Bell's Palsy & Facial Palsy
Weakness or tightness on one side of the face after Bell's palsy or facial nerve surgery responds to specific, gentle facial exercise, most reliably when it starts early.
Common symptoms
- , Weakness or drooping on one side of the face
- , Difficulty closing one eye fully
- , Uneven smile or difficulty with facial expressions
- , Tightness or pulling as movement returns (synkinesis)
- , Dribbling from one side of the mouth
Common causes
- , Bell's palsy, a sudden inflammation of the facial nerve
- , Facial nerve surgery, including after tumour removal
- , Facial nerve injury following trauma
- , Nerve damage from ear or parotid gland surgery
Why facial recovery is not like other physiotherapy
The muscles of the face are small, numerous, and work in very specific combinations to produce an expression. Retraining them is not about building strength the way a knee or shoulder would be; it is about precise, repeated, often small movements performed in front of a mirror, done correctly rather than often.
Done too generally or too aggressively, facial exercise can encourage synkinesis, the unwanted movement (an eye that narrows when someone smiles, for example) that becomes harder to unlearn the longer it is reinforced. This is why facial rehabilitation specifically, not general exercise advice, matters.
After surgery, not just after Bell’s palsy
Families often call us in a very specific situation: a relative has just come through facial nerve surgery, whether after Bell’s palsy that did not fully resolve, a tumour removal, or ear or salivary gland surgery affecting the nerve nearby. The surgery has addressed the underlying problem; physiotherapy is what turns the nerve recovery that follows into actual, functional movement.
That distinction is worth making clear to a worried family: surgery and physiotherapy are doing different jobs, and the second one usually cannot start properly until the surgeon has cleared it.
What we actually work on
- Symmetry and control, small, specific movements rather than “exercising the face” broadly
- Eye protection, where the eyelid does not close fully, this is addressed first because the eye is at risk
- Synkinesis management, using massage, stretching and re-education to reduce unwanted movement as it appears
- Confidence with eating and speaking, often the most immediately practical concern for the person recovering
Recovery is paced by the nerve, not by effort, and we are honest with families about that from the first visit.
How we treat it
- , Facial muscle re-education, small and specific movements rather than general exercise
- , Soft-tissue and massage work to reduce tightness as movement returns
- , Mirror-based feedback training
- , Management of synkinesis, the unwanted movement that can appear during recovery
- , Eye-care guidance where the eyelid does not close fully
Typical recovery: Most Bell's palsy recovers substantially within 3–6 months; post-surgical recovery is often slower and less complete
See a doctor urgently if you have
- !Facial weakness with slurred speech, arm weakness or confusion: this can be a stroke and needs emergency care immediately
- !The eye that will not close is at risk of injury and needs protection straight away
- !New facial weakness with a rash around the ear or in the mouth
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
My mother has just come out of surgery after Bell's palsy. When should facial physiotherapy start?
As soon as her surgeon confirms she is ready, which is often within the first couple of weeks. Facial muscles respond well to early, gentle, specific work, and waiting rarely helps.
Is it too late if it has already been several months?
No, though earlier is generally better. We will assess what movement she has now and what pattern it is following, including any tightness or unwanted movement (synkinesis), and build a programme around that rather than assuming the window has closed.
Will her face go back to normal?
It varies. Many people, especially with straightforward Bell's palsy, recover close to normal. Recovery after nerve surgery is often partial, and we will give you an honest sense of what is realistic once we have seen how she responds to the first few weeks of treatment, rather than promising a result no one can guarantee.
Can you see her at home if travel after surgery is difficult?
Yes. Facial rehabilitation needs to happen little and often, and a home visit removes the barrier of travel in exactly the weeks after surgery when consistency matters most.
Book a physiotherapist in Nairobi
Clinic appointments in Westlands, or a physiotherapist at your door anywhere in Nairobi. Same-week slots.