Congenital muscular torticollis (WFC) - one of thethe most common diseases of newborn and 2-3 takes place after congenital hip dislocation and congenital clubfoot. This diagnosis is often made by experts, but sometimes it is not confirmed. Perhaps the baby muscle tone. We will try to understand the differences between these diagnoses and what should parents do in each case.
The main reason for the IUD is considered to be innatehypoplasia of the sternocleidomastoid muscle, her trauma during labor and birth trauma of the cervical spine. Sternocleidomastoid muscle bath, located on the side of the neck. With the reduction of the right muscles of the head is tilted to the right, and his face turned to the left; while reducing the left - on the contrary. If at the same time reduces both muscle, then throws back his head and several advances.
Thus, when the IUD is inclined toward the headaffected muscles and rotated in the opposite direction while backward deflection. Shoulder girdle and scapula with severe torticollis on the side of the lesion above his head with a healthy side often sloped. The secondary changes at WMC applies facial asymmetry. In moderate and severe ICH (II-III) there may be a lag in the child's psychomotor development. With the growth of children who had IUDs are marked flattening of the cervical lordosis, the formation of pathological kyphosis, stunting vertebral bodies due to trauma sprout zones, the phenomenon of degenerative disc disease.
If you can not find the above symptomsICH, but the kid likes to keep her head to one side to sleep on one side, most likely, the muscle tone is present. Watch for your baby, and you will notice that the child's movement random and chaotic, he is unable to raise his head and hold it in an upright position. Hands and legs bent in all joints and close to the body, fists clenched. This is due to the fact that up to 3 months of age myshts- flexor tone hands and legs elevated (the so-called physiological tone). But the tone is different. There are hypertonicity (increased muscle tone) and hypotonia (low tone).
We have reviewed the main features of diseases. Now let's talk about their treatment.
ICH treatment begins early, with 2-3 weeks of age, and be sure to include treatment position (laying), massage and physiotherapy exercises.
When the position of the treatment of the child should be based onsemi-hard mattress without a pillow better. Instead of pillows under his head lay folded several times a diaper. It is important that light, toys, communication with adults were from the affected muscles.
You can style your child correctiveposition with the ring, wrapped in cloth and laid under his head, as well as partial bags of sand (salt, barley), which is placed on the bed on either side of the head or on the part of torticollis (above the girdle). The procedure is performed 2-3 times for 1.5-2 h. A day. As newborns and infants are most of the time lying or sleeping, this means easy and effective to use.
A prerequisite is the provision of treatmentthe correct position of the whole body: it must be symmetrical, straight towards your head. To do this, you can put bags or "bedroll" of blankets from the armpits to the knees of the child. The first time you have to watch the baby. Frequent regurgitation exclude the proposed installation.
The child should be often laid on its side. If the child is sleeping on the side of torticollis, the head is put under high pillow if it is on the healthy side, the pillow is not used at all. It is important to carry a child in her arms:
- Taking the baby in an upright position with his back to her, his cheek, turn his head to the affected side, and slightly tilt it in the healthy.
- Carry your child in the "sick" side of the face or back to him. At this time, keep his head, lifting it in a healthy way.
Muscular torticollis may develop (and oftenfound) in children with muscle tone (asymmetry) or constant unilateral position in the crib. To avoid this, it is often necessary to shift the baby to approach it from different angles.
From the outset of treatment massage takes WMCleading position, held against the backdrop of a restorative complex, age-appropriate and child development. Massage prescribed by the physician, and must carry out its qualified. After the first course of massage, conducted by an experienced specialist, refresher courses can hold parents carefully observe and trained masseur.
LFK course is 15-20 sessions, whichare conducted daily or every other day, with a break between courses in 1-1.5 months (at this time of major exercises involved parents). Until the year baby dolzhёn receive 3-4 courses of combination therapy and even the course of 2-3 to 7-year-olds. In addition, every day up to 2 years, parents must deal with a child 3-4 times a day for 5-15 minutes.
From an early age children with torticollis shows exercises in the pool with a water temperature of 35-36 ° C. Special exercises in the water:
- Hands methodologists (or their parents) under the neck of the child lying on the back, padded thumbs stroking performed sternocleidomastoid muscle (the child's neck in water).
- The smooth movement of the child in the same position for the head to the right, then to the left.
- The circular movement of the child lying on the water behind the head so that the affected side was on the outside of the circle.
- The child in a cap lying on his back, the legs are omitted. Methodist performs hand movement in his hands - down, performing a smooth correction of torticollis, reinforcing rod from damage.
- Reclining on the child's abdomen under the chin support, lead by the width of the pool. Other hand movements smooth resilient elated shoulder girdle hold water.
In milder forms of the IUD is recommendedorthopedic devices. If unable to correct torticollis massage and exercise therapy have resorted to surgery. There are pre- and post-operative periods at a polyclinic stage of rehabilitation sessions continue until 9-12 months. Home LFC task - complete restoration of function of the operated muscle. To this end, various movements of the head with the resistance and weights in different positions. Continues posture correction (especially in the thoracic spine).
From the tone of the muscles will help to cope massage. This is the most effective way to bring the muscles to a normal state, ie, balance the tone of the flexor and extensor muscles of the extremities. However, before the procedure is necessary to consult a neurologist, as there may be cases where the use of massage only is not enough.
The massage should be guided by the statemuscle tone. In particular, the muscle extensor and flexor. On the hand flexor located on its inner surface on the foot - of the back surface. Massage flexor should lower the tone. In this case, the relaxing massage techniques: stroking, rubbing and light gentle kneading, vibration, shaking. Massage the extensor aims at improving the tone. Done firming massage: stroking, more vigorous rubbing and kneading, stimulating tingling and percussion techniques.
Classes are preferably carried out on reaching thebaby 2 months, if there is no other doctor's appointments. Before the start of classes, consult an experienced massage therapist on how to do massage correctly. After all, the lessons on balancing muscle tone has its own peculiarities.
For example, when the flexor hypertoniaextremities can be used only those exercises which relate to straightening. Based on this principle, all active (ie when a child makes their own motion) exercises. As for the passive (performed with the help of an adult) movements of the limbs, up to 3 months, they may not be the case, since in the presence of increased flexor tone perform these movements due to a sharp child resistance and the risk of violence against them.
The main purpose of massage during the testimony of muscletone is a balancing tone muscles flexors and extensors of hands and feet. The number of sessions and their duration are assigned individually. Grow up healthy!