How to Improve the Loss of Facial Expression Caused by Parkinson's
Updated: Aug 3, 2022
The Power of Facial Expression
Facial expression is an important part of communication. It is nonverbal communication that carries a wealth of information that can supplement or clarify our words. A facial expression can convey sarcasm when our words do not. It can add warmth to a simple greeting or communicate anger or frustration when we’d rather not put words to it. Or a facial expression can stand alone when no words are needed. So, when Parkinson’s takes hold and leaves what is known as a “masked” expression, we lose an important part of our communication intent. The loss of facial expression can even affect our ability to connect with others.
There are benefits to working on facial expression that go beyond nonverbal communication. Increasing tone in the muscles around the mouth can help with managing saliva. Exercising the facial muscles can also help with speech clarity. It can help release stiffness or tension in the face and improve blood circulation. And toning the muscles of the face may also have the added benefit of looking younger!
I have outlined 9 facial muscle exercises below. It is recommended to complete these exercises at least daily. Performing the exercises in front of a mirror will yield the best results because the added complication of Parkinson’s disease is that movements become diminished. You may feel you are smiling fully but a mirror will tell you if you have a broad smile or a partial smile. Sometimes a half-smile is the communication intent, but it is important to practice each of these exercises at your fullest expression. Then you will feel and know if you are delivering a full or partial smile.
Facial Muscle Exercises
1. Raise your eyebrows
This simple gesture can convey surprise, but also improves blood circulation. To perform this exercise, rase your eyebrows as high as you can and hold for 5 seconds. Repeat this motion 5 times.
2. Knit your brows
This is basically a frown face. We use these facial muscles to convey anger, frustration, confusion. Practice making your best frown face in the mirror and holding that position for 5 seconds. Repeat for 5 times.
3. Open your eyes widely
Open your eyes wide and relax all the other muscles of the face. Hold this position for 5 seconds and repeat for 5 times.
This movement is similar but distinct from raising your eyebrows. It can convey fear, shock, or surprise. If you have trouble seeing much difference from exercise #1, practice them back-to-back in front of the mirror to see if you can make a difference in these 2 expressions over time.
4. Close your eyes tightly
The eyes carry so much information in facial expression. Many people with Parkinson’s experience reduced eye blinking and this contributes to the masked facial expression. Shut your eyes tightly and hold for 5 seconds. Repeat up to 20 times a day.
5. Smile Broadly
No need to stress how important a full smile is to connecting with others. There’s also research to show that smiling even when you don’t feel happy can help improve your mood. Look in the mirror and hold a broad, toothy smile for 5 seconds. Repeat this 5-20 times a day, gradually increasing the repetitions over time if this is tiring after the first 5.
6. Lip protrusion (pout or pucker)
This exercise is the opposite of a broad smile, so it helps to balance out the way these muscle pairs work together. Protrude your lips (the same movement you'd use to pucker up for a kiss) and hold the position for 5 seconds. Repeat for 5 times.
7. Jaw opening
This exercise is important for the muscles of chewing, for speech clarity (you’ll be less muffled if you are opening your mouth fully to speak), and for volume. Volume? Yes, if you are familiar with vocal function exercises (saying “ahhhh” for voice exercises), you’ll recall the training involves opening the jaw fully for optimal resonance and volume.
To complete this exercise, use the mirror for feedback. Drop you jaw for a wide but relaxed opening (about 3 fingers height) and hold the opening for 5 seconds. Relax and repeat for 5 times.
Tongue movements aren’t so important for facial expression, but they are helpful in chewing and swallowing, as well as speech articulation. While you’re at it, add on these exercises to your facial muscle exercise routine.
8. Circular tongue movements
Think of licking the INSIDE of your lips in a circular fashion. Use a slow deliberate movement to make one big circle in the space between your teeth and the inside of your lips. You can simultaneously work on lip strength by holding your lips tightly closed. Using the mirror for feedback, notice if there is one corner or section that is harder and slow down if you need to for accuracy. After completing the rotation 5 times in one direction, switch to the other direction for 5 times.
9. Tongue lateralization (side to side)
Open your mouth (about 2 fingers height) and move your tongue from one corner of your mouth to the other corner in a slow, deliberate motion. Alternatively, you can do this one with your lips closed and push your tongue against the inside of your cheek (tongue in cheek). By doing this with closed lips, you are again working on lip strength and adding resistance for the tongue. Hold and push the inside of the cheek for 2-3 seconds and switch to the other side. Either way you choose, complete for a total of 10 repetitions (5 on each side).
Learn more about communication, voice and swallow therapy for Parkinson's at Amplify Speech Therapy.