Torticollis (Overview and Physical Therapy Treatment Techniques)
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- เผยแพร่เมื่อ 10 ธ.ค. 2020
- Torticollis may be multi-faceted but is not always difficult to treat.
Corrections:
6:08 - R rotation with L sidebend = plagiocephally on posterior R skull (I'm physically tapping my R side with finger tips but verbalized L side were my palm is).
16:35 - Misspoke: Hypertonicity "ISN'T" velocity dependent (I accidentally said "IS") (Spasticity is the velocity dependent resistance through passive ROM).
Note: during the stretches, I am not using a considerable amount of force at any point. In fact, I only take the child gently into end-range and then I stabilize them there to induce a stretch. If the child is resisting the stretch, they will be strengthening the side of the neck they are resisting with thus further shorten the length of that corresponding musculature. As such, "fighting" a resistant child during a stretch of the short side will lead to further exacerbation of their torticollis via strengthening/shortening a side that's already short. Using this same logic though, for a child that is hyper resistant to physical contact and stretching, perhaps consider this technique contralaterally to strengthen/shorten the elongated side.
For a 5-minute guide on therapeutic interventions for torticollis, check out my other video:
• 5 Minutes of Torticoll...
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This video was made for the purposes of providing guidance to newer pediatric physical therapists and is meant to be coupled with their own clinical decision making and judgment. Given the implications of different medical conditions, the education and techniques used in this video may not be entirely applicable for every patient and should not be used if contraindications are present.
Copyright, Liability Waiver and Disclaimers. All rights reserved.
This publication may not be reproduced in any part, transmitted in any form, or stored in a retrieval system except under the express written permission of Warren McAdams, PT, DPT as permitted under the United States Copyright Act.
Information provided is for the guidance of licensed physical therapists only and is not meant to supplement a formal physical therapy evaluation or physician visit. Seek consult from your appropriate health care provider for questions pertaining to your medical concerns. Warren McAdams will not be liable for any injuries or damages resulting from advice and/or treatment strategies presented in this video thus will not be liable for any consequential, direct or indirect, incidental, or punitive damages or harm arising out of access to or the use of any content.
#physicaltherapy #education #training #rehab #torticollis
Apart from such good explanation you are a one cutest physiotherapist I've even seen 😁
That is a very flattering comment which brought a smile to my face. Thank you so much for that.
Wow! This was so so so helpful and thorough that I feel so much more equipped to support my baby's needs now as she stretches and strengthens her neck! Thank you!
I'm so glad that the video was helpful for you! It's great to hear that you feel more equipped to support your baby's needs. Remember that every baby is different, so always consult with your pediatrician and a pediatric physical therapist that can personally perform an evaluation to ensure you are providing the best care for your baby. Keep up the good work, and best of luck to you and your baby!
You a very special human I'm thankful for your work
Gosh, that is such an incredible comment to receive. Thank you so much for those words. I appreciate it very much, and it definitely helps motivate me as a PT.
Just wondering, where is your office based at? Would be wonderful if it were in Florida! I just took my 4 month in to see a physical therapist in regards to her right torticollis and I just felt rushed and that he wasn’t super educated in this type of problem. Frustrating. First I was told when she was born that she will “grow out of it.” Her case is mild because I’ve been on top of doing stretches BUT she still favors leaning her head to the right.. 😕 THANK YOU so very much for you video. Wish there were more of you!
I’ll be using these techniques with my 2 month old. Exceptionally knowledgeable and so thorough!! Thank you
Thank you for your kind words! Positive feedback is always very motivating and makes me happy to continue working hard as a PT. So I'm glad you found the video informative and valuable for your 2-month-old. And while these exercises and activities may be helpful, remember to consult with a physician and a pediatric PT who can perform an in-person evaluation to check for any other conditions that may lead to torticollis so they can monitor your child's progress and address your child's specific needs.
Very interesting, Thank you for sharing
My pleasure! I'm glad you enjoyed it!
@@WarrenMcAdamsPT I hope to see more of your videos
Thanks sir ...its a great video
Thank you for the wonderful comment. I appreciate it Haroon!
Your voice works as ASMR for me :-)
Haha, I must admit that I laughed when I read your comment.
Thank you for the added happiness to my day.
1:01 my daughter has been holding it to one side but looking and tilting to one side. What can I do to help?
Stretches at 17:45
I have an 11 month old, could I use a neck brace for short periods of time to keep neck from leaning right?
It is generally not recommended to use a neck brace for infants with torticollis, as it may impede the natural movement and development of the neck. Instead, I prefer bolstering as it is less restrictive. However, depending on the child, that can be a suffocation risk if they cannot reposition their own head (the concern applies more so to infants or the very developmentally delayed).
Physical therapy is typically the recommended treatment for infants with torticollis. A physical therapist can work with you and your baby to develop exercises and stretches to improve the range of motion in the neck and promote proper muscle development. It's important to consult with your pediatrician and a pediatric physical therapist before beginning any treatment for your baby.
Plz reply the best sleeping position for troticollis baby
Hello sir my baby is about now 1 year 2 month old and he suffering from torticollis. We should more doctors and did X-ray but no problem found of reason. Sir if I do 1 exercise regularly can be my son get rid of this
Unfortunately, without evaluating your child, I don't have the insight to answer that question. I will say though that, typically, one exercise alone is not enough to resolve a condition like torticollis as it often has multiple contributors (muscle weakness, muscle shortening, maybe visual impairment, etc.) that could cause the postural asymmetries. It is good that you correspond with a physician and have x-rays to rule out certain conditions that could lead to torticollis. Still, I would consult with a local PT who can visit in person to give you advice specific to your child's particular needs.
My son is about to be 4 months old and I believe he has this. How can I contact you?
Lois,
At this time, there is a PT licensure compact across 34 states, but there is far too much grey area for my comfort to consult with you. Because, unfortunately, I am not well versed in the legal implications of practicing across state lines (as we likely do not live in the same state).
If you feel your infant may have torticollis, I recommend discussing your concern with the pediatrician either over the phone or during your next scheduled visit. At 4 months of age, it's usually quick and easy for a physician to refer your child to home health physical therapy for an evaluation and treatment. In that setting, a PT can come directly to your home to facilitate treatment sessions. Or, given the pandemic, many agencies still have the option to enable telehealth visits in which a provider will work with you over an audiovisual platform (like FaceTime, Zoom, WhatsApp, etc).
Best regards,
Warren
my son is about to be 1 month old can we use this procedure to my baby?
While these techniques are commonly used in pediatrics due to their low likelihood for injury, I have not assessed your child or their head and neck integrity. Many factors go into an assessment, so I suggest having a PT perform a thorough evaluation in person to give you the most accurate and safe activities or exercises specifically for your 1-month old.
Now, if your child already has the diagnosis of torticollis or if you suspect your child has said condition, you can request a PT referral from your physician, and they should have no issues sending someone out to perform an evaluation.
Hopefully this helps,
Warren