Bell’s Palsy Facial Exercises

Bell’s palsy affects an estimated 30,000 – 40,000 Americans every year, and it is most common in people between the ages of 20 to 40 years, with higher incidences in individuals with diabetes mellitus and pregnant women. This condition is known as a diagnosis of exclusion, meaning that it has no proven, single cause and is diagnosed after medical professionals exclude more serious conditions such as a stroke or brain tumor.

Many cases of Bell’s palsy are thought to occur when the seventh cranial nerve becomes irritated, swollen, or compressed. Various viruses and infections, including the herpes simplex virus, chicken pox, and Epstein-Barr (which causes mononucleosis) can affect the seventh cranial nerve. Facial muscle movements are controlled by this nerve, and when it is irritated, the affected individual may experience facial weakness or paralysis. In most cases, Bell’s palsy affects only one side of the face. Symptoms develop rapidly and often without an apparent cause. Common symptoms include: 

• Inability to close one or both eyes all the way
• Problems chewing and swallowing food
• Drooling
• Reduced ability to make tears
• Difficulty speaking
• Pain around the ears
• Ringing in the ears
• Decreased sensation of taste

These symptoms can be worrying, and those affected should seek medical care right away to rule out stroke or other serious conditions. Once a doctor has diagnosed a patient, they may prescribe medications to help decrease swelling in the seventh cranial nerve. Some evidence suggests that customized Bell’s palsy therapy like facial muscle exercises can help patients improve their facial function, as well. For patients who cannot fully close their eyes, consultation with an eye doctor is critical. Serious complications can develop if the eye is not adequately moistened and cleaned by the eyelid. An eye doctor can help patients find methods to keep the eye closed and lubricated.  

Bell’s palsy cases vary, but individuals dealing with this condition also may experience any or all  of the following symptoms:

• Synkinesis ( unwanted muscle contractions during attempted motion)
• Cross-wiring of the facial muscles
• Hypertonic (tight) facial muscles
• Facial muscle spasms

For some patients, the facial muscles start to make unwanted movements, and these movements must be re-coordinated through training. During Bell’s Palsy therapy, facial muscles that are “holding other muscles captive” have to be retrained to allow the primary muscles to move properly.

The basic idea behind facial muscle exercises for Bell’s palsy is to slowly recreate the brain-to-nerve-to-muscle routine. At first, the goal is to regain the capability of doing correct facial muscle movements voluntarily, and Bell’s palsy physical therapy focuses on specific facial muscle movements. Over time, these facial movements may result in natural facial movements and expressions.

At the Facial Paralysis Institute, we stress the importance of being evaluated by an expert neuromuscular therapist. Each Bell’s palsy and facial paralysis patient is unique and has a different functional profile. Therefore, there is no single Bell’s palsy physical therapy protocol that works for everyone. Upon evaluation with our expert facial paralysis physical therapists, you will learn the exact exercises that will benefit you the most.

Facial Exercises for Bell’s Palsy: What You Need to Know

Before prescribing a patient with a set of Bell’s palsy exercises for their treatment plan, one of our physical therapists will evaluate the patient. This will include a review of their medical history, when the symptoms began, what seems to make them improve or become worse, and a physical assessment. 

During the initial assessment, the therapist will evaluate the following facial movements: 

• Jaw and mouth movements
• Movement of the eyebrow
• Ability to pucker lips
• Ability to raise or lower the lips
• Lip closure
• Eye movements
• Smiling while engaging the cheeks
• Ability to suck the inner cheek between the teeth
• Frowning
• Facial expressions
• Forehead wrinkling

After the assessment, each therapist will provide a customized Bell’s palsy physical therapy plan to help patients recover some of their lost functionality. Depending on what the patient’s particular case looks like, the physical therapist may begin with facial muscle exercises that trigger facial movement. They will demonstrate to the patient how to manipulate their facial muscles to make it easier to move them, ensuring that they can perform facial exercises to address areas of the face affected by paralysis.

For example, if the affected individuals are struggling with overly tight muscles or facial spasms, the physical therapist will create a custom plan of facial muscle exercises to relax the muscles responsible and increase muscle strength and coordination in the face elsewhere.

These Bell’s palsy exercises will focus on giving the face plenty of activity, making sure the muscles repeatedly practice the movements necessary in order to restore function. When the patient’s physical therapist feels the facial muscles have improved general activity, he or she will work with the patient to increase muscle strength and refine movements of the face, such as those used in speaking, smiling, closing the eyes, and swallowing.

It is important that patients follow their physical therapist’s recommendations for performing exercises or techniques at home. By repeating exercises several times a day for prescribed periods of time, the muscles have the best chance to relearn natural facial movements.

