Torticollis

Pediatrics

Have you or someone you know just welcomed a new addition to the family? If so, this article may be for you! Since the promotion of “Back to Sleep” as well as babies having to spend time in the NICU or PICU due to numerous conditions, head shape issues have been increasing. Torticollis can also be caused by trauma during birth, awkward positioning in the uterus and other conditions.
When a baby is born, the bones that make up their skull are soft and gradually overtime they begin to fuse. If during this time there is more pressure put on one side than the other, the baby’s head may start to flatten more on one side. This is called “Plagiocephaly.”. Sometimes the flattening can be severe and facial features can begin to shift as well. The most notable being a shift of the ear and forehead and an asymmetry between the baby’s cheeks and jawline. If a baby spends most of the time on their back or had to spend time in the NICU/PICU, there may be equal flattening on both sides resulting in “Braciocephaly.”
Often the first time this is brought to the family’s attention is at their 3 month check-up or vaccinations. If this has happened to you, don’t fret and stay off the internet!! Most of the time this condition results from a tightness or imbalance of strength between the babies neck muscles called the sternocleidomastoid or SCM for short. If this muscle is the culprit then the condition can also be referred to as Congenital Torticollis. Torticollis can have many different causes, some worse than others, but 80% are due to muscular issues from the SCM.
The condition is most apparent around 2-3 months or older. At this time babies are getting stronger and exploring their environment more. If you notice your baby tends to look one direction more than the other, especially when they are on their back, this may be an indication of torticollis. Often the first indication is the flattening at the back of the head.
Torticollis can be easily treated without any manipulations or medications. With gentle stretches and strengthening exercises, the baby’s neck muscles can even out and this will help with their head shape as well. It is best to see your physiotherapist before 6 months of age. This is due to the skull bones becoming increasingly fused as well as the creeping, crawling and rolling when babies begin to explore their environment.
If your healthcare provider or someone you know has brought this condition to your attention, don’t worry. Come see your physiotherapist for an assessment and treatment plan that works for you and your little one.

 

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Hip Strengthening

Hips and Knees

Your Hips: The ‘Core’ of the Problem?

I think most of us by now have heard about the importance of strengthening your ‘core’. But did you know that the most important part of your core for preventing hip, knee, and ankle injuries are your hip muscles? Your hip muscles or ‘glutes’ are the largest group of muscles in your lower body and are a part of your core that are often much weaker than they should be.

So what exactly are the hip muscles responsible for? Strong hip muscles keep your spine, pelvis, knees and ankles in alignment. If your glute muscles aren’t strong enough your hips rotate and drop, your knees move inward and your feet flatten (pronation). All of these motions create more strain on the joints, ligaments and tendons of your lower body. This excessive strain often leads to injury and persistent pain. Achilles tendinosis, patellofemoral knee pain, iliotibial band (ITB) syndrome, and piriformis syndrome are all common injuries linked to weak hip muscles. Research is also showing that hip weakness is a major risk factor for non-contact ACL (knee ligament) injuries.

So why do our hip muscles become weak in the first place and what can we do about it? The latest research done by Dr. Powers who is a physiotherapist in Los Angeles, shows that our brains have only a very small area dedicated to controlling the hip muscles. It is unclear why this is the case but it may explain why the majority of us don’t naturally use our hip muscles during activities such as: running, walking and hiking. The good news is that the same research shows that exercise can change the way our brains work.

In the study, patients that took part in specific hip strengthening exercises, actually showed changes in brain function. The areas on the brain controlling the hip muscles became larger after only a week of exercise! This is important because the larger the area of your brain dedicated to a certain muscle group is, the easier it is to ‘turn on’ and strengthen that muscle. Keep in mind though, these strengthening exercises need to be done for a minimum of 3 months in order to get significant strength improvements in the muscle.

So if you suffer from ongoing hip, knee or ankle pain, strengthening your hips may be the key to getting over your injury problems. Visit your local physiotherapist and ask for an assessment on your hip strength. If your muscles are weak your physiotherapist will give you the proper home strengthening exercises to address the weakness. Through these exercises you can change your brain to help change your pain.