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Torticollis: What Is It and How Do You Treat It?

By Allison Elbeblawy PTA

What is torticollis?

Torticollis, also known as wry neck, means “twisted neck.” It is most often caused by the tightening of the muscle that connects the breastbone and the collarbone to the skull. This muscle is called the sternocleidomastoid or SCM, which is the common abbreviation. The SCM assists in rotation and side bending of the neck. Who does it affect and why?

Torticollis most commonly affects infants. When a baby is born with the condition, it is called congenital muscular torticollis. It can also occur after birth and sometimes later on in life, which is called acquired muscular torticollis. Congenital torticollis most likely happens in utero and can be caused by the way your baby is positioned in the womb, with his/ her head tilted to one side. It can also be due to injury of the muscle during delivery. Although it can look painful, it usually is not. Acquired muscular torticollis in an infant can be caused by positioning. If the baby tends to sleep with his/her head towards one side or is positioned to one side during feeding, the SCM can tighten. It can also be caused by an injury to the head or neck, which can cause the muscle to spasm.

In much less common cases, the condition can be caused by abnormalities of the cervical vertebrae (bones in the neck). The bones in the neck can either be abnormally formed, fused together, or both. This condition is called Klippel-Feil syndrome. This condition can also affect a child’s hearing and kidney function. The recommended stretching exercises performed to treat congenital and acquired muscular torticollis are ineffective and can be dangerous for a child with Klippel-Feil syndrome. It is important to have a thorough examination by your baby’s pediatrician to determine the cause of your child’s symptoms.

What does it look like?

Torticollis is usually spotted in the first couple months of the child’s life. It can be very prominent and can look like your child’s head is tilted to one side and has limited neck movement. Another common sign can be a small bump on the side of the neck. In more severe cases, it can be accompanied by positional plagiocephaly (flat head), which happens when the child consistently sleeps and rests his/her head to one side, flattening that side of the skull. The condition’s severity can also be very mild and may be difficult to detect when looking at your baby. There is no need to worry if you don’t notice because your pediatrician most definitely will. Your pediatrician will provide a physical examination and possibly order X-rays to determine which type of torticollis your child may have. Depending on the type and severity, your doctor may order other diagnostic testing.

Treating torticollis with physical therapy

Physical therapy is often prescribed by the doctor and is a successful intervention of the condition. A physical therapist will perform an initial evaluation of the child, which can include measurements and palpation. Then the therapist will develop a specific treatment plan for your child. After the plan of care is developed, it is recommended that your child be seen by the physical therapist or physical therapist assistant as prescribed by the doctor. Treatment can include stretching exercises, various positioning to promote head control, and soft tissue massage to the affected muscle. Treatment should always incorporate various forms of play, whether it be visually using toys or through playful sounds or song that will stimulate the baby and encourage him/her to turn toward the desired side. This can also assist in keeping your baby calm and relaxed to achieve a successful treatment.

A home program including the stretching and positioning will be given by the therapist for the parent to continue with at home. Positioning throughout the day during play time, feeding time, and while sleeping and resting are also very important for the child’s recovery. “Tummy time” is also very important as it allows for the strengthening and stability of the neck muscles. If muscular torticollis is detected early within the first couple of months of life, and consistent treatment through physical therapy and the instructed home stretching program is followed, then results and improvements will begin to be seen. At All-Care Physical Therapy Center, we can provide one-onone treatment that will assist in the recovery of this condition.

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Allison Elbeblawy PTA Physical Therapy Assistant

Allison Elbeblawy is a Physical Therapist Assistant (PTA) in All Care Physical Therapy. She holds an Associate’s Degree in Applied Science from the Physical Therapist Assistant Program at Union County College.

Allison works closely with supervising Physical Therapists to implement treatment programs in order to decrease pain, increase strength, and improve ADL function to improve the patient’s quality of life. She has a focus in outpatient orthopedic care where she utilizes various manual therapy techniques and therapeutic exercise interventions. Allison has worked with patient’s of all ages ranging from 6 weeks to 96 years, but has found a passion for working with babies and children with Special Needs.

