To our surprise, the physical therapist that has been coming over to help w/Josiah's torticollis suggested that we pursue some other avenues to make sure that his torticollis isn't being caused by something physical, rather than muscular. Since we haven't seen as consistent progress in the last month or two, she said that on rare occasions, there could be a misalignment in his vertebrae that could be causing the tilt. So she suggested we see a pediatric orthopedic to look at him and see if he should have some x-rays done.
We went to Children's and had him looked at by a nurse and a physical therapist. They did a few stretches w/him and watched him walk and crawl. After working with him for a few minutes, they said that he has great range. They said that in most cases w/torticollis, it's an issue of stretching and strengthening. From the stretches they did, they said his range is fantastic. He can stretch easily to both sides of his neck without difficulty, and they couldn't feel any muscle tightness on his left side. So they said they suspected it's not a stretching issue anymore. And from observing him, they saw that his tilt wasn't evident all the time. It seemed more out of habit and when he was in a resting state, that his tilt would come out. If it was a misalignment, then they would have seen his crawling compensating for the tilt and it would be consistently there. So they emphasized the need to do more strengthening exercises w/him. They gave us some strengthening ideas, which were very helpful since he's at that age where he won't sit still long. It really has to be something more active we can do w/him, like having him climb, doing balancing activities, or things we could do w/him at a pool.
The physical therapist did not see a need whatsoever to do x-rays or anything since she said usually in those cases, the neck muscles are still somewhat tight. But w/Josiah, they didn't feel any tightness at all and especially since his tilt comes and goes (especially depending on how active he is), they suspected that it's more strengthening we need to work on. They did mention something called the tot collar (I know, it sounds horrible!). It's a collar that you put on and they wear it for 6-8 hours/day. It's adjusted so that it's uncomfortable when you turn your neck a certain way, so it forces you to hold your head in the correct position. The idea is that if you do it for 6-8 wks, it should help break the habit of tilting the head. But the PT said she usually recommends it for cases that are worse than Josiah. But if it was something we wanted to look into later, especially if the strengthening exercises aren't working, we could meet w/her again.
I don't want to do the tot collar. The PT said that since his torticollis is so mild, it's something that Josiah could actually outgrow on his own anyway as he becomes more and more active. What a relief to hear! So we'll just keep plugging away w/our monkey. =) We have another appt in October at Kennedy Krieger (in Baltimore), which has their own cranial clinic. Not sure if we will keep that one, but we'll see how Josiah does in the coming months.
No comments:
Post a Comment