Why is muscle relaxation important?
Throughout your recovery from facial palsy muscle relaxation will be an important feature of your rehabilitation. It is the foundation upon which all other aspects of your recovery depend. Relaxation forms the building blocks for healthy facial muscles. Nerve recovery happens spontaneously. There is very little you can do to influence the degree or speed of nerve recovery. This means that the core of rehabilitation is ensuring that the facial muscles are as healthy as possible so that they can respond appropriately when the nerve does start to function.
The aims of relaxation are:
- To prevent dominance of the uninjured side of the face.
- To teach the recovering nerve how to rest when the face is not moving, as the nerve loses its capacity to moderate its electrical output.
- To maintain muscle health and prevent the facial muscles from becoming short, tight and immobile.
- To minimise pain secondary to tightness of the muscles.
- To minimise the development of synkinesis (involuntary/unwanted facial movements).
Prevent dominance of the uninjured side
Having a facial palsy on one side of your face will have an impact on how the uninjured side of your face behaves. When the muscles on the injured side are weak and floppy, the uninjured side reacts by trying to compensate. This results in the dominance of the uninjured side. Movements become exaggerated pulling the weak muscles over to the uninjured side which emphasises the facial asymmetry.
Teach the injured nerve to rest
As the injured nerve begins to recover it does not have the capacity to moderate the amount of electrical energy it powers into the facial muscles. The result is that even though you may not be moving your face the nerve still powers it with more electrical activity than it requires. The nerve no longer knows how to rest and excess energy starts to power tiny microscopic muscle fibres which begin to contract when they should be relaxed. This leads to the facial muscles becoming thicker, shorter and tighter and therefore less mobile and elastic. If it is possible to minimise this happening then the facial muscles will keep their length and elasticity and therefore their mobility.
Minimise pain secondary to muscle tightness
Facial pain due to muscle tightness is a common symptom of facial palsy especially for those who experience a slower recovery. Learning how to relax your face when it is at rest will help minimise the development of muscle tightness and with regular practice throughout the day, the nerve will begin to learn how to moderate its electrical output.
Minimise the development of synkinesis.
People who experience a slower recovery are almost inevitably going to develop synkinesis to a greater or lesser extent. The synkinesis may be so minimal that only the person with facial palsy is aware of it happening. In contrast, it may be severe and obvious to the observer.
Learning how to relax your face will help minimise the development of synkinesis firstly, when the face is at rest. Secondly, by relaxation of synkinetic movement when practicing facial expressions. The aim is to inhibit the synkinetic muscle activity by relaxing that muscle and developing the correct movement in the correct muscle. For example, if the target movement is to smile and the eye closes as well, the aim will be to keep the eye relaxed and focus on just moving the smile muscles.
LESS IS MORE. This means too much practice, making too much effort, and not relaxing your face between repetitions of movement will create more problems than it cures.
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