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Physical Therapy Month: What do Physical Therapists Treat?

When I tell people that I am a pediatric physical therapist I am often met with a blank, questioning stare. Why could children possibly need physical therapy? When most people think of physical blog-physical therapy-month-main-landscapetherapy, they think of recovering from a back injury or shoulder surgery, or maybe they think of someone in a nursing home going through rehab after a stroke. However, children can often benefit from the services of a physical therapist as well, from newborns all the way through adolescents. Pediatric physical therapists focus on the gross motor development of children, and work to address any limitations that may impact that development.

Pediatric physical therapists therefore work with a wide range of diagnoses and conditions including:

  • Gross motor delay: Development of gross motor skills is an important piece of child development. Since these skills build on one another, a delay with one skill can lead to further delays or difficulty with later skills. Pediatric physical therapists can help your child develop the major gross motor milestones listed below, as well as many more!
    • Rolling
    • Sitting
    • Crawling
    • Standing
    • Walking
    • Running
    • Jumping
  • Torticollis and plagiocephaly: Torticollis is a condition that occurs when there is asymmetrical muscle length and strength in a baby’s neck muscles, and therefore limits symmetrical neck motion. Plagiocephaly, or asymmetrical head shape, often occurs when a child has torticollis, as a result of frequent pressure being put on only one part of the head. A pediatric physical therapist can help to stretch and strengthen the child’s neck in order to promote symmetrical motion and head shape.
  • Balance and coordination disorders: Limitations in balance and coordination can have a significant impact on a child’s ability to develop motor skills, as well as to safely negotiate his or her natural environments. A pediatric physical therapist can treat these limitations to allow for improved functioning and safety.
  • Neurological disorders: A neurological disorder occurs when there is abnormal functioning of the body’s nerves, spinal cord, or brain. These are just a few of the disorders that a pediatric physical therapist can treat.
    • Cerebral palsy
    • Spina bifida
    • Traumatic brain injury
    • Spinal cord injury
  • Orthopedic conditions: Children get hurt too! Even though children tend to be more resilient to injury then adults, children who suffer an injury or require surgery can also benefit from physical therapy services to help restore function to the musculoskeletal system.
    • Post-injury
    • Post-surgery
    • Scoliosis
  • Genetic disorders: Genetic mutations may result in impaired development and functioning in children, and can therefore be addressed through intervention with a pediatric physical therapist. While there is a wide range of genetic disorders and their resulting impact on child development, below are a few examples of genetic disorders where a pediatric physical therapist is typically a part of the child’s team of providers.
    • Down syndrome
    • Duchenne muscular dystrophy
    • Prader-Willi syndrome
  • Gait abnormalities: The way a child’s lower extremity bones and muscles develop have a large impact on the child’s gait mechanics. Abnormalities with gait, such as toe-walking, can be addressed by a pediatric physical therapist.
  • Many more! If you are unsure of whether your child may benefit from the services of a pediatric physical therapist, speak with your pediatrician or reach out to a pediatric physical therapist near you.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood,Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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How is Torticollis Diagnosed?

Congenital muscular Torticollis should be a suspected diagnosis if your infant demonstrates a preferred head position or posture. Infants will present with reduced cervical range of motion, a potential palpable mass in the sternocleidomasoid muscle and/or craniofacial asymmetry.BlogTorticollisDiagnosis-Main-Landscape

A diagnosis is made by your pediatrician and can usually be done based on a simple history and physical examination. Physical examination findings may include:

  • Head tilt to one side
  • Reduced range of motion
  • Palpable SCM tightness
  • Absence of findings associated with non-muscular causes of congenital Torticollis

[1] Cheng JC, Tang SP, Chen TM, et al. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants–a study of 1,086 cases. J Pediatric Surg 2000; 35:1091.

