A comprehensive treatment protocol for Torticollis should include:
1) Passive and active neck and trunk range of motion
2) Strengthening exercises, neck and trunk gravity assisted
3) Positioning and handling to promote midline and improve symmetry
5) Righting reactions in supine, prone and sidelying
6) Postural education
7) Visual exercises to promote active head rotation
8) Environmental adaptations
Perform Stretches and range of motion activities…
1) Side-bending: With child positioned comfortably on back either on softly padded floor or therapist/caregiver’s lap begin tilting the head to opposite side. If you are trying to stretch the muscles on the left side, place your right hand on child’s left shoulder. Press down as you use your left hand to tilt the child’s right ear to his/her left shoulder. Hold this stretch for 10-15 seconds
2) Rotation: Place your right hand on child’s right shoulder, cup child’s head with left hand. Slowly turn child’s nose to left shoulder. Hold this stretch for 10-15 seconds.
1) Encourage “Tummy Time”: Place child on stomach, even if it is a few seconds at first…We want to work up to 30 minute intervals-Give child breaks when they become agitated, this should be a positive experience!!
2) Utilize bolster, you can roll up small towel or blanket and place this under the child’s chest. Position arms under the bolster with hands flat, make sure the chin is over bolster so mouth and nose get plenty of air!
3) You can also use the “Boppy Pillow” a product marketed to help parents during feeding, to promote sitting and play. This functions similar to the bolster, with a bit more support to promote child active head/neck control as well as upper body strengthening.
4) The “Tumzee” is a great tool to encourage active play during tummy time…by utilizing the incline design it assists in neck and back musculature development and allows upper extremities to manipulate toys as well as prop up for weight bearing in prone.
1. Hold toys so that your child has to look up and toward limited side.
2. Position your child in the crib so that activities in the room encourage him to look toward limited side.
3. While bottle-feeding your child, position him to face toward limited side.
4. While holding your child across your shoulder, position him to face toward from limited side
Carrying technique for child with left-sided tilt