You may or may not know that you do early in your Bell’s Palsy recovery greatly affect your progress.
For 29% of people, turns out that that it is key in their recovery, being part of the group that will not just recover on its own.
The problem is that when you have Bell’s palsy, you have no way of knowing which group you belong to.
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And It Does Not Work!
Most people that suffer from Bell’s Palsy will read about or hear about electrical stimulation for treatment of BP
The chance is that they will think of a TENS unit as viable in treating facial paralysis... And IT IS NOT.
TENS unit is for treatment of pain only, NOT to activate and strengthen muscles
The user manuals clearly say to never apply on the face ( that should be your first clue )
The size of the electrode, as with 95% of other type of electrical stimulation units, is not appropriate as it would stimulate too many muscles at once>>>> hence the risk of developing synkinesis since you would be contracting several muscles at once instead of one.
So, all in all, TENS is not a modality that has any benefits in treating BP. And possibly negative effects in reality.
DO NOT USE TENS UNIT TO TREAT BELL’S PALSY!
What healthcare professionals can help me when I am dealing with Bell’s Palsy?
First and foremost, you should be evaluated by a physician. Most people will see their primary care physician/family doctor, or an Emergency or urgent care department physician. The goal here should be for a correct Bell’s Palsy diagnosis and prescription of steroids and antivirals.
Consulting with a facial specialist within the first 3 weeks after onset, especially if there are no signs of improvement, should be the next step. You can consult with:
An Otolaryngologist, or ENT( for ear, nose and throat doctor).
An Opthalmologist, especially if your eye is involved, you cannot blink, your eyes is irritated, itchy, red and painful. If your condition goes on for too long, an oculopastic surgeon ophtalmologist should be helpul
Neurologist: there exist many different type of neurologist and subspecialty and of course, I would recommend one with extra facial paralysis and conditions training
Physical / Physio Therapist ( that’s me , ).
I would be particularly picky in finding a PT with experience and training in treating Bell’s Palsy. A normal university PT curriculum does not teach facial muscles rehab to their student. Just ask when you contact them.
If you failed to progress after several months and still suffer with severe paralysis, consulting with a facial plastic surgeon would be helpful as they can help with recovery of facial movements and expressions
When Is It Safe To Return To Activity / Workout?
Common question people ask, wanting to make sure they won’t make things worse by exercising.
There exists many reasons to stay active and return to your exercise routine even if you suffer from facial paralysis.
But before we talk about exercising, let’s talk about rest:
-rest can be important as facial paralysis can be very taxing emotionally and physically.
Remember BP diagnosis and cause is linked to an exposure to a virus, during a time when your immune system was down.
So that would make sense that during this time you feel fatigue and tired.
BP affects people very differently, to different degrees, and rest might be necessary initially, just like when you have flu symptoms. That rest will help your body use energy to heal.
The key here is to listen to your body and do what you can. If you feel you are only mildly affected, i would suggest to continue your normal routine as much as possible. If you are exhausted, maybe taking some time off work might be necessary
Exercising and staying active remains to this day the single most important factors in keeping multiple body systems healthy: musculoskeletal, cardiovascular, respiratory, immune system amongst other...
Exercising helps release endorphins , which is your body’s own painkiller, and promote increased circulation. These could be needed with managing your Bell’s Palsy symptoms.
Exercising could also be a distraction from your current symptoms, and have been shown to help improve mental health.
The key here is to let your body guide you. Resume exercising and activity as early as you feel ready for it.
You might have to return progressively to it and that is ok.If you are normally sedentary and don’t exercise, going on walks should be beneficial and I would highly suggest it.
Common question: Should I get acupuncture treatment with a diagnosis of Bell’s Palsy? Can it help?
Studies have shown that acupuncture can help decrease inflammation and pain. Bell’s palsy can produce facial and neck pain and is an inflammation of the 7th cranial nerve. Hence, acupuncture could be a helpful modalities in treatment of BP.
Acupuncture assists with relaxation. Avoiding stress and striving to relax should be part of treating Bell’s palsy as symptoms are made worse by stress.
Studies have shown that the insertion of a needle can help start an immune reaction, which could boost healing of facial muscles and nerve.
Acupuncture is a fairly safe modality and can be used early on after onset of Bell’s Palsy.
Not to be negated, acupuncture could have a placebo effect, just from the fact of being treated. And if it is, so be it. Nothing wrong with that.
If you choose to try acupuncture, make sure you work with an acupuncturist that has training and experience with neurological condition
Predictors of recovery with Bell’s Palsy
Here are some data that might help predict your recovery from Bell’s palsy and can be a sign of more difficult recovery.
