congenital torticollis

[meganli]

If you push the head sidewaysw with ball, you won't strengthen in isolation of SCM, but also upper trapezius, scalene, levator scapulae....... muscles of the neck.

If will cause muscle imbalance which will hinder postural re-education

[physiobob]

If you push the head sidewaysw with ball, you won't strengthen in isolation of SCM, but also upper trapezius, scalene, levator scapulae....... muscles of the neck. If will cause muscle imbalance which will hinder postural re-education

I totally agree with you on that one. Who would even suggest that sternocleidomastoid (SCM) is weak on one side? I have never seen an actually weak SCM, only ever overactive one's. The deep neck flexors might well be weak and also easily fatigued. Simple retractions exercises are often enough to tire them out so tread carefully. Don't focus on SCM at all as it's overactivity has been part of the problem (OK, passive stretching would be fine). Look at the thoracocervical junction and the mobility of the thoracic spine and even further down to the upper lumbar spine for a comprehensive approach to rehab in the older client where this is also known as a wry neck.

[meganli]

So, has I said that strengthening should be included in the treatment? I'd never.

[physiobob]

I agree with you and have edited my message to make it clearer on that issue. You do raise a good point about other elevators and accessories what we wish to keep quiet. We could also assess breathing patterns in the younger person to see if increased accessory mm use might be impacting on the problem. Respiratory problems can arise with positioning in the very young. That said positioning them to assist "stretch the SCM" can assist to add some passive treatment when they are resting.

p.s. There is also another discussion on torticollis in the forum. Click on the tags link and then on torticollis to find it