Stollery Children’s Hospital Canada T6G 2B7 Torticollis Stretches: … · 2019. 5. 21. · C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip \torticollis

$Page 1: Stollery Children’s Hospital Canada T6G 2B7 Torticollis Stretches: … · 2019. 5. 21. · C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip \torticollis$
__________________________________________________________________Stollery Children’s Hospital__

8440-112 Street Edmonton, Alberta

Canada T6G 2B7

_________________________________________________________________________ www.albertahealthservices.ca

Drafted: October 2011 C:\Users\Abaird\AppData\Local\Temp\Temp2_Handout torticollis exercises.zip\torticollis exercises\Left Carry Position (Left Stretch).doc

Torticollis Stretches: Left Carry Position

1. Hold your baby in a side lying position on his/her left side. 2. Place your left arm between baby’s left shoulder and neck.. 3. Place your right hand on your baby’s left shoulder. 4. Gently use your left arm to move baby’s head away from his/her left shoulder. 5. Gently but firmly use your right hand to pull the left shoulder down slightly during stretch.



Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\left sided righting reactions.doc

Torticollis Strengthening: Left Righting Reactions

1. Sit your baby facing you. 2. Slowly tilt him/her to the right. 3. Wait 5-10 seconds, your baby should correct his/her head position by lifting his/her head towards the left. This strengthens the left neck muscles.

Drafted: October 2011



Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\Left Sided Tightness.doc

Torticollis Stretches: Left Sided Tightness

Torticollis in babies occurs when there is tightness in a muscle called the sternocleidomastoid (SCM). This muscle tilts the head to the left and rotates the head to the right. If babies have this tightness they will have a positional preference and this can lead to a flat spot on the right side of the head. This muscle will need to be stretched in both of its directions to correct the tightness. Each stretch will be held for 10-20 seconds and repeated 3 times, 5 sessions per day. Try pairing the stretches with diaper changes or a bottle to ensure you repeat them 5 times throughout the day. Rotation Stretch: 1. Lay your baby on his/her back. Hold the right shoulder down with your left hand. 2. Gently turn your baby’s head towards the left shoulder using your right hand on your baby’s left cheek. Use a toy to bring your baby’s attention to the left to make this stretch easier. 3. Hold the stretch for 10-20 seconds. Side Bend Stretch: 1. Lay your baby on his/her back. Gently pull the left shoulder down with your right hand. 2. Keep baby’s nose pointing towards ceiling. 3. Curl your left hand around your baby’s head and gently bring baby’s right ear to right shoulder. 4. Hold the stretch for 10-20 seconds.


Stollery Children’s Hospital Northern Alberta Neonatal Intensive Care Program Royal Alexandra and Stollery Children’s Hospital Sites

Left Sided Torticollis: Your baby tilts his/her head to the left and prefers to look to the right. Starting Position: • For the following stretching exercises, the parent sits

with his/her back against the wall and knees bent. • Place the child in your lap, with the child on her back

and knees tucked. • Or place baby on flat surface (bed, couch, floor) while

you kneel or stand above. Neck Side Flexion

• Hold the child’s LEFT shoulder down with your RIGHT hand • Place your LEFT hand on top of the LEFT side of the child’s

head, and slowly bend her head towards her RIGHT shoulder

• Hold the position for up to 10 seconds. Repeat 2-3 times, at every nap.

Neck Rotation • Place your LEFT forearm against the child’s RIGHT

shoulder, and cup the child’s head with the same hand. • Use your RIGHT hand to hold the child’s chin. • Slowly rotate the child’s face to her LEFT. • Hold the position for up to 10 - 15 seconds. Repeat 2-3

times, at every nap.

Tummy Time Positioning • When the child is on her stomach, position all toys so

that the child has to turn her face to the LEFT. • You can also have your child lie on your chest with

his/her head turned towards his/her LEFT side. • Working on getting your baby to lift his head straight up

to look at toys is also helpful for general neck strengthening

STRETCHING AND POSITIONING FOR A LEFT SIDED TORTICOLLIS


Carrying Position • Hold the child facing away from you, in a side-lying

position, with the child’s LEFT ear resting against your LEFT forearm.