Allison strives to give each patient she works with the best quality of care while upholding a positive attitude and compassion.

Medical Professionals Medical Professionals Medical Pro11 fessionals Groundbreaking New Technology for Laser Tattoo RemovalGroundbreaking New Technology for Laser Tattoo Removal Groundbreaking New Technology For Laser Tattoo Removal

Shore Vascular & Vein Center Cost treatment of all color tattoos and skin types, even the traditionally very difficult Shore Vascular & Vein Center / Aesthetic Laser Center announces enlighten ™ , the newest, most complete solution / Aesthetic Laser Center announces enlighten™, the newest, most complete solution Cost will vary depending on a number of factors including the size of the tattoo and the number of treatments needed. Keep in mind that with enlighten™, you should anticipate requiring far fewer treatments than required ones, with a single device. This provides effective results in approximately half the number of treatments of prior lasers. Number of Treatments Required and Results Shore Vascular & Vein Center / Aesthetic Laser Center announces enlighten™, the newest, most complete solution available anywhere for laser tattoo removal. enlighten™ is the most advanced laser system available for safe and effective tattoo removal. It is the world’s first laser system to combine both picosecond and nanosecond technology with dual wavelength lasers. This allows individualized treatment of all colors of ink and skin types for the fastest, most complete laser tattoo removal ever available. The “Pico” Difference Lasers remove tattoos by delivering high energy over a very short period of time to break up ink. Inks of different types, colors and depth can provide significant challenges to remove. It has been shown that shorter duration pulses are more effective in completely removing tattoos than longer duration pulses. Our new enlighten™ laser can deliver energy at picosecond intervals. A picosecond is one trillionth of a second. This is one thousand times shorter than prior lasers for tattoo removal. Picosecond, sometimes referred to as “pico,” lasers have been shown to remove tattoos more completely and with fewer treatments, than with lasers used in the past. People often ask how long it will take to remove their tattoo, and will it be able to be removed completely. Laser tattoo removal typically takes multiple treatments. That is because tattoo ink is deposited deep into the skin and multiple treatments are needed to reach all of the ink and break it up completely. In addition, tattoos of various sizes, colors and ages may respond differently to treatment. Some colors are more difficult to clear completely than others. Therefore, it is impossible to know in the very beginning how many treatments will ultimately be needed or how completely it will be removed. However, our new laser has been shown to be faster and more effective than the prior lasers used for tattoo removal. In fact, many people can expect to obtain excellent results in half the number of treatments, or less, than with prior lasers. Our doctor can give you a good idea of the number of treatments that will be needed after your tattoo is examined. Partial Tattoo Removal Due to change in circumstances, relationships and other factors, some people desire to have their tattoos changed. We can remove parts of tattoos, while leaving other parts intact, to allow for tattoo changes. Cost Cost will vary depending on a number of factors including the size of the tattoo and the number of treatments needed. Keep in mind that with requiring far fewer treatments than required with other lasers. You can also anticipate more complete results. However, since the exact number of treatments will not initially be known, we offer complete tattoo removal packages. That gives you a set price in the beginning and eliminates the uncertainty of not knowing the exact number of treatments that will ultimately be needed. Our staff can give you more information about pricing after we examine your tattoo. enlighten™ is the most advanced laser system available for safe and effective tattoo removal. It is the world’s first laser system to combine both picosecond and nanosecond technology with dual wavelength lasers. This allows individualized treatment of all colors of ink and skin types for the fastest, most complete laser tattoo removal ever available. The “Pico” Difference Lasers remove tattoos by delivering high energy over a very short period of time to break up ink. Inks of different types, colors and depth can provide significant challenges to remove. It has been shown that shorter duration pulses are more effective in completely removing tattoos than longer duration pulses. Our new enlighten™ laser can deliver energy at picosecond intervals. A picosecond is one trillionth of a second. This is one thousand times shorter than prior lasers for tattoo removal. Picosecond, sometimes referred to as “pico,” lasers have been shown