What is Synkinesis?
Synkinesis is a condition that can develop after a facial nerve injury, where facial muscles begin to move involuntarily when you are trying to perform a different facial movement. It commonly occurs during recovery from Bell's palsy, facial nerve surgery, trauma or other causes of facial paralysis.
As the facial nerve regenerates, some nerve fibres may reconnect to the wrong muscles. This means that when you try to smile, close your eye or raise your eyebrow, other facial muscles move unintentionally.
Common examples include:
- The eye closing when smiling
- The corner of the mouth moving when blinking
- Tightness in the cheek during facial movements
- Neck muscles tightening during facial expressions
- Difficulty producing smooth, natural facial expressions
Synkinesis usually develops 3 to 6 months after the initial facial nerve injury and can range from mild to severe. While it cannot always be completely eliminated, specialist facial rehabilitation can significantly improve movement quality, reduce tightness and improve facial symmetry.
How Can Physiotherapy Help?
Specialist facial physiotherapy is considered one of the main treatments for synkinesis. Rather than strengthening the facial muscles, rehabilitation focuses on retraining the brain and facial muscles to produce more coordinated, selective movement.
Treatment may include:
- Comprehensive facial movement assessment
- Neuromuscular retraining
- Facial muscle relaxation techniques
- Mirror feedback therapy
- Biofeedback training where appropriate
- Stretching for facial tightness
- Soft tissue massage
- Selective muscle activation exercises
- Synkinesis inhibition techniques
- Functional retraining for smiling, blinking and speech
- Personalised home exercise programme
Treatment aims to reduce unwanted muscle activity while improving the quality and control of voluntary facial movements.
Why Choose Greenacre Physio?
Facial rehabilitation is one of Greenacre Physio's specialist neurological services. Our clinicians have extensive experience treating people with synkinesis through specialist NHS neurological services and dedicated facial rehabilitation clinics.
We understand that synkinesis can affect confidence, communication, eating, drinking and emotional wellbeing. Our evidence-based rehabilitation programmes are tailored to your individual movement patterns, helping you regain more natural facial control while reducing tightness and discomfort.
Appointments are available at our Essex and Cambridge clinics, with virtual consultations also available where appropriate.
What to Expect
During your first appointment, we will discuss your facial nerve injury, how your recovery has progressed and the movements that are causing concern. We will perform a detailed assessment of your facial symmetry, voluntary movements, muscle tightness and involuntary muscle activity.
Following your assessment, we'll explain your individual movement pattern and develop a personalised rehabilitation programme. Your exercises will focus on improving movement quality rather than muscle strength, and treatment will be adjusted as your facial control improves.
Frequently Asked Questions
What causes synkinesis?
Synkinesis occurs when the facial nerve heals after an injury but some nerve fibres reconnect to the wrong facial muscles. This leads to involuntary muscle movements during normal facial expressions.
Can synkinesis be cured?
There is currently no cure for synkinesis, but specialist physiotherapy can significantly reduce unwanted movements, improve facial symmetry and help you regain better control of your facial expressions. Many people also benefit from treatments such as botulinum toxin (Botox®) injections alongside physiotherapy, when recommended by a specialist.
Will facial exercises make synkinesis worse?
General facial strengthening exercises can sometimes increase abnormal muscle activity if performed incorrectly. This is why assessment and guidance from a physiotherapist experienced in facial rehabilitation is essential.
When should I start treatment?
Treatment usually begins once synkinesis develops, often several months after the initial facial nerve injury. However, early facial rehabilitation following facial palsy may help reduce the likelihood or severity of synkinesis developing.
Do I need a referral?
No. You can self-refer directly to Greenacre Physio. We also accept referrals from GPs, neurologists, ENT consultants, plastic surgeons, maxillofacial surgeons and other healthcare professionals.
Book an Appointment
If you're experiencing unwanted facial movements, facial tightness or difficulty controlling your facial expressions following Bell's palsy, facial surgery or another facial nerve injury, we're here to help.
Book an appointment at one of our Essex or Cambridge clinics or arrange a virtual consultation with one of our experienced facial rehabilitation physiotherapists.
Common Symptoms We Treat
- Eye closing when smiling
- Mouth movement during blinking
- Facial tightness
- Facial stiffness
- Facial asymmetry
- Difficulty producing natural facial expressions
- Muscle overactivity
- Neck tightness during facial movement
- Reduced facial control
- Facial discomfort
- Reduced confidence with facial expressions
Why Choose Greenacre Physio for Synkinesis?
Synkinesis is a complex condition that requires specialist assessment and targeted rehabilitation. At Greenacre Physio, we combine extensive experience from specialist NHS neurological services and dedicated facial rehabilitation clinics to provide evidence-based treatment tailored to your individual movement patterns.
Whether your synkinesis developed following Bell's palsy, Ramsay Hunt syndrome, parotid surgery, acoustic neuroma surgery or another facial nerve injury, we'll help you improve facial symmetry, reduce unwanted movements and regain more natural, controlled facial expressions. Our goal is to maximise your facial function, improve confidence and support your long-term recovery through personalised rehabilitation.