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Torticollis: A Tearless Approach To Treatment

“I watched a remarkable, quiet, tearless session…that ended with his body and head in midline. No neck stretching!! No stretching of any kind!  It’s particularly appealing in that parents get to hug and hold their children and get changes…without imposing any demands.”
Billi Cusick’s PT, MS, COF

Torticollis is a term used when a baby tends to keep their head tilted or turned to one side. The most common type of torticollis in children in Congenital Muscular Torticollis. The head is positioned in various degrees of tilt to one side and then rotation to the opposite side.Evidence-Based Care Guideline for Management of Congenital Muscular Torticollis in children age 0 to 36 months describes the traditional approach to torticollis treatment, which includes stretching, positioning, and active movement on the weaker side.  The guideline does include assessing the full body, but treatment of these findings is not specifically recommended.  Traditionally, the therapist will assess the full body, but then treat the neck in isolation because this is the most visible and obvious problem area.

The TMR approach to torticollis addresses the body as a WHOLE.  Eliminate imbalances in the larger muscles to allow the tiny neck muscles to do their job spontaneously.  Its like a potted plant growing crooked.  We don’t stretch the leaves or the little stems.  We repot the roots so that the plant can grow straight.  Our visual and balance systems will automatically bring the head to the middle once we help balance out our roots, which in the body is the pelvis.

Some red flags that parents may notice outside of the head position or turning preference is that it may be harder to put one arm in the shirt when dressing, the baby always rolls to one side, or the baby learning to sit always falls in the same direction.  Some other signs are bottom scooting rather than crawling on hands and knees, cruising along the couch in only one direction, and walking with one foot turned out.

Parents are taught how to do positioning and play at home that comfortably releases the bodies restrictions. They are also taught how to monitor their child’s movement patterns over time, so that if asymmetries increase while a child is learning a new skill, they will know how to address it.

Curious if this tearless appropach may be best for you and your baby?  Call us to set up a screening at 908-543-4390.

16 replies
    • Dr. Joni Redlich, DPT
      Dr. Joni Redlich, DPT says:

      I wrote the overview specifically to torticollis, but the responses that I have been getting from my kids with CP have been incredible. I have never been overly focussed on alignment before, because I was more focussed on function. Using the TMR approach though I am able to improve alignment RAPIDLY (minutes) and then the kids are spontaneously increasing the function piece.

      Reply
    • Dr. Joni Redlich, DPT
      Dr. Joni Redlich, DPT says:

      I wrote the overview specifically to torticollis, but the responses that I have been getting from my kids with CP have been incredible. I have never been overly focussed on alignment before, because I was more focussed on function. Using the TMR approach though I am able to improve alignment RAPIDLY (minutes) and then the kids are spontaneously increasing the function piece.

      Reply
  1. Barbara
    Barbara says:

    Interesting – when I taught (teach) NDT – alignment is the key concept (for reducing spasticity or poor patterns). The issue w/ NDT is once your hands go away, so does the effect – unless practice/repetition in alignment is HUGE. (Or, well, bracing, soft or hard.)

    Reply
    • Dr. Joni Redlich, DPT
      Dr. Joni Redlich, DPT says:

      Absolutely, alignment for NDT is the key to activate: elongate, align, activate. I never had a great “elongate” tool before that worked dramatically and that the parents could easily do.

      Reply
  2. Mary Jonas-Buckley
    Mary Jonas-Buckley says:

    I have followed a few of Susan’s past experiences and treatment with children using TMR.I would like to learn more.I am now treating a few children with torticollis and want to teach the parents a different way ( without tears). I am an old friend and would like to contact her regarding her treatment and our past relationship as therapists Could you forward to her my e-mail info. thank you, Mary (Jonas)Buckley PT

    Reply
  3. Mary Jonas-Buckley
    Mary Jonas-Buckley says:

    I have followed a few of Susan’s past experiences and treatment with children using TMR.I would like to learn more.I am now treating a few children with torticollis and want to teach the parents a different way ( without tears). I am an old friend and would like to contact her regarding her treatment and our past relationship as therapists Could you forward to her my e-mail info. thank you, Mary (Jonas)Buckley PT

    Reply

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