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.

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