Treating Older Babies with Torticollis

Torticollis is difficult to treat. Plain and simple. Many therapists will tell you this, and many of us struggle with similar questions. How often should we treat it? What is considered “normal” progress? How does treatment change as the baby gets older? When is it necessary to recommend another therapist? When do we discharge the baby from therapy?

We all agree, however, that the earlier you start therapy the easier your journey will be. Young babies are more malleable. They haven’t formed atypical movement patterns that then need to be retaught. They tolerate handling very well. Physically, they are easier to treat because they are small. We can be proactive in facilitating normal motor skills rather than playing catch up later on. The list goes on and on.

As parents, it is important for you to actively participate in the therapeutic process. You must do the recommended activities constantly at home. One or two times a week with a therapist isn’t enough! Hopefully your therapist has given you play activities that you can incorporate into your day. Stretches become more difficult, certainly, but purposeful, well–thought-out play can make a world of difference in your baby’s outcomes. Be sure to have numerous options in your arsenal, so everything you do is based around the idea of stretching the neck/shoulders.

Frequency of therapy depends on many factors – therapist recommendation, insurance coverage, parent involvement, location, scheduling, etc. In my opinion, frequency isn’t as important as quality. If you are only doing once a week, and the baby is showing consistent improvement, then that seems adequate. If you are doing three times a week, and your baby is still not showing marked improvement, there might be a problem.

Sometimes, after seeing a baby for a while, I can sense that we are reaching a “plateau”. It is hard for therapists (me included) to admit this because we care so much for our patients. We can be a little protective. But truth be told, it may be time for another set of eyes. On several occasions, I have referred my patients to another therapist (and vice versa) when I wasn’t getting the results I really wanted. Each therapist comes with a new approach, additional activity ideas, a different relationship with the baby and perhaps the “key” to getting more out of the baby. It’s a win-win for everyone.

Hopefully, this information will give you more direction in deciding what is best for your baby. A qualified therapist early on is the best case scenario. And please, avoid doing the stretches that you find on the internet, as torticollis is a complex condition that requires a professional evaluation. Even if you only see a therapist a few times, at least they can get you started on an appropriate and safe home program.

In treating older babies with torticollis, the old saying “Patience Is a Virtue”, is right on the mark. It takes a lot of hard work, both from you and your therapist, but you should see gradual improvement as you go. If you aren’t, then talk to your therapist to see if any modifications need to be made.

Best of luck, and here’s to lots of straight necks!

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