Parkinson’s disease and dementia. We are dedicated to providing individualized evidence-based therapy to help you improve cognitive or communication changes while empowering you to reach your full potential. If you're ready to work hard and return to doing what you love, give us a call!

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AphasiaExerciseStudy (1)
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