No significant difference between male and female, meaning your gender in itself does not seem to affect your chance of recovery
Bell’s Palsy can really take place at any age with a majority of cases between age 15 and 45. That said many experience Bell’s Palsy after 45. It is rare after age 60 but was found that full recovery tends to be more complicated and least likely.
Being diabetic, you have more chance of developing Bell’s Palsy, and that also puts you at more risk for a more difficult recovery. Possibly because healing tends to be slower in general in this population.
Obesity and hypertension have also been found to put you at more risk of developing Bell’s Palsy.
The incidence of developing Bell’s palsy during pregnancy for the expecting mother is also a known risk factors and also put her at more chance of a possible longer and more difficult recovery. Having preeclampsia during a pregnancy is also another risk factor
Upper respiratory problems, such as an infection, was also found to put you at more risk of developing Bell’s palsy. Anecdotally, I struggled with difficulty breathing and heavy coughing for a whole month about 3-4 months before I was diagnosed with my BP. I will of course never know for sure if that was the reason, but studies have shown a link between the two.
A relationship between experiencing significant pain upon onset of Bell’s palsy and a more difficult recovery has been shown.
Of course, just because you have any of the above does not mean you will experience or struggle with your recovery from it. What I would keep in mind is how important it is to be proactive and act early in your Bell’s Palsy treatment. Just like a stroke, BP is a neurological condition. Nerve heals very slowly, if ever. Time and waiting are not on your side when you suffer from Bell’s Palsy.
Find help to be guided, taught and cued with how to properly perform facial exercises, which one you should focus on, make this treatment tailored to your needs ( remember Bell’s palsy presents differently from one person to another). If you have been going over three weeks with no changes, you owe it to yourself to absolutely seek help if you expect to recover. Also remember that no improvement for 1.5 months is also a sure sign for a difficult recovery.
Facial exercises are an essential and necessary part of treating Bell’s Palsy correctly
Facial paralysis from Bell’s Palsy leads to weak and possibly unresponsive muscles due to inflammation of the facial nerve.
Facial exercises are essential in regaining facial motion, control and expression.
The problem resides once again from a lack of consistent and common consensus and treatment plan once the patient has been diagnosed with BP and prescribed steroids (and hopefully antivirals, as it has been shown that people prescribed with both recover quicker).
Mainly, some patients are recommended to start facial exercises, without any real guidance, and a vast majority are told to wait for steroids to do their magic.
Well, in regards to muscles function and physiology as well as recovery from a nerve injury and paralysis, it makes sense to start facial exercises early to increase your chance of full recovery
Most BP patients learn about these exercises after some online search, finding description and pictures on various site and on YouTube.
It is a start in the right direction.
The problem is that a vast majority are generic at best and do not address individual needs. Bell’s palsy manifest itself very differently in symptoms from one person to another.
The appropriate way to perform them often requires some modifications and cueing, proper direction and technique from a trained professional.
Many end up performing an oversimplified version of these which can lead to complication, incomplete healing and synkinesis.
Get Help With Your Facial Exercise!!
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#facialstrengthening #bellspalsysurvivor #paralisisfacial #facialexercises #synkinesis
#bellspalsysmile #paralisiadebell #paralysiedebell
-how well were they managed medically ( most people only see their GP or an ER doc throughout the whole course... Even without significant progress in their symptoms)
-were they diagnosed correctly? Several other known condition create facial paralysis like BP does but the medical treatment is different
-medical history and chronic conditions present
Even though it might seem that BP is common and your doctor will prescribe you with the necessary steroids to alleviate inflammation of the facial nerve, for many, this is where the extent of medical management of BP will end... « as it will go away on its own »...
Well, for one in 4, it does not just go away.
It becomes so important that you, as the patient, become proactive and involved in your medical care early on. Do not let more than 3 weeks pass if you are not seeing changes without talking to your physician and pushing for a referral and consultation with a specialist, such as an otolaryngologist or a neurologist, as well as starting facial exercises by the end of the first week, and getting training, cueing and support in performing them correctly. A trained physical therapist / physiotherapist can help you with that.
Bell's palsy is the most common cause of acute unilateral facial paralysis and represents about 60-75% of cases.
The yearly incidence is 15-30 cases per 100.000 persons. The annual incidence of Bell's palsy in the United States is approximately 23 cases per 100.000 persons, and in the United Kingdom 20 cases per 100.000 persons
1 person in 65 will be diagnosed with Bell’s Palsy in their lifetime.
These numbers varies widely by country
with the highest number of cases being found in Japan according to a study, and Sweden had the lowest reported incidence.
And of course these depends on what has been actually officially reported and studied.
It tends to happen more in winter since lower temperatures are associated with an overall higher risk, from exposure to cold and decreased immunity
Big word for one of the most disturbing and annoying symptoms of bell’s palsy:
The inability to blink.
