TOT collar: What is it and When it is Appropriate to Use?

A TOT collar is a device used to correct torticollis, often in addition to physical therapy. Next, you may be asking “what is torticollis?” Torticollis, often referred to “wryneck” is a tightening or shortening of the sternocleidomastoid muscle in the neck. Infants with torticollis will likely present with a head tilt to one side, and chin rotated to the other side. Congenital muscular torticollis is usually recognized in the first 6 to 8 weeks of life. With physical therapy, it is correctible in over 90% of cases. tot collarHowever, if left untreated, can lead to scoliosis, plagiocephaly (head flattening) and asymmetry with gross motor milestones.

If the child has a head tilt of 5 degrees or more and can lift his or her head away from the side of the head tilt, a TOT collar can be used, in addition to physical therapy, to help correct torticollis. The TOT collar is made of soft tubing and nylon tubes. The tubing is then fastened with a connecting strap.

The basis of the TOT collar is to have a stimulus to the side of the head tilt so that the child will be able to move his or her head away from the stimulus toward a midline head position.

Early intervention is key when treating torticollis. If you or your pediatrician see flattening on one side of your infants skull and notice that they are looking to one side, make sure to see a physical therapist for treatment.

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