fbpx
Visit our Location
670 Taunton Road East, Unit B2 Whitby, ON

Torticollis and Plagiocephaly: What is it? How can it affect your baby?

Baby in White OnesieTorticollis is a turning and/or tilting of the neck causing restriction in the available range of motion. This can cause the neck to be turned or tilted away from midline and difficult to move the head to a particular side. For example, the neck at rest can be turned towards the right and tilted towards the left, giving the appearance of a “twisted” position. Torticollis with this alignment can make it difficult to move the head in the opposite directions: rotating left and tilting right. The causes of torticollis can be from pain, stiffness, head/neck injury, or muscle spasm.
Torticollis can occur across the lifespan from newborns to adulthood. The difference for newborns and infants is that their skulls are largely cartilaginous and can be shaped. This combination of malleable shaping of the head and torticollis can result in a progressive flattening of a particular side or portion of the head due to any constant turning to a side, away from midline at rest. This flattening is referred to as plagiocephaly. Flattening can be congenital, developed in utero, or can be related to head position (i.e. with toricollis); in the latter case, the flattening is termed positional plagiocephaly and is often linked with torticollis. It is important to note that although toricollis and plagiocephaly affect the shape of the head, there are no direct affects on brain development or function.
If there are concerns with the baby’s neck range of motion or positioning, physiotherapy can help guide stretches and exercises to restore full range of motion. There are additional concerns with plagiocephaly, physiotherapy can help with establishing exercises are strategies to counteract this shaping.
Questions or concerns regarding your child? Book your 15 minute free consultation today! 

Paediatric Milestone series: Activities in Supported Standing

Before we discuss independent standing and standing up without using support, it would be appropriate to consider simple exercises when the child is standing at the couch, ottoman, coffee table, etc. In fact, this is quite a critical period for the child to master their body in space when trying to stand and balance at their support surface.

 

Once the child is up and standing at their preferred support surface, placing toys or any other item of interest just out of reach on the couch is an excellent activity to practice weight shifting and challenging the boundaries of their balance while they are well supported. During a single lateral reach, the child will shift their body and take more weight on the same-sided leg and foot. This simple and subtle movement is so important because this allows the child to unweight the opposite leg and foot. With progression and strengthening, complete lifting of the opposite foot from the ground will be achieved to reach even further. Mastery of this combination of weight shifting and balancing is incredibly important because this skill is absolutely necessary for walking; weight shifting onto a single leg, lifting the opposite leg, and progressing the unweighted leg and foot forward to walk.

 

For continued balance and strength development, encourage rotation and reaching away from their support. Start by using a toy on the couch or table and slowly pull the toy out of reach along the surface and more towards the side of the child to encourage reaching away from their support. Continue to repeat this to both sides and within their tolerance, ensuring to give breaks as needed. Gradually increase how far the child reaches in an arc around their reaching radius until they can almost reach behind by rotating at the trunk and waist with a hand still on their support. Again, this exercise is working their ability to weight shift and balance at the same time; however, with rotating and balancing as well, we are working on trunk strengthening with movement to build strong core muscles to support the trunk and upper body when it is time for standing and walking independently.

 

Of course, during these activities it is important to give plenty of positive reinforcement and feedback to demonstrate the importance and excitement of standing, reaching, rotating, and moving.

 

We will take another detour before we get to independent standing up; we will first discuss cruising along their support on the next blog post.

 

By: Chris Dahiroc, PT.

 

Questions or concerns regarding your child’s development? Contact us for your free 15 minute meet and greet today!

Reaching the next milestone: ground to standing

Getting into a standing position independently is a massive and exciting milestone for a developing child. The progression of developing this important skill goes from the child pulling to stand at support with their hands, to standing up with support at the hips, to standing up independently and hands-free. In this post, we will cover pulling to stand.

The height level of the support surface that a child pulls to stand is a big factor in determining successful standing. Generally, the higher the surface, the more support that it will provide, making it easier to pull into standing. Using the couch (with the seat cushions in place) is a common place to start. Place toys of interest at the elevated surface to draw the child’s attention. Ideally, this should draw the child towards the couch and crawl up the face of the couch and place them in a kneeling position with their hands on-top of the couch. From here, encourage the child to take a step forward with a foot into a half kneeling position, then stand up from this position. Hands-on support can be provided throughout these movements to help the child along. As this transition becomes easier, lower the support surface; this can be easily done by removing the couch cushions, and progressing to even lower support like a step stool. As the support decreases, there is more demand on the legs and balance to stand up, driving the strengthening process.

Once the child is up and standing at support, the previous activities discussed in the previous post can be easily practiced to bring together all of their skills. After they have spent some time standing and need a rest, the transition to the floor is essentially reversed: standing to half kneeling, and half kneeling to high kneeling.

Next post will continue with the theme of standing up, but this time without using the hands to pull for help.

By: Chris Dahiroc PT.

 

Questions or concerns regarding your child’s development? Contact us for your free 15 minute meet and greet today!