Benefits of Exercises for Bell’s Palsy

Bell’s palsy exercises often play a vital role in the long-term success of a facial paralysis treatment. While the area is under-researched, some studies show that facial exercises can help improve functionality of the face after a facial paralysis event. With the help of a professional physical therapist, patients can learn ways to exercise the facial muscles with the goal of restoring some of the lost function.

Facial Exercises For Bell’s Palsy Recovery

Facial exercises for Bell’s palsy promote brain-to-nerve muscle communication in the face. They are usually simple to complete, and over time, help Bell’s palsy increase strength and improve coordination of facial muscles.

There is no shortage of facial exercises for Bell’s palsy recovery, and these exercises may involve the muscles in the nose, lips and cheeks. Prior to starting a Bell’s palsy recovery exercise routine, patients should consult with an expert physical therapist.

At The Facial Paralysis Institute, our team understands that no two Bell’s palsy patients are exactly alike. We also recognize that the facial exercises required to help one patient may vary from those required for another patient. Thus, we tailor each Bell’s palsy recovery facial exercise regimen for his patient. This ensures that patients can use specific facial exercises to quickly and safely achieve the best possible results.

While it is tempting to provide Bell’s palsy exercises on a website, it is important to understand that exercises done incorrectly or exercises that are not appropriate for your condition can create more problems. Our physical therapists will put together a customized plan based on the impact Bell’s palsy is having on your face.

Are Facial Exercises for Bell’s Palsy Recovery Effective?

Ultimately, facial exercises can help ensure a safe, effective recovery from Bell’s palsy. By working closely with a physical therapist, affected individuals can learn the right exercises to streamline recovery and strengthen muscles in the face. 

The overall effectiveness of facial exercises for Bell’s palsy recovery depends on the patient. If a Bell’s palsy patient follows a physical therapist’s instructions, he or she is better equipped than ever before to optimize the results of facial exercises. Conversely, if a Bell’s palsy patient does not follow a physical therapist’s facial exercise instructions, he or she is less likely to improve facial muscle strength and coordination.

If the paralysis does not resolve within eight months, the team at the Facial Paralysis Institute may determine that additional treatment is needed. Botox and facial muscle reanimation surgery are two options patients can discuss with the team, and it’s likely that the physical therapists will ask patients to perform facial muscle exercises alongside these treatments to help aid in recovery.

Bell’s Palsy Massage

Bell’s palsy massage is sometimes recommended as part of a facial paralysis treatment program. Initially, a massage or physical therapist teaches a patient how to massage for Bell’s palsy. The therapist performs massage therapy for Bell’s palsy and responds to a patient’s concerns and questions. Then, when a patient is comfortable with facial massage, this individual can perform massage techniques outside of a therapist’s office.

Typical Bell’s palsy massage techniques focus on several areas of the face, including:

• Lower Facial Muscles: Mouth exercises often require a patient to grasp the center of the lips with the thumb and index finger, then push the lips toward the face and move the lips into a smile position. This helps a patient strengthen the lower facial muscles and regain the ability to naturally smile, frown, and make other facial expressions.
• Forehead: Massaging the upper portion of the face sometimes helps a Bell’s palsy patient reduce muscle weakness in the forehead.
• Cheeks: Using the fingertips to perform a circular motion around the cheeks may help a Bell’s palsy patient increase muscle movement in the cheeks.

A therapist may request that a patient apply moist heat to the face after performing massage therapy for Bell’s palsy. This helps minimize pain associated with inflammation and maximize the effectiveness of Bell’s palsy massage.

For patients who are exploring massage therapy, it is critical to meet with the Facial Paralysis Institute team. Patients can then learn about different treatments, as well as evaluate Bell’s palsy massage and other therapy options.

If massage therapy for Bell’s palsy is recommended, a patient will receive a custom therapy plan. The patient is given comprehensive massage therapy instructions and can perform various massage techniques in conjunction with a therapist. Once a therapist believes the patient can safely perform massage techniques, the patient is then asked to complete the techniques without assistance.

Each patient is responsible for following a massage therapy regimen and can reach out to a therapist at any time for extra support. As the individual completes massage therapy, the patient’s progress is monitored. If a Bell’s palsy patient discovers massage therapy delivers the desired results, the program remains intact. Or, if massage therapy does not help a patient reduce facial paralysis symptoms, additional therapy options can be explored.

Schedule a Bell’s Palsy Treatment Consultation with the Facial Paralysis Institute

For more information about our customized approach to Bell’s palsy and facial paralysis physical therapy, please contact us today at (310) 923-7793 to schedule a consultation with Beverly Hills Bell’s palsy expert Dr. Azizzadeh.