The ABC’s of Torticollis

A: What is it?

  • Torticollis is a very common diagnosis seen by pediatric physical therapists.
  • It occurs when the neck muscles are tightened on one side and weak on the other side.
  • Tightness in the sternocleidomastoid (SCM) muscle on one side of the neck is usually to blame. Tightness can also occur in other muscles of the neck and shoulders.
  • This causes an abnormal position of the head and neck.

B: What does it look like?

  • Tilting of the head to one side:
    • You may notice that your child tilts his head to one side, causing one ear to be closer to the shoulder on that side.
    • This is often noticed when lying down or when in the car seat.
  • Preferring to look in one direction:
    • You may notice that your child has a preference for looking to one side, rather than straight ahead.
    • In older babies, you may notice that your child is able to look straight ahead but has difficulty turning to look to one side.

torticollis

Image by Jennuine Captures Photography on Flickr (https://www.flickr.com/photos/picturepurrfect685/7024053515/in/photolist-bGG7oX-ovEFGd-oeHKfv-ow5qb2-ow955q-oeSiuL-oukqhG-ovXSWo-owkuqq-oy6Vw4-owoYLC-ovKW6p-oeTkqK-6oepds-ow2AUT-otKQET-owjZpR-osFqg1-owaUe7-ovX5h9-ouAcrE-oe3vaH-ocEMnT-oeHAi2-odbM5u-owrsKR-osQbzq-odb8DN-osQDmS-oeqXZc-oeWsro-oez7Du-ovVKsF-oukpTA-oeSmb5-oexu2f-ow4XEF-oePcSM-ovZDZe-ow9xMj-owEuQB-ovR76G-oyevvH-oun1UR-oupE2Y-oy4K18-ou3HnJ-7a2eWF-ovqnjY-ovsyRS)

C: How is it treated?

  • If you think your child has torticollis, you should make an appointment to visit your pediatrician.
  • Your pediatrician should then refer you to a pediatric physical therapist.
  • There are 3 main approaches to treating it:
  1.  Positioning: Look at your baby’s head position throughout the day. Help your baby keep his head in a straight position, looking forward. It can be helpful to use small towel rolls to position your baby’s head when in a car seat or bouncer seat. Do not place towels in cribs or any other sleeping areas.

torticollis2

Image by Jennifer on Flickr (https://www.flickr.com/photos/nathaniel_mark_2011/5695100104/in/photolist-xmY5bR-7JH55s-4HJ5qb-6b59fK-NQVE5-9FfSR7-5v3coc-6PsjcK-4Wx9kH-6CWQza-j489h-5iVbeZ-ouhjGf-bPRJCR-oN6TqK-3Kt6s4-oC7ch-aAEgzp-4oNXAG-ekift-o7vJbn)

2.  Tummy Time: This is crucial for your baby’s development and it helps strengthen the neck muscles. Time spent on the tummy can also prevent plagiocephaly (flattening of the back of the head). You want to do this in 10-15 minute intervals throughout each day.  If your child does not tolerate lying flat, try propping him on a towel roll/crescent shaped pillow or over your legs.

torticollis3

Image by Jon Pinder on Flickr (https://www.flickr.com/photos/rofanator/16552752212)

3.  Stretching: Your therapist should provide you with specific stretches depending on your child’s torticollis. Only perform stretches with instruction from your physical therapist. In most cases, you cannot stretch too often. Many children tolerate stretching well when sleepy or when taking a warm bath.

About the Author:

Abby McAvoy, Doctor of Physical Therapy, graduated Cum Laude from the University of Georgia in 2012, with a B.S. in Health Promotion and Behavior. In 2015, she received her Doctorate of Physical Therapy from Armstrong State University in Savannah, GA. Abby is a member of the American Physical Therapy Association (APTA) and presented her capstone research at the APTA’s national Combined Sections Meeting in 2014. During a clinical rotation in an outpatient pediatric facility, she discovered a great passion for working with the pediatric population and decided to pursue a career in pediatric physical therapy post graduation. Abby hopes to expand her skill set by obtaining specialized training in aquatic physical therapy, manual therapy, and the NDT treatment approach, in order to provide the most comprehensive physical therapy services possible to her patients at The Therapy SPOT. In her free time, she enjoys spending time with family and friends, cooking, and being outdoors with her dog.

