Rankin Physiotherapy

Facial Palsy and Vestibular Treatment


Burlington/Hamilton FNMR Course

On May 3, 2019, 17 therapists attended the foundation course for Facial Neuromuscular Retraining (FNMR). There were therapists from the US, Brazil, New Brunswick and Ontario. Most had already seen facial patients prior to the course and were looking to gain more knowledge about their treatment.

On May 4 and 5, three therapists carried on to complete the practical component of the course. Beth Kroetsch, a long standing facial therapist in Hamilton, had arranged a good group of patients for us to assess, educate and treat.

The 3 new fully trained facial therapists are, from Left to Right:

Denis Savoie, PT

Centre Hospitalier Universitaire
tel: 506-862-4100
Dr. Georges L Dumont
330 Avenue Universite
Moncton, NB

Adiilah Heenaye Sumser, PT


tel: 416-519-9122
Bayview Physiotherapy
& Sports Medicine Clinic
586 Eglinton Ave. East, Suite 312
Toronto, Ontario

Tel: 289-863-1009
Dome Physiotherapy and Wellness Clinic
1325 Eglinton Avenue East,
Suite 220
Mississauga, Ontario

Tel: 289-863-1009
In Home Physiotherapy
Oakville and Milton areas

Anellina Ventre, SLP

Her contact information is:

Tel: 416-557-7237

What is Synkinesis?

Syn = Abnormal
Kinesis = Movement

So how is this abnormal movement (synkinesis) created in facial palsy?

When the nerve is compressed in the acute phase of a facial palsy due to either inflammation, surgery, or tumours; it is possible that some of the axons or “wires” will be severed.

Our peripheral nerves have the capacity to regrow and do so at the rate of 1mm per day. In the process of regrowing, sometimes the nerves get crossed and end up going to a different muscle than they did originally (see diagram below). The left side of the face is normal and the right side depicts synkinesis.

C. Beurskens, PT

A nerve that originally went to the eye, for example, is now going to the mouth. The brain still thinks it’s talking to the eye, but now the mouth is reacting. This is how movements become connected so that when a person with synkinesis blinks, their mouth might also move. Through hard work and the help of a trained facial therapist, it is possible to create a new pathway using the principles of neuroplasticity. For a great reference on neuroplasticity see Norman Doidge’s book The Brain that Changes Itself.

Shift Concussion Management

On May 25 to 27, Susan Rankin successfully completed the Shift Concussion Management course.

Post concussion syndrome was presented as a “brain energy” issue. Many of the symptoms post-concussion include dizziness, headache, nausea, fatigue, and fogginess caused by the brain’s inability to produce the energy required to sustain its normal processes.

Rest is important for a few days up to 2 weeks, but interspersed with daily walking, no sleeping in the daytime and eliminating visual tasks. Yes, that means no computers, no phones and no TV.

Music, talking-books and walking outside are all encouraged in the early stages. Then a balance between vestibular, visual-motor, and cervical treatments should begin as the symptoms subside.

In order to achieve good results all areas need to be assessed and treated.