[2] Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 2013; 25:348.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Baby Sleeping

Babies, Misshapen Heads, and Plagiocephaly Helmets: a Physical Therapist Perspective

A majority of the babies I see in the clinic are those diagnosed with torticollis and plagiocephaly. These babies are often accompanied by bewildered first-time parents with worried looks, scared by those big diagnostic words. The first questions they ask are “could I have prevented this?” and “will he need a corrective helmet?”

What is plagiocephaly and what causes it?

Since the beginning of the “Back to Sleep” program in the 1990s, which kept babies off their tummies to prevent Sudden Infant Death Syndrome, many babies started to develop flat spots on the back of their heads. Plagiocephaly and brachycephaly are two terms used to describe the abnormal head shape, depending on the degree of distortion and location of the flatness. While most parents think they were partially responsible for the flat spot developing in their newborn, an infant’s head is extremely malleable before it reaches cranial maturity. Any prolonged external force leads to some skull shape changes. Plagiocephaly and brachycephaly can be associated with many conditions, from prematurity and twin births, to torticollis (asymmetrically tight neck muscle), to developmental delay. Often times, the asymmetries are resolved with simple repositioning and stretching exercises to encourage the child to look to both sides, physical therapy, as well as nap and play time on the tummy, all with supervision of course.

How do plagiocephaly helmets work and what’s the best time to get one?

Plagiocephaly helmets are cranial orthoses made out of a hard plastic shell with Baby Sleepingfoam lining, custom made to each child, and designed to keep pressure off the flat spots to help the head naturally round itself out. They are meant to be worn for 8-12 weeks for at least 23 hours a day, during sleep and play. Certain hospitals, orthotics companies, and plastic surgeon’s offices design their own version of the helmets, but the concept is still the same.

The earlier a child with torticollis and plagiocephaly starts a repositioning and physical therapy program, the less likely he will need a skull reshaping orthosis. As physical therapists, we usually recommend a helmet evaluation if 1) A baby has been repositioned off his flat spot and participating in physical therapy for 1-2 months without any significant changes noted to his head shape, 2) A baby has spent 1-2 months sitting independently with good head control and playing easily in tummy time, and moderate to severe plagiocephaly is still present, or 3) A baby is over 6 months of age and facial asymmetries are still obvious. Usually, helmets are not expected to be effective for kids over 18 months.  What facial asymmetries do we look for as an indication of moderate to severe cranial change? A smaller chin on the affected side, a smaller ear or an ear that’s shifted forward, and a smaller or droopy eye on one side are examples. Of course, every baby develops differently and other factors may be taken into consideration, such as if his abnormal head shape is keeping him from achieving gross motor milestones (rolling, head control, etc).

Do helmets actually help? Aren’t all of our heads a little bit asymmetrical? What happens if my child doesn’t get one?

In its early years, the infant helmet received a bit of scrutiny. The biggest push-back from some insurance companies and doctors against cranial helmets is that asymmetrical head shape in babies appears to be a cosmetic complaint that hardly justifies a costly and bulky orthosis. Parents and practitioners alike question the association between deformational plagiocephaly and long-term functional delay in kids. There has been research over the last two decades on whether helmets alone prevent long-term asymmetries, if cranial asymmetries lead to other medical issues, or if neurodevelopmental delays occur in school-aged children with plagiocephaly. While the literature is still young and long-term research is still in the works, untreated cranial asymmetries have been linked to visual defects, ear infections, middle ear malfunction, jaw bone changes, developmental delay, learning difficulties, and other psychomotor delays.

In a brand new study out of the Netherlands this month, researchers found that helmet therapy alone yields similar results to natural cranial growth. The study, however, focused only on babies with mild plagiocephaly, not torticollis, prematurity, or other associated conditions. Babies with severe plagiocephaly were also not included in the study, which limited the population to a very specific, underrepresented, group in pediatric clinics. Interestingly enough, the study found that by the time their child was 2 years old, parent satisfaction was much higher and parent anxiety was slightly lower in the group who received helmets. Even in this study suggesting the ineffectiveness of helmets, the authors referenced other studies that discussed the long-term implications of letting deformational plagiocephaly go untreated. These included researchers from different fields, such as neurology, child development, physical therapy, orthotics and prosthetics, and plastic surgery. Overall, developmental experts agree, long term consequences of untreated plagiocephaly are multi-faceted and future research is imperative.