to remove tattoos more completely and with fewer anticipate requiring far fewer treatments than required with other lasers. You can also anticipate more complete results. However, since the exact number of treatments will not initially be known, we offer complete tattoo removal packages. That gives you a set price in the beginning and eliminates the uncertainty of not knowing the exact number of treatments that will ultimately be needed. Our staff can give you more information about pricing after we examine your tattoo. About Us Our medical director, Dr. Jeffrey Gosin, is a Board Certified Vascular Surgeon. He has years of experience in performing cosmetic vascular laser procedures using the highly acclaimed Excel V™ laser. Over those years, he has been asked by many patients if he could also remove their tattoos with his laser. While the Excel V™ laser is bestin-class for vascular applications, it is not designed for removing tattoos. Other prior lasers also had significant limitations. Therefore, he previously would not provide this available anywhere for laser tattoo removal.available anywhere for laser tattoo removal. enlighten™ is the most advanced laser system available for safe and effective tattoo removal. It is the world’s first laser system to combine both picosecond and nanosecond technology with dual wavelength lasers. This allows individualized treatment of all colors of ink and skin types for the fastest, most complete laser tattoo removal ever available. The “Pico” Difference Lasers remove tattoos by delivering high energy over a very short period of time to break up ink. Inks of different types, colors and depth can provide significant challenges to remove. It has been shown that shorter duration pulses are more effective in completely removing tattoos than longer duration pulses. Our new enlighten™ laser can deliver energy at picosecond intervals. A picosecond is one trillionth of a second. This is one thousand times shorter than prior lasers for tattoo removal. Picosecond, sometimes referred to as “pico,” lasers have been shown to remove tattoos more completely and with fewer treatments, than with lasers used in the past. with other lasers. You can also anticipate more complete results. However, since the exact number of treatments will not initially be known, we offer complete tattoo removal packages. That gives you a set price in the beginning and eliminates the uncertainty of not knowing the exact number of treatments that will ultimately be needed. Our staff can give you more information about pricing after we examine your tattoo. About Us Our medical director, Dr. Jeffrey Gosin, is a Board Certified Vascular Surgeon. He has years of experience in performing cosmetic vascular laser procedures using the highly acclaimed Excel V™ laser. Over those years, he has been asked by many patients if he could also remove their tattoos with his laser. While the Excel V™ laser is best-in-class for vascular applications, it is not designed for removing tattoos. Other prior lasers also had significant limitations. Therefore, he previously would not provide this service. When the new enlighten™ laser finally became available, that completely changed things. Dr. Gosin researched treatments, than with lasers used in the past. Flexibility Picosecond lasers are the newest, most advanced tattoo removal technology available. Our enlighten™ laser combines this “pico” technology with the flexibility of both 1064nm and 532nm dual wavelength lasers. Never before has this combination of power and versatility been available. This now allows for the treatment of all color tattoos and skin types, even the traditionally very difficult ones, with a single device. This provides effective results in approximately half the number of treatments of prior lasers. Number of Treatments Required and Results People often ask how long it will take to remove their tattoo, and will it be able to be removed completely. Laser tattoo removal typically takes multiple treatments. That is because tattoo ink is deposited deep into the skin and multiple treatments are needed to reach all of the ink and break it up completely. In addition, tattoos of various sizes, colors and ages may respond differently to treatment. Some colors are more difficult to clear completely than others. Therefore, it is impossible to know in the very beginning how many treatments will ultimately be needed or how completely it will be removed. However, our new enlighten™ picosecond laser has been shown to be faster and more effective than the prior lasers used for tattoo removal. In fact, many people can expect to obtain excellent results in half the number of treatments, or less, than with prior lasers. Our doctor can give you a good idea of the number of treatments that will be needed after your tattoo is examined. Partial Tattoo Removal Due to change in circumstances, relationships and other factors, some people desire to have their tattoos changed. We can remove parts of