The Therapy S.P.O.T. – Speech, Physical, and Occupational Therapy

Our multidisciplinary therapy center was established in 2007, and is committed to providing quality therapy services in a fun, family and child centered environment. We provide pediatric speech, feeding, physical, and occupational therapy as well as adult speech and swallowing therapy.  Our therapists have unique and specialized skills and training, and we strive to pair our patients with the therapists who will best meet their specific needs.  You can learn more about our services at http://www.therapyspotstatesboro.com.  Questions or concerns?  Call us at (912) 681-7768 for a free consultation.

www.jasonhurstphotography.com ©Jason Hurst Photography 2014-2015
http://www.jasonhurstphotography.com ©Jason Hurst Photography 2014-2015
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How Do I Know If My Adult Loved One Needs Speech Therapy? Watch For These Six Changes

Changes to watch for:

  • Decreased swallowing ability: difficulty chewing, choking/coughing when eating/drinking, residual food in mouth following swallow, wet/gurgly voice, throat clearing after swallows, delayed coughing (several minutes after swallowing), runny nose/sneezing, and oxygen fluctuations during meals
  • Diagnosis of CVA (stroke), Traumatic Brain Injury, aspiration pneumonia
  • Change in communication or cognition: poor attention, decreased memory, problem solving/judgement, safety awareness, inability to find words, producing ‘nonsense’ words, or difficulty understanding speech
  • Tracheotomy patients unable to produce speech
  • Patients with progressive diseases who have difficulty speaking and may benefit from the development and training of augmentative alternative communication devices prior to progression of disease
  • Recent inability to make voice (constant hoarseness)

Ok, so I think my loved one may benefit from speech therapy.  Now what?  Talk to their doctor or nurse, ask questions, and request a referral.  Friends and family members identifying patients serve as advocates, providing each patient with the opportunity for improved quality of life!  In many cases, insurance covers the cost of therapy and your entire family can reap the rewards of improved swallowing and communication!   

Speech therapists are essential resources for adults experiencing difficulty communicating and swallowing in homes, hospitals, rehabilitation facilities, and assisted living facilities to assist patients’ ability to maintain current level of function for prolonged periods of time, improving overall quality of life.  And, yes, The Therapy SPOT offers speech therapy for adults! We have speech-language pathologists on staff with experience and expertise in treating and evaluating adults with communication and swallowing disorders.  

Speech therapists complete:

  • Aphasia therapy (post stroke/TBI)
  • Dysphagia therapy (following decreased swallowing function)
  • Augmentative/alternative communication training
  • Neuromuscular electrical stimulation therapy for dysphagia
  • Cognitive linguistic therapy
  • Speaking valve training with tracheostomy patients
  • Voice Disorder therapy

About the author:  Danielle Carey, M.S., CCC-SLP, became a licensed speech-language pathologist in 2012, treating patients mainly in hospitals and subacute rehab centers with clinical time spent in the public school and at a private practice treating patients ages 2-60+.  She received her bachelor’s degree in communication sciences and disorders with a minor in child development and family relations from East Carolina University.  Danielle received her master’s degree in Speech-Language Pathology from Old Dominion University.  She is a member of American Speech-Language-Hearing Association.  Danielle received VitalStim certification (neuromuscular electrical stimulation) in 2014 to use for adults with dysphagia (swallowing impairment).  She enjoys treating patients ranging from early intervention age through our older adults.   Danielle  enjoys working at The Therapy SPOT with both children and adults.  She is passionate about speech-language pathology and enjoys completing continuing education courses and sharing knowledge with colleagues.  Danielle and her husband Jared have one spunky daughter, and love to travel and take her on adventures.  In her free time, Danielle enjoys reading, riding horses, cooking, and spending time at the beach.

The Therapy S.P.O.T. – Speech, Physical, and Occupational Therapy

Our multidisciplinary therapy center was established in 2007, and is committed to providing quality therapy services in a fun, family and child centered environment. We provide pediatric speech, feeding, physical, and occupational therapy as well as adult speech and swallowing therapy.  Our therapists have unique and specialized skills and training, and we strive to pair our patients with the therapists who will best meet their specific needs.  You can learn more about our services at http://www.therapyspotstatesboro.com.  Questions or concerns?  Call us at (912) 681-7768 for a free consultation.

www.jasonhurstphotography.com ©Jason Hurst Photography 2014-2015