Because physical therapists like us have no association with helmet companies, doctors’ offices, or orthotists, our recommendations are purely based on the child and family’s needs. What I always tell anxious parents trying to make this decision of whether or not to try the cranial orthosis helmet with their child is this:

Helmets are not right for every baby with cranial asymmetry. The results you can get out of a helmet depends on the fit, consistency of wear, and the baby’s growth. The most effective time period to make the most changes to a baby’s head is short. Don’t let a medical professional bully you into making a decision you aren’t comfortable with. At the same time, take on a wider perspective when trying to make this decision. Have we done all the necessary exercises and reposition changes? Have we taken into consideration medical advice from all the different health professionals involved in your baby’s care? Did the helmet evaluation (with measurements done by machines for precision) reveal moderate to severe cranial changes? Are you worried about side effects or costly interventions that might be needed down the road? These are great questions to talk out with your pediatrician or physical therapist.

In my clinical experience, I have never had a parent regret the decision they made, whether it was to seek out a helmet evaluation or to forgo helmet therapy. Though often it was a hard decision to make, we were able to work through the questions together to determine the best course of action for their precious little one’s all-important noggin.

 

Do you still have questions or have experience you want to share? Please let us know!



References:

Kordestani R, Patel S, Bard D. Neurodevelopmental Delays in Children with Deformational Plagiocephaly. Plastic and Reconstructive Surgery 2006;117:1. Available from: www.plasreconsurg.org. [accessed 15 April 2014]

Miller RI, Clarren SK. Long-term developmental outcomes in patients with deformational plagiocephaly. Pediatrics 2000; 105:e26. Available from: http://pediatrics.aapublications.org/content/105/2/e26.full.html. [accessed 15 April 2014]

Stevens, P. Beyond Cosmetic Concerns – Functional Deficits Associated with Deformational Plagiocephaly. April 2012. The O&P EDGE. Available from: http://www.oandp.com/articles/2012-04_02.asp [accessed 15 April 2014]

Van Wikl RM, van Vlimmeren LA, Groothuis-Oudshoorn CGM. Helmet therapy in infants with positional skull deformation: randomized controlled trial. BMJ 2014;348:g2741. Available from: http://www.bmj.com. [accessed 12 May 2014]

 

Arm with kinesiotape

What is Kinesio® Tape and why is it used on children?

Physical therapists and occupational therapists often use Kinesio® Tape on their clients as an adjunct to therapy. So what is Kinesio® Tape? You might have seen this colorful tape on Olympic athletes in various locations and various patterns. It is an elastic tape that has multiple purposes depending on where and how it is applied. It is often used to reduce pain, swelling, improve strength, encourage optimal alignment, and decrease muscle fatigue.  Kinesio® Tape can be used at full tension like regular athletic tape. However, it is the elastic qualities of Kinesio® Tape that make it therapeutic.

Properties of Kinesio® Tape:

-Latex free
-Variable tension depending on function
-Adhesive is medical grade acrylic and heat sensitive
-Allows for free movement instead of restricted movement like regular athletic tape
-Similar elasticity as human skin, so it can stay on for days to maximize its full effect

Purpose of Kinesio® Tape:

-To hold a joint in optimal position to help an overstretched or overworked muscle to rest and return to its most efficient length.
-Keeping a body part in better alignment helps the muscles contract and work in a less stressful fashion during daily activities.
-To increase input to the skin around a specific muscle or joint. With this new proprioceptive input, more awareness of that body part leads to more strength.
-To help relax an overused muscle which helps reduce pain and swelling
-Improve lymphatic flow and reduce edema and bruising, allowing for accelerated healing

Who can benefit:

People with a variety of orthopedic, neuromuscular, or medical conditions, such as:

-Cerebral Palsy
-Conditions with weakness or paralysis of a certain body part
-Down Syndrome
-Gross Motor Developmental Delay
-Children with gait abnormalities such as toe-walking, flat feet, hyperextension, etc.
-Low muscle tone
-Decreased coordination
-Brain injury
-Torticollis
-Lymphedema
-Painful orthopedic injury
-Poor posture
-And many more…

Not only is Kinesio® Tape safe for use on children, I have found Kinesio® Taping to be extremely beneficial and valuable to my clinical practice.  This elastic tape can be left on for 3-4 days after application. Often times, I put it on at the end of a session to help my clients retain the gains we made during the session. In a way, it improves carryover from week to week, and brings the physical effects of therapy home. With babies, this “reminder” is especially important, as they are still working on their neuromuscular control and cannot make a conscious effort to contract a certain muscle or hold a specific position during their play activities. With children, the colorful tape gives them a fun visual cue to increase use of a certain body part and strengthen those all important neuromuscular connections.

Reference:

Kase, K, Martin, P, Yasukawa, A. Kinesio®Taping in Pediatrics. 2006. Kinesio® USA , LLC. 16-19.


Tummy Time the First Year: A Month by Month Primer

As a follow-up question to the importance of tummy time discussion, most parents want to know what their babies should be doing on their tummies for the first year.  Are they still working their muscles if they are just resting their cheek or gnawing on the floor mat? What if he is just kicking and screaming with hands fisted? Is he really doing what he should be doing? When he starts sitting independently, why can’t I just let him sit all the time?

Questioning if your 2 months old should be holding his head up when he is on his tummy? Wondering if your 8 months old should be crawling more? Wonder no more.

Here is a month by month guide on what your child should be doing on his tummy the first year of life.

  • Month 1: Tummy time can start as early as day 1.  By the time a baby is a month old, he can most likely lift his head enough to turn his head and rest his cheek to the other side.
  • Month 2: After 2 months of spending plenty of time on his tummy, a baby is now not as curled up into the fetal position as before.  His hips are a little more stretched out and he has the strength to lift his head even higher. He can put weight on the outer edges of his forearms and his shoulders are strong enough to bring his hands out from underneath his chest.
  •  Month 3: By the 3rd month, a baby can put more and more weight through his elbows when he is on his tummy. Because of increased strength in his neck and trunk muscles, he can now lift up his chest and keep his hips down.  Weight-bearing through the forearms is so important because it builds strength and stability in the chest and shoulder muscles and joints.
  • Month 4: The 4th month is a great month for baby development. This is the month of significantly better head control, muscle control, and symmetry.  The 4 month old can now push even higher through his forearms, lift his head up to 90 degrees, and hold his head in midline. His neck now looks longer as his neck muscles develop more strength to hold his head up against gravity.
  • Month 5: Around the 5th month, a baby starts pushing through his hands with the elbows straight. He is learning to shift his weight from one side to the other. Because of this, he might reach with one arm for a toy or accidentally roll over from tummy to back. He is better at using his back muscles against gravity and may look like he is swimming as he kicks his arms and legs up from the floor.
  • Month 6: At the halfway point of a baby’s first year, a lot of maturation has occurred (Read more about tummy time at 6 months of age here). The baby is able to perform tasks with much more equilibrium and control.  The baby is now constantly on the move and loves tummy time because he can do so much and see so much. If you place him on his back, he will most likely roll himself over to his tummy. Place him on his tummy and he won’t fall over accidentally anymore, because of increased motor control.
  • Month 7: Between all the swimming and pushing off of the floor in the previous months, the 7 month old has developed a lot of trunk strength and shoulder/hip stability. He can now separate his two sides and pivot himself around in a circle to get to toys. He has the control to shift his weight to one elbow and play with the other hand. Some babies may start pushing themselves back into a bear position (hands and feet) or quadruped position (hands and knees).  They may rock back and forth in this position, which strengthens their upper and lower bodies to prepare for crawling and standing and improves their sense of balance.
  • Month 8: The 7th – 8th month is usually when babies start pulling to stand from a quadruped position.  Some babies may skip belly crawling all the together, but most babies creep by the 8th or 9th month. An early crawler will show a low-hanging belly close to the floor, but as he practices crawling more and works on his tummy muscles, he will start creeping with all trunk muscles engaged. The typical 8 months old will no longer need his upper body to lift his trunk. He may be seen more and more in a kneeling position so his hands can be free for play.
  • Month 9: The typically developing 9 months old is now constantly on the move. Crawling is his main method of locomotion. He has enough trunk and muscle control to transition easily between sitting, quadruped, and tummy time. He may start pulling himself into standing though still needs his arms to do most of the work. One thing he may be able to do better is pulling to stand with one foot in front kneeling (half-kneeling).
  • Month 10: By month 10, a baby will be transitioning to stand via half-kneeling more often. In standing, a 10 month old will have developed the hip/trunk control to rotate his trunk and weight-shift. This is mostly because of the hard work he did on his tummy before! Not only can he transition well by himself, he does so with more control and is much more safe, steady, and efficient.
  • Month 11: The 11 months old now has more control of his hips and trunk when on his knees. He may be able to play in tall kneeling and half-kneeling positions without falling. His leg and hip muscles are now strong enough that he doesn’t need his hands as much to pull to stand.
  • Month 12: By a baby’s first birthday, he will have developed full trunk control and ability to use one side independent of the other. This allows for improved weight shifting during standing, increased use of kneeling and half-kneeling, and stability during standing.  The 1 year old is able to transition in and out of quadruped position and is now ready to take some independent steps!