tattoos, while leaving other parts Flexibility Picosecond lasers are the newest, most advanced tattoo removal technology available. Our enlighten™ laser combines this “pico” technology with the flexibility of both 1064nm and 532nm dual wavelength lasers. Never before has this combination of power and versatility been available. This now allows for the treatment of all color tattoos and skin types, even the traditionally very difficult ones, with a single device. This provides effective results in approximately half the number of treatments of prior lasers. Number of Treatments Required and Result People often ask how long it will take to remove their tattoo, and will it be able to be removed completely. Laser tattoo removal typically takes multiple treatments. That is because tattoo ink is deposited deep into the skin and multiple treatments are needed to reach all of the ink and break it up completely. In addition, tattoos of various sizes, colors and ages may respond differently to treatment. Some colors are more difficult to clear completely than others. Therefore, it is impossible to know in the very beginning how many treatments will ultimately be needed or how completely it will be removed. However, our new enlighten™ picosecond laser has been shown to be faster and more effective than the prior lasers used for tattoo removal. In fact, many people can expect to obtain excellent results in half the number of treatments, or less, than with prior lasers. Our doctor can give you a good idea of the number of treatments that will be needed after your tattoo is examined. Flexibility Picosecond lasers are the newest, most advanced tattoo removal technology available. Our enlighten™ laser combines this “pico” technology with the flexibility of both 1064nm and 532nm dual wavelength lasers. Never before has this combination of power and versatility been available. This now allows for the About Us Our medical director, Dr. Jeffrey Gosin, is a Board Certified Vascular Surgeon. He has years of experience in performing cosmetic vascular laser procedures using the highly acclaimed Excel V™ laser. Over those years, he has been asked by many patients if he could also remove their tattoos with his laser. While the Excel V™ laser is best-in-class for vascular applications, it is not designed for removing tattoos. Other prior lasers also had significant limitations. Therefore, he previously would not provide this service. When the new completely changed things. Dr. Gosin researched the technology, attended conferences, and personally consulted with laser experts from around the country who were involved in the very early use of this remarkable new device. It became clear that this technology would set the new standard in laser tattoo removal. We are very pleased to be the first center in the entire Delaware Valley to be able to offer this cutting-edge technology. If you are experiencing “tattoo regret” and would like to have your tattoo removed or changed, call us for a consultation. “University Quality Care at the Jersey Shore” 442 Bethel Road Somers Point, NJ 08244 (609) 927-VEIN (8346) www.EndTattooRegret.com service. When the new enlighten ™ laser finally became available, that completely changed things. Dr. Gosin researched the technology, attended conferences, and personally consulted with laser experts from around the country who were involved in the very early use of this remarkable new device. It became clear that this technology would set the new standard in laser tattoo removal. We are very pleased to be the first center in the entire Delaware Valley to be able to offer this cutting-edge technology. If you are experiencing “tattoo regret” and would like to have your tattoo removed or changed, call us for a consultation. “University Quality Care at the Jersey Shore” 442 Bethel Road Somers Point, NJ 08244For more information, JEFFREY S. GOSIN, MD FACS the technology, attended conferences, and personally consulted with laser experts from around the country who were involved in the very early use of this remarkable new device. It became clear that this technology would set the new standard in laser tattoo removal. We are very pleased to be the first center in the entire Delaware Valley to be able to offer this cutting-edge technology. If you are experiencing “tattoo regret” and would like to have your tattoo removed or changed, call us for a consultation. intact, to allow for tattoo changes. Partial Tattoo Removal call 609-927-8346 Cost Cost will vary depending on a number of factors including the size of the tattoo and the number of treatments needed. Keep in mind that with enlighten™, you should Due to change in circumstances, relationships and other factors, some people desire to have their tattoos changed. We can remove parts of tattoos, while leaving other parts intact, to allow for tattoo changes. The County Woman Magazine www.TheCountyWoman.com(609) 927 VEIN (8346) www.EndTattooRegret.com or visit www.EndTattooRegret.com.