Shoulder Stretch for Elevated Shoulder

Along with her right torticollis, my daughter often elevated her right shoulder.  This caused her torticollis to look a lot worse than it actually was.  Once I started doing this stretch with her regularly, I noticed that she did not raise her shoulder up as much or as frequently.  If your baby doesn't elevate her shoulder, then disregard this stretch. As you'll see below, I included a video tutorial and written instructions to show you how I do this stretch with my daughter.

Video Tutorial: 

Torticollis Physical Therapy Re-evaluation

Kellyn had her eight week re-evaluation with her outpatient physical therapist today. Kellyn must have known she had to perform because she was having "a good torticollis day." Anyways, the physical therapist noticed continued improvement in her muscle strength and flexibility. She was also happy to see that Kellyn's head tilt was negligible while lying on her back.

As you can see, Kellyn's head looks nice and straight while lying down.
Maybe she's showing off for her big brother.

1st Chiropractic Adjustment for Torticollis

As I mentioned before, Ryan and I have been considering supplementing Kellyn's physical therapy with chiropractic treatment. Before Kellyn got diagnosed with torticollis, I would have never imagined I would be taking my baby to a chiropractor. However, torticollis is a stubborn little condition that improves very gradually. So, after two months straight of daily physical therapy exercises, I was ready to take it up a notch. After hearing such awesome reviews about chiropractic from other "tort parents", I started wondering if perhaps it could work for Kellyn. After praying, researching, watching YouTube videos of pediatric adjustments, and having a consultation with the chiropractor, we finally felt comfortable scheduling the chiropractic appointment for Kellyn.

Kellyn's torticollis presentation one day after her first chiropractic adjustment.

Supported Crawling Position

You may be wondering, 'Why are you concerned about crawling? Shouldn't you be working on torticollis-specific exercises?'. By encouraging Kellyn to learn to crawl, I am indirectly treating her torticollis. Once she starts to crawl, she will hopefully be less likely to tilt her head. Before a baby crawls, she obviously needs to first be comfortable on all four's. This exercise focuses on becoming comfortable on hands and knees, which is a precursor to crawling. Below I have a video tutorial and written step-by-step instructions to show you this simple exercise.

Video Tutorial:

Consultation with Chiropractor

We recently had a consultation with a chiropractor who has experience working with babies and children.  She came highly recommended to us by our daughter's outpatient physical therapist.  My husband and I have been considering supplementing Kellyn's PT with chiropractic since we have heard a lot of positive feedback from other parents of babies with torticollis.

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Range of Motion Stretch for Right Torticollis

In addition to a head tilt, many babies with torticollis also have limited range of motion in the neck to one side.  Kellyn's limited range of motion is to her right side.  Therefore, I stretch her head in the right direction.  In this post, I will provide both a video demonstration AND a written explanation of the exercise (with pictures).

Video Tutorial:

 

Stretches Possibly Worsening Torticollis

Kellyn's outpatient physical therapist made an astute perception about Kellyn's torticollis at her physical therapy session last week.  She noticed that Kellyn was resisting frequently during her neck stretches.  The physical therapist said I should not stretch Kellyn if she is resisting because I could indirectly be strengthening the right neck muscle that is overactive.

These were the good ol' days when Kellyn was much more compliant with her torticollis stretches.
Amazing, how much can change within a few weeks time.

 

Football Hold Strengthening for Right Torticollis

This is a great exercise for Kellyn to work against gravity and strengthen her weak side of her neck muscles.  She also stretches the tight side of her trunk muscles during this exercise.  This is a great two-for-one exercise as it simultaneously works her neck and trunk muscles in different ways.  In this post, I'll include both a YouTube video demonstration AND step-by-step written instructions with a picture.  Please note that this exercise is for babies with right torticollis.

Video Tutorial:

Seven Weeks into Physical Therapy

So here are some pictures seven weeks into physical therapy. Although Kellyn has had some plateaus and regressions since her four week pictures, today happened to be a "good torticollis day." I knew I had to capture it on camera. Basically, Kellyn was holding her head at mid line a lot more frequently than usual. In addition, she was not raising her right shoulder as much as she normally does.

Since she's looking straight ahead, her head tilt is less noticeable here.
Although she still has a slight C-shaped curvature in her trunk,
it's improved dramatically since the beginning of PT.

 

Stability Ball Strengthening for Right Torticollis

Since Kellyn's left neck and trunk muscles are both weak, this is a great two-for-one strengthening exercise for her.  This exercise looks so fun that my son Luke gets jealous when I do this with her.  The only way I can complete this exercise with Kellyn is if I promise that he gets a turn doing the ball exercise after her.  Just what I need...even more physical therapy exercises to do :) Anyways, here's a video tutorial AND step-by-step written instructions (with pictures) below.  This exercise is for babies with right torticollis.

Video Tutorial:

Six Weeks of PT

So I'm not as excited about these six week pictures as I was about the four week pictures.  As you can see her torticollis looks worse in these pictures than it did just a couple of weeks prior.  Her tilt has likely worsened because she is teething.

Tilt Regression

Disappointment and frustration are starting to creep up on me again.  I felt like Kellyn's four-week physical therapy evaluation went so well and that she was improving.  I thought it was going to be a continuous improvement from there on out.  But recently, it looks like her torticollis got worse.  She seems to be tilting her head more and doing this more frequently.  And she seems to be more resistant to me stretching her neck in the opposite direction.  It's like her neck is completely stubborn and doesn't want to change.

I don't think Kellyn was too happy about getting her picture taken here.

Treating Torticollis with Alternative Medicine

So its been a little over a month of treating Kellyn's torticollis with physical therapy.  And she has certainly made progress, but she has not improved to the degree I would have expected considering how much time I spend daily working with her.  I truly believe that physical therapy is the best and most effective treatment for torticollis.  However, I am getting at the point where I would consider adding in some alternative medicine approaches to complement her physical therapy treatment plan.  If there is additional things I could be doing to help my daughter recover faster, I want to do them. 

I have heard of a variety of different alternative medical treatment approaches for torticollis.  Chiropractic, acupuncture, accupressure, massage therapy, osteopathy, cranial sacral therapy, and heat treatment have all been listed as various alternative methods of treating torticollis.  I have read numerous posts from parents who have had great success using several of these previously mentioned alternative medical approaches.  Each time I read about their experiences, I get excited about the possibility of my daughter also improving from these alternative treatments.

kudryashka © 123RF.com | kudryashka

Overwhelmed with the Treatment Process

The past couple weeks has been pretty hectic for our family.   Ryan's back has been really bothering him and he is pretty limited to how he can help with the kids or with housework.  Unfortunately, he is now unable to help me get Kellyn's in-home exercises done, so its solely up to me to make sure this gets done.  Also, we have been spending a lot of time researching and shopping around for a new car since our car got totaled from the car accident two weeks ago.  In addition, we have also had so many things like doctor's appointments and various commitments to go to.  

With so much going on, its been tricky to get in the recommended minimum of five sets of physical therapy in-home exercises for Kellyn.  I feel that Kellyn's head tilt has gotten worse recently because I haven't been working with her as frequently at home.  Regardless of what else is going on, I need to remind myself daily to make her in-home exercises a priority.  Most days, I find it unrealistic to get all five sets of her exercises done, while also attending to daily household responsibilities and taking care of my family's needs.  Each day, I feel like I can't win no matter how hard I try.  

Physical Therapy 4-week Evaluation

So today was a big day for us because it was Kellyn's 4-week evaluation at her outpatient physical therapy clinic.  Overall, it went pretty well.  Four weeks ago, Kellyn measured at about an eighteen degree tilt.  Today Kellyn was measuring at about a ten degree tilt.  So she is definitely tilting her head less.  The physical therapist also noticed improved strength in both her neck and trunk.  *Anna was also happy with how Kellyn's gross motor skills were progressing. She said that Kellyn has progressed faster than she expected in many areas.

Kellyn around the time of her four week physical therapy evaluation. 

Rolling Belly-to-Back (towards right side)

Kellyn could easily roll from belly-to-back towards her left side.  This makes sense since her trunk favors the left side.  She had a much harder time putting weight and pressure on her right side of her trunk.  Therefore, her PT really encourage us to work with her on rolling this way.

1.  Place Kellyn on her tummy and put a toy on her left side of her body.

2.  If possible, encourage her to reach her left hand up and out towards the toy.  Her head should tilt back as she looks up at the toy.

Kellyn's got some serious bed-head going on in this picture.

Four Weeks into Physical Therapy

Here are some updated pictures of Kellyn after four weeks of physical therapy.  Her left trunk tilt is much less pronounced and her right head tilt has decreased some, as well.  Her physical therapist noticed that she tilts her head more when she is looking down.  Kellyn is more inclined to keep her head straight when she is looking straight ahead or laying down on her back.  What you won't be able to see in these pictures is how much stronger she is getting at doing her strengthening exercises.  She has also had amazing progress in her motor skill progression.  In addition, I believe her facial symmetry is improving.  I am very pleased with her progress so far.

She holds her head up much more straight when she is looking straight ahead.

Cranial Facial Appointment

Yesterday, my daughter had an appointment with a pediatric cranial facial specialist.  As I mentioned in a previous post, Kellyn has some of the classic facial asymmetries that torticollis can cause: one eye smaller, one cheek fuller, one jawline more pronounced, depression on one side of her neck, and a flat spot on the back of one side of her head.  In my opinion, they are very minor and barely noticeable unless you were looking for them.  But I wanted the doctor to take a look at her and see what he thought.

The cranial facial specialist was outstanding.  He carefully evaluated every facial feature while Kellyn made goo-goo eyes at him.  After his analysis, he confirmed that she did have some minor facial asymmetries and minor plagiocephaly that that were caused by the torticollis.  However, he said that everyone's face is asymmetrical and that her facial asymmetries were not outside the normal range.  He said that the only reason I probably noticed it is because I am her mother and that the average person wouldn't have even noticed.  Phew!  That felt great to hear, especially from a specialist who stares at faces all day long.  If anyone would be critical about that sort of thing, I am assuming it would be him. 

Kellyn's Progress in Physical Therapy

So Kellyn has been in physical therapy now for about three weeks.  Overall, I think she is making good progress.  I have noticed that her right head tilt is not as pronounced as it previously was.  Also when I tilt her to her right, she is now able to pick her head up much easier than she used to.  So her neck muscles have definitely strengthened.  Her trunk is much less inclined to tilt to the left now too.  I think the lessening of her trunk tilt is a more dramatic improvement compared to her the decrease in her head tilt.

TOT Collar Review

I am the type of person who wants to feel like I have exhausted EVERY avenue possible to fix a problem.  So when I heard about the TOT collar on a torticollis forum, I immediately started researching it.  Basically the TOT collar is a device to help correct torticollis.  It is is made out of soft tubing that goes around the child's neck.  The TOT collar has two vertical nylon tubes positioned on the torticollis side that discourage the child from tilting his head to that particular side.  Please note that it is very important to always be supervising your child when he/she is wearing the TOT collar.  It also should not be used while sleeping or riding in a car seat.  As far as the reviews I read about the TOT collar, they were mixed.  Some parents liked it and thought it helped, while others said it did not help as much.  But for the price, I thought it was worth it if there was a possibility of it helping our daughter.

In this picture, the TOT collar was working quite well for her.