In the past decade, as parents try to find a balance between “Back to Sleep” and “Prone to Play”, we have found that incidences of torticollis and plagiocephaly are rising and children are being treated later and later, with some ultimately requiring helmets or collars. Clinical experience further suggests that children with torticollis are at risk for developmental delay.
Torticollis is a congenital or acquired condition of limited neck range of motion, usually caused by shortening of the sternocleidomastoid muscle. The infants head will often be tilted one way and their chin rotated in the opposite direction. Because skull bones are so thin in infants, prolonged positioning with the head rotated in their preferred direction can quickly result in molding of the head. This resultant positional plagiocephaly (misshaped head) usually presents as a flat spot on one side of the back of the head and bulging on the same side at the forehead. This can easily be detected by taking a bird’s eye view when looking at the infants head. The asymmetry can become permanent as the skull hardens resulting in facial asymmetry for life.
Early detection and treatment of torticollis and plagiocephaly is very important. The earlier physiotherapy begins the more effective it will be. It is much easier to treat torticollis and prevent plagiocephaly then to correct it. At blueballoon Health Services, our physiotherapists are experienced in the assessment and treatment of infants and children with torticollis and plagiocephaly. blueballoon has developed a protocol with evidenced based practice for assessing and treating torticollis and plagiocephaly in infants.
Assessment Overview
Clients will be evaluated on the following areas during the assessment:
- The resting head position in all functional positions
- Skull or facial asymmetries and provide a plagiocephaly severity score which can be used as a marker of improvement
- Range, muscle tone, strength and muscle abnormalities which may be contributing to the torticollis
- Gross motor skills to monitor the effect of the torticollis or plagiocephaly on the child’s development and provide a percentile ranking using the Alberta Infant Motor Scale
Treatment Overview
After an assessment has been completed, parents will be provided with an individualized home program including detailed notes and pictures explaining how to carry out exercises at home. In addition to stretching and strengthening exercises, parents will be provided with recommendations on positioning baby in the crib, car seat, and while carrying. We also demonstrate different ways to enjoy tummy time with baby and give exercises to promote gross motor skill development. Bi-monthly follow-up appointments are required to monitor the effectiveness of the treatment plan and to ensure home exercises are performed correctly.
No doctor referral is necessary. Please complete our Self Referral Form: Click here
