Have you ever gotten a “crick” in your neck (or back)?
If you have, then you probably noticed that though the pain and restricted movement may have been specific to one small area, it affected your body in other ways. – you may have walked differently or been more careful about turning your body. When one part of the body is injured or pulled out of proper alignment, the rest of the body begins to compensate for the restricted or injured part. Now imagine what the eventual effect would be if that “crick” was permanent.
Many children with torticollis, cerebral palsy, and other motor function disorders can benefit from a treatment approach called TMR Tots. TMR stands for Total Motion Release and was originally developed for adult patients, and uses a systematic way to identify and prioritize treatment for patients to gain function and reduce pain with movement. TMR has been used for many years with adults, and one of the big benefits is it enables adults to “treat” themselves (and manage their issues) after being treated in a clinic. The program was expanded and modified to treat children several years ago, particularly those with torticollis and other asymmetrical movement issues, such as cerebral palsy.
TMR Tots uses the same proven treatment techniques therapists have already been using, but organizes them in order to achieve better, faster results, tailored to each individual child. In the case of torticollis, it replaces painful stretches that some physical therapists used to attempt to bring the head and trunk into better alignment. In the same way that TMR allows adults to “treat” themselves, TMR Tots provides therapists with a way to teach parents or caregivers to use these techniques to help their children between treatment sessions.
TMR is an approach that understands the body as a 3-D entity with movements that happen in all three dimensions. The body is made up of a network of connective tissue that connects every cell, tissue, organ – basically, everything from head to toe. Each organ is made up of individual cells that are “wrapped” in this flexible “web” of connective tissue which then gives shape and form to each organ – the brain, individual muscles, bones, the heart, the nerves, and so on.
A 3-D “web” or “shrink wrap” might be a good analogy of how our body keeps itself together. When one part of this “shrink-wrapped” body is injured or pulled out of symmetrical alignment, it compensates for that restricted or injured part. In the case of torticollis, we see an infant with a head and neck that is “stuck.” In the case of children who learn to move with tight or spastic muscles (and even low tone or loose muscles), they develop movement patterns that can interfere with learning “typical” movement patterns. These nontypical gait patterns can cause orthopedic deformities due to poor alignment. Because each motor milestone is based on skills learned previously, poor or asymmetrical alignment causes delays acquiring the next motor milestone (and therefore all the ones that follow it).
TMR Tots is an easy program for parents to follow up at home – the routines are simple and pain-free, in part because they always start with doing the “easy” (i.e., more flexible) side. Parents are also taught what to observe, empowering them to understand the development of their child and anticipate the next big milestone.
If you’d like to learn more about TMR Tots and discuss whether this treatment approach could be beneficial for your child, give me a call here at Kid’s Creek Therapy.
Karolee Stauduhar, Physical Therapist