Very often the patients after long-standing Bell’s palsy complain about the stiffness of the facial muscles on the affected side and about becoming tired so quickly. There are a few reasons for that.
1. Your brain is exaggerating every movement
Your brain uses too much power. It uses a “mimetic amplifier” – it overdoses each and every effort that is intended. You want to close the eye and instead of doing it gently and simply, the brain puts all hands on deck to just CLOSE THE EYE! If you want to smile, it will not just smile, but SMILE! All this extra effort for each and every facial movement makes you exhausted very fast.
2. Your muscles do not have a possibility to relax
Since the brain, instead of speaking to the muscles normally, is shouting to the muscles, it gives them no time to relax. Imagine this: if I keep my arm extended for any serious amount of time, I become tired. It is the same with your facial muscles – if the muscles do not have time to relax, to drop the tension, they become tired.
3. The emotional boomerang also makes you feel tired
When our facial muscles are contracted, it has a boomerang effect on our emotional condition. Not only the emotions we experience send signals to our facial muscles, but it is also the other way around. Whatever our face is producing, whichever is our facial expression – the same emotion we may feel.
The paradox with the Bell’s palsy patient is that one part of our face, the healthy side produces regular emotions. Respectively, it sends regular sensory feedback to the brain. While the affected part of our face produces a disrupted spectrum of contractions. So actually, it shows a disrupted emotional pattern on one half of the face and so, the contradicting sensory signals arrive at the brain. The brain becomes confused and uses a lot of power to process that information. That’s why we become very emotionally tired. Especially by the end of the day or after we have experienced strong emotions.
What you can do to reduce the stiffness of facial muscles?
A very general advice – try to avoid forcing your face into facial expressions. If your face cannot produce a certain movement, do not try to forcefully do it. Your muscles are healthy, you do not need to push them. The forced attitude only makes your brain exaggerate the signals it produces. However, if the facial nerve did not recover sufficiently, these signals cannot reach the muscles, no matter how hard you try.
Instead, take 10-15 minutes once or twice per day and focus on conscious facial relaxation. Take your time, eliminate any distractions and interruptions. Try to feel your muscles and feel where they are tight. Then, one by one, focus on relaxing your facial muscles (on both healthy and affected sides). You can touch your face with your hands, do a soft massage to help them relax.
When your face relaxed, your background tension signals become smaller. You can start feeling the difference after a couple of weeks of these daily relaxations.
Frequently Asked Questions
Facial stiffness after long-standing Bell's palsy is usually caused by increased resting tone in the facial muscles on the affected side. During long-term recovery, synkinesis can cause multiple muscles to contract simultaneously, leading to chronic tension and a stiff feeling.
When synkinesis is present, your facial muscles work much harder than normal because multiple muscles contract at the same time for even simple movements like speaking or eating. This constant overactivity leads to faster fatigue, especially toward the end of the day.
Yes. Specialized facial rehabilitation can help reduce synkinesis and improve the coordination of facial muscle contractions. As the involuntary co-movements decrease, the muscles work more efficiently, reducing both stiffness and fatigue.