• Place your RIGHT arm between the child’s legs and support the child’s body.

Other Suggestions • Hold toys so that the child has to look up and out to her LEFT • Position child in crib so that activities in the room encourage your child to look LEFT. • While bottle feeding the child, position her to face LEFT • While holding the baby across the shoulder, position her to face LEFT • Encourage your child to look to his/her LEFT side while sitting in the car seat. You

can stick toys to the window to his/her LEFT side to encourage this. How To Make Tummy Time And Stretching More Enjoyable For All • Blow bubbles to the LEFT of baby. This will encourage baby to look towards the

LEFT. • Tickle, laugh, sing songs, make funny faces • Have someone help distract baby. Older siblings work well as do pets. • Use a mirror to the LEFT of baby to capture his/her attention. • Kisses on the LEFT cheek to make the head turn. • Blow in baby’s ear to encourage head turning to the LEFT



Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\Left Sided Upper Trapezius Stretch.doc

Torticollis Stretches: Left Sided Upper Trapezius Stretch

1. Sit your baby on your lap facing away from you. 2. Bring your right arm under your baby’s right arm and place on baby’s left shoulder. 3. Make an “L” with your left index finger and thumb. 4. Place your thumb just below the bump at back of baby’s head. Secure fingers around top of head. 5. Gently bring baby’s right ear towards right shoulder. At the same time apply a gentle downward pressure on your baby’s left shoulder. 6. While holding this position, gently tilt your baby’s head forward, moving chin towards chest. 7. Hold stretch for 10-20 seconds, repeat 3 times, 5 sessions per day.




Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\left strengthening handouts.doc

Muscle Imbalance: Left Strengthening Exercises

When your baby has a tight muscle on one side of the neck this can make the muscles on the opposite side of the neck over-stretched and weak. It is important to strengthen the weaker muscles at the same time as you stretch the tight muscles. Neck muscles can be strengthened by the way you lift, carry, hold and play with your baby. Here are some examples: Diagonal Lift 1. Place your hands under your baby’s arms and roll baby onto the right side. 2. Slowly lift your baby’s upper body off bed while keeping him/her in the right side position. 3. Your baby should use the muscles on the left side of the neck to lift his/her head while you pick him/her up. Diagonal Carry 1. While holding your baby, turn him/her to face away from you. 2. Place your left hand between your baby’s legs. 3. Put the back of your baby’s head to your right shoulder. 4. Your right arm will be under your baby’s right arm. 5. Tilt your baby to the right side. 6. Your baby should use the muscles on the left side his/her the neck to keep his/her head in midline.



Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\left strengthening handouts.doc




Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\left sustained side flex stretch handouts.doc

Torticollis Stretches: Left Sustained Side Flexion Stretch

1. Lay your baby on his/her left side. 2. Ensure shoulder is in line with body. 3. Place folded towels under his/her head. 4. Keep baby in this position for as long as he/she tolerates (working towards 2 minutes).




Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\Left two person stretch.doc

Torticollis Stretches: Left Two-Person Stretch

Rotation: 1. Lay your baby on his/her back. 2. One person place hands on both of baby’s shoulders applying a gentle downward pressure. 3. Second person place hands on either side of head and gently turn baby’s head to the left. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day. Side Flexion: 1. Lay your baby on his/her back. 2. One person place hand on left shoulder applying a gentle downward pressure. 3. Second person place hands on either side of head and gently bring baby’s right ear to right shoulder. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day.




Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\Left two person trunk stretch.doc

Torticollis Stretches: Left Two-Person Trunk Stretch

Side Flexion: 1. Lay your baby on his/her back. 2. a) One person place hand on left shoulder applying a gentle downward pressure. b) Place other hand at your baby’s left pelvis, applying a gentle downward pressure to lengthen trunk. 3. Second person place hands on either side of head and gently bring baby’s right ear to right shoulder. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day.


http://www.albertahealthservices.ca/



Canada T6G 2B7


L:\\Materials\Handouts\Torticollis Drafted: October 2011

Torticollis Stretches: Right Carry Position

1. Hold your baby in a side lying position on his/her right side. 2. Place your right arm between baby’s right shoulder and neck. 3. Place your left hand on your baby’s right shoulder. 4. Gently use your right arm to move baby’s head away from his/her right shoulder. 5. Gently but firmly use your left hand to pull the right shoulder down slightly during stretch.




Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\right sided righting reactions.doc

Torticollis Strengthening: Right Righting Reactions

1. Sit your baby facing you. 2. Slowly tilt him/her to the left. 3. Wait 5-10 seconds, your baby should correct his/her head position by lifting his/her head towards the right. This strengthens the right neck muscles.




Canada T6G 2B7


L:\\Materials\Handouts\Torticollis

Torticollis Stretches: Right Sided Tightness

Torticollis in babies occurs when there is tightness in a muscle called the sternocleidomastoid (SCM). This muscle tilts the head to the right and rotates the head to the left. If babies have this tightness they will have a positional ppreferenc and this can lead to a flat spot on the left side of the head. This muscle will need to be stretched in both of its directions to correct the tightness. Each stretch will be held for 10-20 seconds and repeated 3 times, 5 sessions per day. Try pairing the stretches with diaper changes or a bottle to ensure you repeat them 5 times throughout the day. Rotation Stretch: 1. Lay your baby on his/her back. Hold the left shoulder down.with your right hand. 2. Gently turn your baby’s head towards the right shoulder using your left hand on your baby’s right cheek. Use a toy to bring your baby’s attention to the right to make this stretch easier. 3. Hold the stretch for 10-20 seconds. Side Bend Stretch: 1. Lau your baby on his/her back. Gently pull the right shoulder down with your left hand. 2. Keep baby’s nose pointing towards ceiling. 3. Curl your right hand around your baby’s head and gently bring baby’s left ear to left shoulder. 4. Hold the stretch for 10-20 seconds.




Right Sided Torticollis: Your baby tilts his/her head to the right and prefers to look to the left. Starting Position: • For the following stretching exercises, the parent

sits with his/her back against the wall and knees bent.

• Place the child in your lap, with the child on her back and knees tucked.

• Or place baby on flat surface (bed, couch, floor) while you kneel above.

Neck Side Flexion (“Ear to Shoulder”)

• Hold the child’s RIGHT shoulder down with your LEFT

hand • Place your RIGHT hand on top of the RIGHT side of the

child’s head, and slowly bend her head towards her LEFT shoulder

• Hold the position for up to 30 seconds. Repeat 10-15 times, twice a day.

Neck Rotation (“Side to Side”) • Place your RIGHT forearm against the child’s LEFT

shoulder, and cup the child’s head with the same hand. • Use your LEFT hand to hold the child’s chin. • Slowly rotate the child’s face to her RIGHT. • Hold the position for up to 30 seconds. Repeat 10-15

times, twice a day.

Tummy Time Positioning • When the child is on her stomach, position all toys so

that the child has to turn her face to the RIGHT. • You can also have your child lie on your chest with

his/her head turned towards his/her RIGHT side.

STRETCHING AND POSITIONING FOR A RIGHT SIDED TORTICOLLIS


Carrying Position • Hold the child facing away from you, in a side-lying

position, with the child’s RIGHT ear resting against your RIGHT forearm.

• Place your LEFT arm between the child’s legs and support the child’s body.

