Beyond the Droop: Understanding Facial Synkinesis and Bell's Palsy Recovery

If you are recovering from Bell's palsy, you know that the journey is about more than just waiting for movement to return. It is a slow, often frustrating process of reconnecting your brain to your face. However, as the nerves begin to regenerate at a rate of only about 1 millimeter per day, a new challenge can arise: Facial Synkinesis.

At Rehab and Revive, we specialize in helping patients navigate these neurological hurdles. Synkinesis is essentially the involuntary "discordination" of facial muscles. It happens when regenerating nerves accidentally "cross-wire" and trigger the wrong muscle. For example, you might try to smile, but your eye unintentionally closes, or you blink and your neck muscles tighten.

Why You Can’t "Force" Your Way to Recovery of Bell's Palsy

The most important thing to understand is that your face needs teamwork, not force. We recommend collaborating with an MD or ENT who specializes in facial paralysis to ensure a coordinated recovery.

When retraining the face, many people make the mistake of trying to move as hard as possible. This actually builds bad habits and compensations. If you use generic electrical stimulation pads, you might stimulate too many muscles at once, which can actually encourage synkinesis. Instead, we focus on isolated, intentional movement and imagery.

Mobilize First, Retrain Second

Before you can retrain a smile, you have to assess the flexibility of the tissue. After prolonged paralysis, muscles can become incredibly stiff, even on the "strong" side, which has been working overtime to compensate.

By going inside the mouth and gently stretching the cheek and lip tissues, we "clear the path" for movement. Once the tissue is lengthened, we use tools like vibration or localized feedback to give the brain a "target." The goal isn't to zap the muscle into moving; it is to provide sensory feedback so the brain can find the right "button" to push.

You can find the vibrating tool I use in the clinic on Amazon here!

The Mirror is Your Best Friend

Because you often can't "feel" these abnormal movements, I always tell my patients to videotape themselves eating or laughing. You might be surprised to see your nose scrunching or your neck tightening during a simple smile.

Using a mirror allows you to provide "biofeedback" to your brain. You can use your hand to hold an overactive muscle down (like an eye that wants to squint) while you practice isolated nose or mouth movements. This teaches your nerves the proper timing and coordination required for a natural, symmetric face.

Watch as I demonstrate how to assess your tissue and use localized feedback to retrain your smile in the video below:

https://www.youtube.com/watch?v=hNg_uJ62X8M

Which symptom is most frustrating for you right now?

• 0%Lack of movement
• 0%Involuntary movements or synkinesis
• 0%Facial stiffness
• 0%Numbness