Later Stage Management

Managing Patients at the Later Stage

Patients often present with a range of complex problems that need to be addressed:

Facial muscle weakness

Low self esteem

Synkinetic facial movements

Abnormal, uncoordinated movement patterns


Tightness and contracture of facial muscles and soft tissue

Hyperactivity of facial muscles on the affected and unaffected side

Managing patients at this stage can be challenging. Lack of mobility and reduced range of motion caused by antagonistic co-contraction of tight, synkinetic muscles can visually mimic weakness. This often causes patients to use excessive effort as they try to “force” movement, which, counterintuitively, further reduces dynamic motion. They often require a combination of treatment approaches and multidisciplinary therapy input. Having the opportunity to discuss these more complex cases with other therapists/doctors is very important. If at all possible they should be referred to specialist facial centres that are able to provide a range of interventions. Please see our contact us page for details on the location of specialist centres in the UK. If not, use your facial rehabilitation network as a discussion forum.

Video for patients to use when assessed to be at this stage: