PT Corner: The Saga (Torticollis) Continues…
[Source: Heartspace PT]
by Shelley Mannell, PT, C/NDT
Unfortunately in pediatrics the saga is the continued increase in the number of children referred for torticollis. The numbers are so high that the APTA has a set of clinical guidelines for its management (1).
We have observed that this phenomenon correlates with the “Back to Sleep” campaign, which further correlates with the rise of baby equipment (that is all a variation of the supine/back-lying position). I’ve talked about various aspects of torticollis before here, here and here. As therapists we continue to work hard at promoting tummy time . But we should realize that the world order has changed – today’s babies are not ever going to come close to the 20 hours per day babies used to spend in tummy time prior to the 1994 Back to Sleep campaign (2) – it’s time to advance our practice.
Rather than thinking about torticollis as solely a musculoskeletal problem, I think we should also consider the vestibular system and the role it plays during the development of head/neck/trunk control. When a baby is born, the vestibular system is fully developed and ready to help the baby cope with gravity (3) – it’s like the Jedi force of the sensory
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