It truly amazes me how many new skills babies can acquire in just the first year. Want to know the key gross motor milestones of a baby’s first year?  Click here.



3 Easy Alternatives for Tummy Time

Every parent knows how important tummy time is for their baby. Most parents also know how difficult it is to get the necessary infant on tummyamount of tummy time into each day. This is only made more difficult when babies dislike tummy time and cry whenever placed on their belly. Here are some simple alternatives to laying your baby flat on their stomach as well as provide the benefits of tummy time and keeping baby and parent happy.

3 Alternatives for Tummy Time:

  1. Front Carry: Hold baby facing away from you, supporting him/her around their rib-cage  With their bottom tucked into your belly, tilt their trunk forward so that it is parallel with the ground. This will encourage the baby to look forward, strengthening the muscles in the back of the neck and along the spine. The more horizontal the baby is, the more difficult it will be for them to lift and hold their head. Lift the baby’s trunk up every 30-60 seconds to give them a break.
  2. Baby on Shins: Lay on your back with your legs bent so that your shins are parallel to the ground. Lay the baby on your shins with their head hanging off your knees and holding onto their hands. This is a great alternative as you can look at the baby as well as move your legs to entertain the baby (similar to airplanes). This is also a good core exercise for mommy!
  3. Baby on Lap: Sit on the floor with your legs straight out in front of you (support your back on the wall if necessary) and lay your baby across your legs with their head hanging off one side of your thigh. This is an effective exercise because you can easily move a toy with one hand to encourage them to look around and strengthen the baby’s neck muscles.

Tummy time is vital for a baby to grow and learn new gross motor milestones. The goal is to have the baby be on their bellies 50% of their awake time. If a baby does not spend enough time on their stomachs, future gross motor skills, such as crawling, may be delayed. There may be specific reasons, such as weakness, low muscle tone or torticollis, that can cause your child discomfort during tummy time. If you have any questions or concerns regarding your baby’s tummy time, please click here to request a meeting with a physical therapist or speak with your pediatrician.

Tummy Time Frequently Asked Questions

What exactly is tummy time?

Tummy time is either:

  • Supervised time when your child is laying on a firm flat surface on her tummy.
  • When your child is being in a position where she is face down and has to lift her head up against gravity.

