As kids get bigger I find that we often continue to see the tilt from having torticollis. This could be at the neck or the trunk. This is because they are often weight shifted towards the longer side because the tighter side is better at turning on to right their body so they don’t fall. This means that they are always slightly off of midline so their body isn’t recognizing true midline and it is responding to the altered midline making their short side continue to over fire and their lengthened side under fire.
So, what can we do about this? Here are some ideas that can help but every time they have a growth spurt you may see it come out again so be diligent with working some of these ideas into your day to day!
For purposes of not confusing everyone the exercise examples I give will be based on a child with a left tilt. So that means the left side is shortened and the right side is lengthened. So we want to stretch the left side and strengthen the right side. We also want to shift the weight from primarily being to the right so it can realign in the middle.
- Climbing leading with the right leg (lengthened side): Kids will often lead with the leg on the left (shortened side) because they are used to shifting their weight onto the right (lengthened side) because they know that their left side will stabilize them. So, find the just right climbing challenge for your child (could be stairs or could be complex play structures or rock walls) and have them just lead with their right (lengthened side). This will cause them to shift their weight onto the left (shortened side) and activate the right (lengthened side) so they don’t fall to their left.
- Standing with the left leg (shortened side) downhill: You can also use a small step to put the right foot (lengthened) on if you don’t have a hill or a wedge or a ramp. By putting the right foot higher than the left foot you are shifting the weight onto the left foot so they have to use their right side to stabilize and maintain balance. The closer together the feet are the more they have to work to hold their balance and activate the right (lengthened side). To make it fun I love to play catch with a ball or balloon or even better, the Olly Ball!
- Left (shortened side) side sitting: Side sitting is a great way to lengthen the left (shortened side) and activate the right (lengthened side). You can also use it for playing games or reading books so that they hang out in this position for a longer period of time. Try to make it so that they don’t have to put their left hand (shortened side) on the ground. By putting the hand on the ground to the side they are widening their base of support so that they don’t feel as unstable and their right (lengthened) side doesn’t have to activate as much to keep them upright.
- Sit with a folded towel under right hip (lengthened side): If side sitting is too challenging you can fold up a towel and place it under the right hip (lengthened side), which will tip them to the left (shortened side) and encourage them to activate their right (lengthened side) muscles. You can play games, read, color, or any other sitting activity.
- Therapy Ball: Here is a video with a baby showing how to use it for torticollis. You can make this fun by singing songs or having them reach for items items to throw. You want to make sure they ball is shifted to their left (shortened side) so they are activating their right (lengthened side).
- ‘Tummy Time’: You can never have too much tummy time. This can be done directly on the floor or it can be over a cushion (or peanut ball or foam roller). The more of their trunk they have off the support surface the harder they have to work. You can do a puzzle or read a book or play a game. I recommend having them use their right hand (lengthened side) to move pieces, turn pages, etc as this will cause them to shift onto their left (shortened side) so that the right (lengthened side) has to activate.
- Sit ups: You can work on getting into sitting so that they are pushing up from their left (lengthened) side and leading with their right (shortened side). If you watch them getting into sitting you will probably find that they tend to do it the opposite way because it is easier to lead with the left (shortened) side. Make it a game where everytime they sit up they get to do something like throw a ball, put a puzzle piece in, etc.
- Three wheel scooter glides: Use a three wheel scooter (two wheels in front) to work on gliding with the left (shortened side) foot on the scooter and pushing with the right (lengthened side) foot. Try to see how long they can glide, can they follow a straight line, can they weave around cones. Because these scooters use weight shifting for steering the will have to adjust their weight to not just always go to the right (lengthened side) which is what their body will want to do.
I hope some of these ideas are helpful and we would love to hear some of your favorite go to’s.