It can be one of the first symptoms of BP but is certainly one of the most serious as blinking is essential to the health of our eyes.
Our eye relies on blinking to provide enough moisture by way of tearing to the surface of the eye. This is the process that keeps our eye lubricated.
Not being able to blink and normally lubricate the eye, our body, being the extraordinary machine that it is, will alert the brain and tell your eye to produce more tears( well, actually your lacrimal glands create the watery part of the tears).
Because tears are also made up of a mucous like substance and oil, and because the lack of blinking also does not allow the mucous and oil to be mixed properly with the water part, your eyes becomes dry, telling your brain to keep producing tears.
And that is the reason why you might feel you are constantly crying after a diagnosis of BP.
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#facialstrengthening#bellspalsysurvivor #paralisisfacial #facialexercises #synkinesis
You are unsure what is causing this and become concerned.
You see a doctor shortly after who after assessing you, prescribes you with corticosteroids and an antiviral to treat the diagnosis of Bell’s Palsy.
As a healthcare provider that has worked and helped Bell's palsy patients for the past 18 years, I can't say I am surprised anymore when a patient or prospective patient mentions they feel lost, alone... Feel like they have not been given much guidance besides, and even not always, been prescribed steroids and antivirals....
They mention how they don't know what they should be doing to work on improving their condition. Should they take vitamin? Should they have massage? Should they use electrical stimulation? Should they continue exercise? Can they continue jogging? Should they just rest, and lie down for the next months crossing their fingers their face will start moving again?
I would like to talk to you about the saphenous nerve. Why am I talking about that today? The saphenous nerve could be the source of pain in your knee or anywhere down your leg, all the way down to your foot for various reason.
This nerve is a continuation of your femoral nerve. Your femoral nerve comes from your lower back... from your spinal cord, into your lower back and around your thigh. It gives into several branches. One of these branch is the saphenous nerve.
One thing to understand is that the saphenous nerve is a sensory nerve and it does not innervate any muscles.
If you sustained an injury to this nerve, you will not see really any particular weakness from that injury. Even without weakness, that could be the source of quite a bit of pain that could arise anywhere along the distribution of that nerve.
WHY WEARING MINIMALIST SHOES COULD HELP YOU MOVE BETTER AND RELIEVE FOOT, ANKLE, KNEE, HIP AND BACK PAIN
You might have heard of them... Or seen more and more people wearing them...Or maybe had a glimpse at them at your favorite shoe retailer. Shoes that look quite different than what you’d consider traditional…they look wider, look shorter, with a very small sole that looks like the manufacturers saved on using material…
Could these really be comfortable and how would it feel to walk in them?
You might be skeptical has you have had foot problems all your life, been told to wear extra insoles with an increased arch, or have seen countless foot doctors that recommended you do so…
In this post I would like to discuss what has been dubbed minimalist shoes, how they could allow a more natural way to move , and how they could help you with aches and pain.
So just a few days ago we looked at how to descend stairs when you have new pain/when going down steps reproduces the pain.
Today, I would like to show you how to properly go up a step, what you can do, how to place your feet and how to optimize the right muscle use to prevent strain on your knee and prevent pain.
What is important to remember with climbing stairs is that most of us are actually climbing stairs the wrong way, or at least not the most optimal way.
So today I would like to start a serie on knee pain. I will approach several common reasons for having knee pain with common movements and tasks. I will also demonstrate what you can do about it and what you can change with specific exercises that will help you correct what you are doing wrong.
We have many patients that come to see us with complaints of knee pain stating that they have had increasing difficulty with knee pain when they ascend or descend stairs, going over curbs or stepping off a high platform, and even walking or hiking on hills.
Using stairs is a required and normal part of life to participate in society but it is far from easy for many.
A lot of people that have knee pain think or have the conception that the problem is coming from inside the knee joint, that a structure is likely injured or not doing what it is supposed to do. I am here to tell you that it is rarely the case. I think that the knee joint generally deteriorates only from direct trauma, or much more often from problem occurring at the hip and ankle joints instead.
So today I would like to talk to you about a question that I often see on forums online or I have been ask by patients is...
Is physical therapy or physiotherapy appropriate after a car accident?
My answer today's is 100%, Yes!
Bell's Palsy is considered a rare condition but it still affects over 40,000 Americans between the age of 16 and 60.
A lot of the research and best course action to treat it remain a source of debate and disagreement.
It is a neuromuskuloskeletal condition since it affects both the facial nerve and muscles of the face it innervates.
I may be be biased, but as a physical therapist (physio for anyone living outside of the USA), and as a fully recovered Bell's palsy patient myself, I believe it is my duty to educate the population with what physical therapy can do when suffering from this rapid, debilitating, physically and socially, condition.
