Our Approach

Torticollis is tightening of the neck musculature that causes infants to have neck tightness, look in one direction, or have a head tilt. This affects their visual tracking, use of upper and lower body movements, use of their neck as needed for feeding and play, and causes muscle weakness preventing them from holding their head in an upright position.

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Torticollis Treatment

Especially in early infancy, physical therapy for torticollis can help prevent plagiocephaly, gross motor delays, and asymmetry. Common treatments include physical therapy evaluations by a torticollis specialist, infant stretches, baby massage and bodywork, and strengthening.

Gross motor milestones signify an infant's ability to perform large movements like rolling, sitting, crawling, and walking. It is important for babies to meet motor milestones because each stage in the developmental sequence lays the foundation for the next milestone in terms of stability, coordination, and balance. Early exploration and play helps with both parental bonding and with the development of an infant’s creative thinking, critical thinking, social skills and language. Signs of developmental delays include:

• Poor head control after 4 months

• Difficulty rolling or sitting by 7 months

• Not crawling by 9 months

• Not standing independently by 12 months

• Not taking 1-2 steps by 14 months

• Brachycephaly (flattening the back of an infant’s head)

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Developmental Delay Treatment

Delays in gross motor skills impact all realms of development. Pediatric physical therapy helps infants achieve their age-appropriate milestones with proper alignment and control through:

• Tummy time

• Joint compressions and alignment

• Postural training 

• Strengthening the core and glutes 

• Purposeful play

Plagiocephaly is a common condition in which an infant has an asymmetrical shaped head because of a flat spot impairing the head shape of the newborn. It sometimes described as causing a “weird shaped head” and is known as “flat head syndrome.” 

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Plagiocephaly Treatment

Pediatric physical therapy can help correct plagiocephaly by providing positioning for  pressure relief, prevent further worsening of the condition, and ensure patients are on track to meet developmental milestones to prevent the risk of developmental delays. However, after a critical period, helmets for infants with plagiocephaly are typically prescribed to correct misshapen heads.

Hypotonia refers to low muscle tone at rest. Muscle tone is the amount of tension or resistance in our muscles and having low muscle tone causes instability and a lack of control with movement. Infants with hypotonia have difficulty achieving developmental milestones due to their difficulty with maintaining head control and transitional movements. It might appear as though the child lacks motivation, has low confidence, or is a "lazy baby". However, their preference to observe instead of to explore and play is driven by their low muscle tone.  

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Hypotonia Treatment

Physical therapy will strengthen the infant’s proximal muscles (core strength) and assist with joint compression, weight bearing, and sensory input processing. As a result, infants will move out of their comfort zones to explore, play, and meet appropriate milestones.

Reflux and ankyloglossia, also known as “tongue-tie” or “lip-tie,” are highly associated with torticollis. Infants with reflux and tongue-tie often have a tight body and neck tightness. In addition, infants with reflux tend to arch or extend their backs due to the discomfort resulting from muscle imbalances. This leads to delayed rolling, sitting and crawling.

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Treatment for Infant Reflux and Tongue-Tie

Physical therapy for reflux and tongue-tie promotes optimal movement patterns, decreases body tightness, body work, builds strength, and helps infants meet developmental milestones. Pediatric Physical Therapists (“Peds PTs”) can also work alongside Speech Therapists or Lactation Consultants to help meet a parent’s feeding goals.

• Gait abnormalities (in-toeing, out-toeing, toe walking)

• Difficulty with balance and coordination

• Increased falls or decreased body awareness

• Musculoskeletal injuries (fractures, ankle sprains, knee pain)

• Neurological conditions (Cerebral Palsy, Spina Bifida)

• Down Syndrome

• Autism

Prematurity is when an infant is born before 37 weeks of gestation, or “pre-term.” Premature infants tend to have difficulty with emotional regulation, increased extension (arching their backs), delays in gross motor skills, and, because of their stay in the Neonatal Intensive Care Unit (NICU), positional head flattening and sensory processing disorders.

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Physical Therapy for Premies

A physical therapy evaluation and treatment plan helps premature infants achieve developmental milestones for their age groups and catch up to their full-term peers. Physical therapy also helps with emotional regulation and addresses secondary conditions caused by their NICU stay and prematurity.