A Balanced Body Opens Doors

I have been working with a family visiting from out of the country over the past month.  His parents were very concerned about his motor development.  Addressing this little guys postural asymmetries using the TMR approach gave him the opportunity to quickly and spontaneously learn new skills.  Within days he was crawling and within weeks he was pulling to stand.  His head control developed and sitting balance became strong.  As this family heads back home with the knowledge to treat their own child, I shared with them some things to look for in the coming months.

Postural asymmetries are very common with children with developmental delays.  The children have found patterns of muscle activation that are easiest for them to use and then repeat these motions over and over.

These asymmetries are not always obvious if you don’t know what to look for.  Once you are tuned in you can make changes much more rapidly than if you focused on what is hard for the child to do and relied simply on practice of those skills.

  1. Torticollis: If a child’s head is tilted and/or turned and having difficulty looking the other way, don’t just focus on the neck.  Make sure the child’s whole body is in balance, not just the muscles they are beginning to activate.
  2. Rolling: The child should roll both directions.
  3. Sitting: The child reaches to each side to play with toys.
  4. Crawling: A symmetric opposite arm/leg pattern is ideal.
  5. Pulling to Stand: the child should be able to pull to stand leading with either leg.
  6. Walking with equal step length between left and right legs.  With walking experience, arms should lower and arms should swing with left arm swinging forward with the right leg and right arm swinging forward with the left leg.    

Tightness always wins!  So if you are working on building “strength” with your child, be sure to rule out any imbalances and turn an uphill battle into rapid change and spontaneous development of new motor skills.

Want to learn more?  Call us at 908-543-4390 or send us an email at info@kidpt.com.

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Torticollis

What does torticollis look like? A child will tilt their ear towards the shoulder and will turn to the opposite direction. A child with left torticollis will tilt their head to the left and prefer to look to the right. A child with right torticollis will tilt their head to the right and prefer to […]

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Torticollis: Addressing the Full Body to Treat the Neck

The child in utero is curled up tight to fit in such a tight space.  If a baby’s neck is tilted, it is visually obvious to the parent and pediatrician.  If they have asymmetry elsewhere the observations may be more subtle.  It may be harder to put one arm in the onesie, the child may prefer to play with toys on one side, or the child may crawl with one leg dragging behind.  Read more

Pregnancy, Pain and Self-Healing

A week ago today I sat on the floor crying because I couldn’t find a position to get up that wasn’t excruciating.  As a physical therapist it is inevitable that the professional will at some point become the patient.  I’ve been there several times before.  Once for a whiplash injury, another time for chronic vertigo and a third time for a shoulder problem.  My last pregnancy I had a lot of pain in my back, pelvis and legs.  There were many times that I could barely walk and trying to work through this was rough.  I almost passed out one time from excruciating pain while walking in a store. Advice from my OB and physical therapist friends didn’t help.  After several months I found a chiropractor that gave me some relief, but I was dependent on my visits and it was expensive. Read more

TMR: Fast-tracking the Speed of Progress in Pediatric PT

Physical therapists work with so many different populations and within those populations are completely different expectations for how quickly the person will achieve their goals. This is a significant issue when dealing with insurance companies. I have been frustrated many times when an insurance company wants to treat a child with a developmental disability with the same progress expectations as an adult with a knee replacement. On the other hand, it is also an issue when children are coming for therapy week after week for years and sometimes it develops into an unclear end and amorphous goal. Read more

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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.

TMR TOTS: Week 1

Its been 3 work days since I came back from the TMR course. I’ve been trialing it out with many of my kiddos. Its definitely taking less time to do the assessment of the 7 positions and to determine which is the hard vs. easy side for each motion. I do get consistent improvement in mobility by doing the TMR method. I am still waiting to see the functional changes before I know whether this is going to be a new tool in my toolbox or not. I plan to do some videotaping in order to look at the subtle changes that may be occurring. Read more

Adventures in PT Land

I just came back from 2 long days at a course called TMR (total motion release) for TOTs. I have been looking into the TMR program since last year around this time, but had only read about it for adults. The creator is a marketing guru if you ask me. I wasn’t too attracted to it initially. Orthopedics is not my thing and I’ve never been good at taking ortho topics and applying it to the kids. I have felt for a long time though that there is a lot of knowledge in ortho land that could help the kids gain mobility- I just never knew how to access this information in a way that I could apply to the population that I work with. Read more