Why does my child need tummy time? Why is it so important?tummy time

  • Studies have shown a link between slowed achievement of developmental milestones and diminished tummy time in babies.
  • Tummy time builds the muscles in your child that are necessary for advanced movements like crawling, walking and (gulp) running.

My child always cries during tummy time, what should I do?

  • Lay on the floor with your child. Babies are often frustrated because they have less ability to interact with the world when they are lying on their tummies, and if they can see your face (and your smile), they may calm down. You may also utilize mirrors or toys to distract them when they get frustrated.
  • Try a “tummy time alternative.” This can be carrying your child face down in a “superman” position or sit with them supporting her trunk and tilt her forward so her shoulders are in front of her hips.
  • As your child gets stronger (and more able to lift her head and play with toys in this position) she will enjoy tummy time more and more.

What can happen if I don’t give my child tummy time?

  • If the child is always on their back, it increases the risk of flattening portions of their head, and if they do not move their heads around in all directions, it increases their risk of developing torticollis.
  • There may be slowed attainment of developmental milestones such as independent sitting, crawling, and walking.

How much tummy time should my child be getting?

  • The goal is that by 6 months of age, your child should be on their tummy 50% of her play time (not including feeding time, bath time, or sleeping time). Remember that this is a goal to work towards and not to be expected the first day you introduce tummy time.

 How old should my child be before I begin tummy time?

  • You may introduce tummy time on day 1, as long as there are no medical complications whereby your pediatrician would recommend avoiding tummy time.

***Most importantly, babies should always be placed to sleep on their back, and supervised when on their tummy***

Click here to watch a 2 minute webisode on the Importance of Tummy TIme

Click here for a printable copy of this blog

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3 At home Exercises For Torticollis | Pediatric Therapy Tv

Here our Pediatric Physical Therapist gives viewers 3 examples of exercises that parents can perform at home with their child who has torticollis.  For more blogs by experts on Torticollis, click here

In This Video You Will Learn:

  • 3 great exercises a parent can do at home with their child who has Torticollis
  • A great alternative to Tummy Time
  • How to get your child to actively move around
  • How to perform an easy pull to sit exercise and why that helps

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now, your host, here’s
Robyn.

Robyn: Hello and welcome to Pediatric Therapy TV. I am your host,
Robyn Ackerman, and today I am sitting here with Jesse Coffelt,
who is a pediatric physical therapist. Jesse, can you please let
us know three exercises that we can do with a baby who has been
diagnosed with torticollis?

Jesse: Absolutely. There are three great exercises, and obviously
tummy time is going to be hugely important for these kiddos.
This is a great carry I like to do with babies, where my hand is
supporting the baby’s chest here. It can be comfortable. You can
carry the child here. You can put your hand on her, and she’s
always got to lift up her head to be looking around. So she’s
getting that tummy time equivalent.

Another one that’s really good is you can hold the baby up like
this. Again, you can be engaging with your child, and you can
kind of just be tipping her side to side, looking at her, really
getting her to actively move around.

The third one, if I could just place the doll right here, it’s
like a pull-to-sit exercise. What you’re doing is you’re going
to grasp the child by her hands and just gently and slowly lift
her up. What you’re looking for is making sure that she is
lifting her neck up and she’s actively engaging her abdominals.
You can come up here to sitting, and then slowly take her back
down to laying on the ground. The slower you move, the more
she’s got to actively work and strengthen those muscles.

Robyn: All right, great. Thank you so much, Jesse, and thank you to
our viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational programming. To
subscribe to our broadcast, read our blogs, or learn more, visit
our website at LearnMore.me. That’s LearnMore.me.

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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What Happens If Torticollis Goes Untreated | Pediatric Therapy Tv

In todays Pediatric Therapy Tv Webisode, a Pediatric Physical Therapist at North Shore Pediatric Therapy explains what happens if the condition of Torticollis goes untreated.

Click here to read more about Torticollis