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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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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 […]

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

“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.