• Carry the child in this position as much as possible. Other Suggestions • Hold toys so that the child has to look up and out to her RIGHT • Position child in crib so that activities in the room encourage her to look RIGHT • While bottle feeding the child, position her to face RIGHT • While holding the baby across the shoulder, position her to face RIGHT • Encourage your child to look to his/her RIGHT side when sitting in the car seat. You

can try sticking toys to the window on his/her RIGHT. How To Make Tummy Time And Stretching More Enjoyable For All • Blow bubbles to the RIGHT of baby. This will encourage baby to look towards the

RIGHT. • Tickle, laugh, sing songs, make funny faces • Have someone help distract baby. Older siblings work well as do pets. • Use a mirror to the RIGHT of baby to capture his/her attention. • Kisses on the RIGHT cheek to make the head turn. • Blow in baby’s ear to encourage head turning to the RIGHT



Canada T6G 2B7



Torticollis Stretches: Right Sided Upper Trapezius Stretch

1. Sit your baby on your lap facing away from you. 2. Bring your left arm under your baby’s left arm and place on baby’s right shoulder. 3. Make an “L” with your right index finger and thumb. 4. Place your thumb just below the bump at back of baby’s head. Secure fingers around top of head. 5. Gently bring baby’s left ear towards left shoulder. At the same time apply a gentle downward pressure on your baby’s right shoulder. 6. While holding this position gently tilt your baby’s head forward, moving chin towards chest. 7. Hold stretch for 10-20 seconds, repeat 3 times, 5 sessions per day.





Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\right strengthening handouts.doc

Muscle Imbalance: Right Strengthening Exercises

When your baby has a tight muscle on one side of the neck this can make the muscles on the opposite side of the neck over-stretched and weak. It is important to strengthen the weaker muscles at the same time as you stretch the tight muscles. Neck muscles can be strengthened by the way you lift, carry, hold and play with your baby. Here are some examples: Diagonal Lift 1. Place your hands under your baby’s arms and roll baby onto his/her left side. 2. Slowly lift your baby’s upper body off bed while keeping him/her in the left side position. 3. Your baby should use the muscles on the right side of the neck to lift his/her head while you pick him/her up. Diagonal Carry 1. While holding your baby, turn him/her to face away from you. 2. Place your right hand between your baby’s legs. 3. Put the back of your baby’s head to your left shoulder. 4. Your left arm will be under your baby’s left arm. 5. Tilt your baby to the left side 6. Your baby should use the muscles on the right side



Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\right strengthening handouts.doc

of the neck to keep his/her head in midline.




Canada T6G 2B7



Torticollis Stretches: Right Sustained Side Flexion Stretch

1. Lay your baby on his/her right side. 2. Ensure shoulder is in line with body. 3. Place folded towels under his/her head. 4. Keep baby in this position for as long as he/she tolerates (working towards 2 minutes).





Canada T6G 2B7


C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip\torticollis exercises\Right two person stretch.doc

Torticollis Stretches: Right Two-Person Stretch

Rotation: 1. Lay your baby on his/her back. 2. One person place hands on both of baby’s shoulders applying a gentle downward pressure. 3. Second person place hands on either side of head and gently turn baby’s head to the right. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day. Side Flexion: 1. Lay your baby on his/her back. 2. One person place hand on right shoulder applying a gentle downward pressure. 3. Second person place hands on either side of head and gently bring baby’s left ear to left shoulder. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day.





Canada T6G 2B7



Torticollis Stretches: Right Two-Person Trunk Stretch

Side Flexion: 1. Lay your baby on his/her back. 2. a) One person place hand on right shoulder applying a gentle downward pressure. b) Place other hand at your baby’s right pelvis, applying a gentle downward pressure to lengthen trunk. 3. Second person place hands on either side of head and gently brings baby’s left ear to left shoulder. 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day.





Canada T6G 2B7


Torticollis Stretches: Suboccipital

1. Lay your baby on his/her back in front of you with his/her head closest to you. 2. Place your fingertips of both of your hands behind head, below bump at back of skull. 3. Gently lift head tilting chin forward towards chest. (Very small movement) 4. Hold stretch 10-20 seconds, repeat 3 times, 5 sessions per day


Documents

Stollery Children’s Hospital Canada T6G 2B7 Torticollis Stretches: … · 2019. 5. 21. · C:\Users\Abaird\AppData\Local\Temp\Temp3_Handout torticollis exercises.zip \torticollis