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Torticollis, more commonly referred to as wry neck or “twisted neck,” is a rather common condition in which a newborn child experiences stiffness of the neck muscles as a result of her position in the womb. This results in the child leaving her head slightly tilted as the muscles form and the tension reduces to allow her to have proper neck functioning. Other children are born with the condition because of difficulties during delivery, a decreased blood supply to the neck muscles, muscular fibrosis or congenital spine anomalies. Even if a child is born with healthy head and neck positioning, infants sometimes develop torticollis when they spend too much time lying on their backs, sitting in car seats, swings, bouncers, or strollers, or lying on play mats. While this is a rather common health problem that newborns experience, it is still typically concerning to see your child born and unable to move her neck to the full capacity. Although, treatment and therapy options are available to help your newborn overcome this problem. In most cases, torticollis resolves by three months of age. (continued inside)
DOES YOUR CHILD HAVE TORTICOLLIS? Neck Stiffness Might Be a Clue!
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DOES YOUR CHILD HAVE TORTICOLLIS? (continued)
to the positioning of your furniture and layout of your nursery. Infant torticollis is treated through a series of targeted exercises. Your pediatrician will talk to you about at-home strategies that you can use to encouragemore neckmovement to reduce stiffness and to help your child overcome the concern. It is not a good idea to try any activities that may encouragemovement of the neck without first discussing the concernwith your pediatrician, and under no circumstances should you try to force your child’s neck to move one way over another. Torticollis Throughout a Child’s Development As torticollis is a condition caused by the shortening of the strenocleidomastoid muscle, it can occur throughout a child’s development. Torticollis can manifest from a neck injury, change in neck positioning, illness, or birth (Congenital Muscular Torticollis). Children with torticollis may exhibit postural asymmetry. Most with torticollis showa left head tilt, with a right head turn. Their left shoulder may be elevated, left arm internally rotated and left handmay be fisted. Some childrenwith torticollis also have oral motor problems. Theymay have an openmouth posture and their tonguemay be pulled to one side. All of these issues will affect feeding. Some Associated Problems Related to Torticollis Include: • Delayed motor development • Visual disturbances (visual field, astigmatism) • Orthodontic and jaw problems (TMJ) • Auditory problems • Oral motor problems (jaw/tongue alignment, muscle strength) • Plagiocephaly (abnormal head shape) • Spine problems • Misalignment of the hip joint (hip dysplasia)
Understanding Torticollis Everyone wakes up time to time with a stiff neck. Sleeping awkwardly on your pillow, or falling asleep in a chair instead of your bed may leave your neck feeling tense and limit your range of motion. This is essentially the problemwith infant torticollis. The difference being that, as an adult, you know that you have the ability to move your neck and that the stiffness is a result of awkward positioning. For newborns, the stiffness in their necks is all they ever know. So, while they experience pain and discomfort from the stiffness, they are not starting to naturally move their neck in the same way as other children. This can be concerning for a parent, but it is important to recognize that there are therapeutic options to support infants who experience this problem. The best way to help your child overcome the concern is to be proactive. There is no explanation as to why some babies develop torticollis while others don’t. All babies grow in the womb, but some babies become cramped and develop this stiffness in their neck as a result. Torticollis is typically recognized by the neonatal staff in the hospital when the infant is born, but there are some cases in which you may notice the concern gradually after returning home with your infant. Symptoms Of Torticollis in an Infant Include: • Constant or almost constant tilting of the head in one direction • Demonstrated preference for looking in one direction over another • Difficulty breastfeeding on one side •Frustration and difficultywith turning in one direction instead of another If you notice one ormore of these concerns, then it is a good idea to bring attention to the problemwith your infant’s pediatrician. Your pediatrician can assess the issue and consider if there is a clear preference for physical reasons or if other concernsmay be at play. For example, some infantsmay prefer one breast over another as a result of a cloggedmilk duct, or perhaps your infant looks onewaymore often than another due
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HOW CAN PHYSICAL THERAPY HELP?
It is vital to seek treatment on behalf of infants or children who are experiencing this type of head or neck positioning. If left too long without intervention, children may experience permanent disability due to shortening neck muscles. One of the first treatments doctors recommend are stretching exercises designed to lengthenand strengthen the neckmuscles holding the head in the incorrect position. 80 percent of all children respond well to this type of treatment plan and do not experience any lasting effects. If these non-invasive treatments do not work, doctors will recommend surgery to lengthen short muscles and return the child’s head to a normal position. Once completed, the child may need physical therapy to strengthen her neckmuscles and prevent the problem from recurring. How We Can Help Physical therapy is the primary treatment for torticollis. At Fitness for Health, our services are designed to facilitate gross and fine motor skills through flexibility, neuromuscular re-education, and muscle activation/inhibition techniques. Our physical therapist will first conduct an assessment to test your child’s range of motion and evaluate any other conditions that often accompany torticollis. The whole child will
be assessed to determine how torticollis is impacting overall function. Once the evaluation is complete, the physical therapist will discuss her findings and a potential treatment plan. She will educate the family on stretches and exercise techniques that should be implemented daily. Therapy may include performing stretching exercises both in the office and at home to increase range of motion and strengthen the neck muscles. Thesemay include passive stretches aswell as active stretches of the neck and shouldermuscles designed to strengthenmuscles that are used to maintain good posture. Even in infants who do not seem to be strong enough to reliably hold their own heads, these stretches and exercises can correct the problemquickly. In fact, early intervention for torticollis often provides the best results. If your child is experiencing painful, incorrect positioning of the head or neck, don’t hesitate to contact Fitness for Health today. We can help you or your little one become pain-free, improve range of motion, and eliminate torticollis for good.
