Prioritising your rehabilitation

You may have just developed synkinesis or have been living with synkinesis for some time.  It is important to remember that synkinesis is an inevitable part of your recovery and there is very little that you can do to prevent it from happening.

Many people blame themselves for their synkinesis and feel they have done something wrong especially when they’ve tried hard to help themselves through their recovery.  This can be quite demotivating and add to a spiral of negative thinking which may prevent you from keeping up with your rehabilitation programme.

If you feel overwhelmed by your rehabilitation programme, then you should prioritize your exercises in the following order:

  • Muscle Releases
  • Retraining Movement exercises to inhibit the synkinetic activity

Muscle releases are top priority

This is your top priority and probably the easiest of all the exercises to learn.  Muscle releases are the backbone of everything else that you do.  You cannot expect to improve your range of movement when muscles are short and tight.  The goal is to improve muscle health so that muscles gain some of their elasticity and length.

You have access to a playlist of all the potential muscle releases that could be done which is very comprehensive.  It would be difficult for you to do all of them every single day.

These are helpful ways to choose the releases to prioritise

  • Think about which areas of your face bother you the most and why?
  • Which muscles feel the tightest?
  • Which area feels most painful as a result of muscles being short and tight?
  • Which movements are the hardest for you to do?
  • Which movements or expressions would you like to improve the most?

Guidance for specific symptoms 

  • Headaches – muscle releases for the back of the scalp and the forehead.  You can also include frown release 1 and 2.
  • Tenderness around the nose and over the sinuses and also if you feel you have a blocked nose – nose releases 1 and 2.
  • Tenderness and/or tightness around the ear – ear releases 1 – 4.  These may also help with sound sensitivity when normal sounds become unbearably loud.
  • A smaller affected eye which is tight and synkinetic – eyelid release and eye muscle release 1 and 2.  Frown releases 1 and 2.
  • Tenderness and tightness in the cheek and very little movement when smiling – cheek releases 1 – 4.
  • Neck cramping especially when swallowing/neck tightness/synkinesis (this is when you can see the thin bands popping up in your neck when you smile, whistle or pout) –  all the muscle releases for the neck.  There are several of them so experiment with each one to identify which feels the most useful (i.e. gives the most relief from tenderness, tightness and cramping).  Try the collar bone release as well if the problems feel lower down.
  • Dimpling in the chin which may be present at rest and during facial movement (which wasn’t present before your facial palsy) – chin releases.

Only got 10 minutes?

If you only have ten minutes available to carry out muscle releases, then pick the most important area of your face or the most troubling symptom and work on that.  Don’t feel you have failed because you can’t do everything everyday even if that is the ultimate goal.

Retraining movements

This type of movement repatterning can be very demanding because the concentration and vigilance required is high.  They can be very tiring especially if you are doing them correctly and remembering to relax your face between each attempt.  When it comes to prioritization when or if you are short of time, then work on the movement that is most important to you or that you find the easiest to do because success will help motivate you to do more.

You may not be able to do all of the expressions everyday but stay focussed and chip away at those you wish to improve and mean the most to your well-being.  You will be successful if you can make your rehabilitation programme fit into your routine so that it becomes a habit just like brushing your teeth.

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Things you can do

Long standing synkinesis