It's February... We are right in the thick of winter. If you exercises outdoor, winter might not be a time you particularly relish. You might even have switch all of your workouts indoor by now. Or worse... You might have stopped exercising altogether because you have been less than motivated and feeling lethargic from the weather...
Curling up under a blanket by a fireplace likely sounds more appealing.
But know that winter tends to bring a weight gain of 5 to 10 pounds on average. Can you only blame the weather?
Winter is of course a great time for outdoor activities and cardiovascular activities.
Today, my only goal is to do a review of the risks, but mostly the benefits of exercising in cold weather.
You might have to take extra precautions and measures but will learn that winter brings on special benefits when it comes to exercising.
Hello followers. So today I would like to discuss a tip for aneck pain. This is also a self test to see if you would benefit from this motion. This particular motion I will demonstrate is called retraction, as well as retraction in combination with side bending. And very often, and I see this with most of my patients and most people that have neck pain is, that motion is being lost over the years. And there's a good reason for that and that is because we really don't do any activities with that particular position of our head and neck. And so I won't, take too much of your time. I will just demonstrate. So the motion I'm talking about is retraction. Retraction is this motion. So not this.... but bringing your chin straight back, just kind of like a turtle.
So what I see is, with my patients... a lot of patients are positioned in this position for too long and they basically can't... they have very, limited emotion in this direction. So one thing that you can do to make this a little bit easier would be to kind of squeeze your shoulder blades a little bit and then bringing your chin back and make sure that you spend less and less amount of time during the day where you're in this position, which can really limit, your mobility over the years of being able to do this. These can create a lot of compression on joints and nerves in your neck and leads to a bunch of problems in the neck as well as the shoulder. So this motion that is called retraction. So if you have neck pain, my suggestion would be to do in case it's about 10 times an hour. So that won't take very long, but that is a good mobility.
The other one would be side bending in combination with retraction. So you would start in the same way... back like this, and then add this motion. So with a lot of my patient, I see a mobility that's just about this way. And then that's it. And that's all they have. And you really want to strive to.... to maintain that mobility as much as you can and both ways.
So that's it for today. Give that a try ..., leave me comments and let me know if that is helping your neck ...
I'll catch you later. Bye
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If you're watching these video is maybe because you have Tennis Elbow otherwise known as lateral epicondylitis... or maybe you know someone that suffers from it. It is fairly common and today I 'd like to show you some exercises and gentle mobilization I give my patients to work on at home in order to treat themself.
So the first thing involved with lateral epicondylitis is generally some tension in the radial nerve. I would like to show you is how to mobilize your radial nerve. In standing like this, the first thing I do is on the involved side, which let's say my right elbow is involved. Turning your arm in, lifting your pinky up and bringing your arm out in a little bit back and immediately returning. You're going to stay within the range of motion and where you feel the pull in your arm. Not trying to go too much into the pain if it's painful at the end of the range. And basically just oscillating like this for 30 seconds.
In this post, I’d like to offer a step-by-step guide to addressing your sciatica, no matter if it has been going on for 3 days or 3 years. My goal is to at least give you a proactive head start and empower you with at least a little knowledge on what you should be actively doing now, even if you are scheduled to work with a physical therapist or another health practitioner in the very near future.
The following tips and instructions should help with at least some of your symptoms, if not all.
I will not go into details as the possible cause and symptoms of why you might be experiencing. For this I will redirect you to a previous post I wrote in 2017, 3 Common Causes & Symptoms of Back Pain & Sciatica.
You can also check more on the definition of sciatica and things to consider in this free E-book on Sciatica:
Most Convenient Way For Physical Therapy: Butheau Physiotherapy Now Offering Virtual/ Telehealth Consultations From The Comfort Of Your Own Home
Let's chat about a topic that is often overlooked and has potential of affecting someone's life and could be resulting in life changing injuries.
Over my 17 years career, I have treated patients in hospitals, outpatient clinics, private homes, skilled nursing facilities and rehab centers and hundreds of them for injuries resulting after a fall. Fractures of the hip and pelvis are the most common but hands, wrist, forearm, ankle and feet fractures are not too far behind.
And today, I 'd like to offer some insight and topics regarding balance and falls with....
Hip joint pain, stiffness and/or discomfort is a common complaint from my patients. Many people suffer from hip pain for years before they start considering having that area looked at and treated. Unless you suffer from direct trauma, such as a fall, It generally starts as mild stiffness or tightness and progress to mobility restriction that can be painful or not.
I consider the hip joint a key joint as it is the link between our legs and the rest of our body. Keeping healthy hips is key not only in preventing hip pain, but also very often in preventing, addressing and fixing ankle, knee, pelvic and lower back pain. I consider hip mobility, or lack thereof, to be the main culprit in many ailments dealing with these areas...