🔴 PHYSIOTHERAPY FOR TORTICOLLIS
🌔 TECHNIQUES:
➡️MANUAL STRETCHING
➡️ MASSAGE
➡️KINESIO TAPING
➡️AROM EXERCISES
➡️PROPER HANDLING TECHNIQUES.
No matter the type of torticollis, the baby’s neck flexes or turns abnormally leading to imbalances in the neck muscles especially the Sternocleidomastoid muscle.
The affected part of the neck will have shortened, strong muscles whilst the opposite side will have stretched, weak muscles.
Regarding this, the affected part is always kept to a fixed position (lateral flexion) due to the Sternocleidomastoid muscle being shortened. There is always feeling of pain especially when active or passive movement opposes this position. This and many other associated impairments necessitate the use of Techniques listed above.
➡️MANUAL STRETCHING
In torticollis, the Sternocleidomastoid muscle becomes very shortened on one side of your baby’s neck. This causes the baby’s head remains in a lateral flexion position and your baby may prefer to keep to that position alone.
With this, we have to perform manual stretching to stretch the shortened muscle on the affected side. This will be very discomfort to your baby though but doing so will lengthen the Sternocleidomastoid muscle on the affected part of the neck to correct the muscle imbalances. This can be done perfectly when Therapist places one of the hands on the shoulder and one on the lateral aspect of the head(temporal bone) ipsilateral to the Shoulder fixated. Therapist then stretches the tight muscle by providing counter stretch force gradually holding it for 10 seconds and then releases it for 10x.
➡️AROM EXERCISES
Active Rom Exercises will be helpful to institute active movement of the baby’s neck. By using certain techniques, therapist can get your baby perform certain neck movement actively. This will not only help promotes strength in the muscles but will also help manage the pain associated with it and at large, ensure voluntary usage of the dormant muscles. Therapist can use stimulants: things the child is interested to cause the child to move the neck along especially when these objects are moved across midline.
➡️ MASSAGE
The affected part of the neck looks very tensed. The muscles are tensed and this is the main reason for excessive pains your baby perceives. After the above techniques are done, massage(light effleurrage) will be essential to relax the muscles and to help improve circulation which will help reduces pain. Massage with Shea butter or baby oil to reduce excessive friction around the area in the course of the massage.
➡️KINESIO TAPING
After all these above are done, therapist can choose to use Kinesiology tape to correct the imbalances in the muscles and to stretch the Sternocleidomastoid muscle on the affected part of the neck.
Powell (2010) concluded from three case studies that kinesio taping might decrease treatment duration due to longer lasting efficacy with Kinesio application. Öhman (2012) concluded kinesio-taping had an immediate effect on muscular imbalance in children with congenital torticollis. Kinesio Taping of Sternocleidomastoid muscle: on the affected side from insertion to origin with 5-10% tension, on the unaffected side from origin to insertion with 10-15% tension. This will help keep your stretched force for longer periods which causes relaxation later on(Relaxation principle).
➡️PROPER HANDLING TECHNIQUES
Teaching the guardians about proper handling techniques for their baby is very essential. Therapist could do all the miracles departmentally, but poor handling of the baby will prolong recovery. Therapist needs to educate them on how best to handle the baby to even assist stretching of the shortened muscle. The baby may prefer one breast to the other and the mother must not entertain that. Mothers must make sure the baby sucks the two breasts, even with the one opposite the part affected being sucked the more. This will help stretch the muscle without the baby imagining it or beyond his or her control. Guardians must also be taught to allow the baby sleep on either sides.