Source: http://kidshealth.org/en/parents/torticollis.html http://www.healthline.com/health/torticollis
KID’S COOKING CORNER Banana Foster Parfaits
• 2 cups plain 2% reduced-fat Greek yogurt • 1/4 cup chopped pecans, toasted
• 2 large ripe bananas • 6 Tbsp dark brown sugar • 2 Tbsp unsweetened apple juice • 1 Tbsp unsalted butter • 1/4 tsp salt
Directions Peel bananas and cut each in half lengthwise. Cut each half into 3 pieces. Combine sugar, apple juice, and butter in a nonstick skillet. Cook overmedium- low heat for 3 minutes or until mixture begins to bubble. Add bananas to pan; cook for 2 minutes or until bananas begin to soften. Spoon 1/2 cup yogurt into the bottom of each of 4 parfait glasses. Divide banana mixture evenly among glasses. Top each serving with 1 tablespoon chopped and toasted pecans.
EXERCISE ESSENTIALS Use This Exercise to Carry Your Infant if She Has Torticollis Exercises copyright of
Theworldhealthcommunity continues tomonitor closely theemergence of the SARS-CoV-2 virus and the disease it causes, coronavirus disease 2019 (COVID-19). At this time, no one knows how severe this outbreak will be. What we do know is that things will be getting worse before they start to improve. Governor Hogan recently mandated that only essential businesses remain open. We may be deemed to provide essential services. However, given the uncertainty of the near future, I feel that it is imprudent and irresponsible to jeopardize the health and welfare of our clients and employees by continuing to remain open. We are closed for face-to- face business until further notice. WenowofferTelehealthServices! Occupational therapy andphysical therapy clients, please check with your insurance providers to learn if Telehealth is covered. Clients with Kaiser Permanente and Tricare are covered through their plans as is. HSCSN requires that we request additional approvals. We will be submitting those requests. We ask that all of our clients and staff follow theCDC recommendations for reducing the transmission of communicable diseases and inform us if you or someone in your family has contracted the virus or has been in contact with someone who has been diagnosed with it and is self-quarantined. This is a dynamic and unprecedented point in our history. We will continue to monitor the situation and actively follow guidance from local and federal governments and the Center for Disease Control, and we will provide you with updates when we have them. If you have any questions, please contact us at email@example.com or at 301-231-7138. Thank you. Marc Sickel , President, Fitness for Health UPDATE ON FITNESS FOR HEALTH’S SERVICES NOWOFFERING: TELEHEALTH!
Cervical Sidebending Stretch: Carrying Your Baby Hold your baby with one arm between her shoulder and neck, while the other hand is holding the shoulder. Your forearm will be between the child’s ear and shoulder to help stretch the tight muscles. You can use your forearm to lift your child’s head away from the shoulder to get a side-bending stretch. Use your forearm to gently move your baby’s head away from the shoulder you are holding. Your other armgentlymoves the shoulder down as shown. Gently stretch your baby’s neck upwith one armand shoulder gently downwith the other, as shown in the image with opposing arrows. Always consult your physical therapist or physician before starting exercises you are unsure of doing.
GIVE YOURSELF AN IMMUNITY BOOST! These Tips can Help You Stay Healthy: 1. Wash your hands frequently with warm, soapy water for at least 20 seconds. 2. Cover your mouth with tissues whenever you sneeze and discard used tissues in the trash. 3. Avoid people who are sick with respiratory symptoms. 4. Clean frequently touched surfaces. 5. Avoid touching your face with your hands. 6. Decide to get up and get moving.
Occupational Therapy, Physical Therapy, & Therapeutic Exercise for Children, Adults, Seniors, & Special Needs Have an issue other than torticollis? We can help get you back to better health. Schedule your appointment today!
7. Make a habit of 20-30 minutes of physical activity a day. 8. Maintain a nutritious diet heavy on fruits and vegetables. 9. Take essential vitamins such as Vitamin C, D, and B6. 10. Aim for 8-9 hours of sleep each night. 11. Don’t smoke.
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12. Drink plenty of water. 13. Take time to stretch. 14. Take frequent breaks for breathing exercises. Inhale and exhale deeply. 15. Continue your home exercise program 2-3 times per week.Page 1 Page 2 Page 3 Page 4
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