Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. In this article we will continue our series of blog posts examining conditions that affect children and are seen by our paediatric physiotherapist. Having looked at the feet, we shall now jump to the opposite end of the body - the head and examine plagiocephaly and how it affects children.

What is Plagiocephaly?

Plagiocephaly is a condition that affects babies and young children and causes a distortion of the normal shape of the head with one side being flattened and is often accompanied by torticolis and a difficulty in turning the head to one side.

What Causes Plagiocephaly?

It is caused either by a restriction in movement and a pressure on the skull in the womb or more commonly by the baby being positioned on its back for too long and not having enough time out of this position. This then causes the skull to flatten at the back or side due to the pressure and the soft nature of the skull bones of young babies. Commonly babies who have plagiocephaly will have a stiff neck (torticollis) and this can either be the primary cause of the plagiocephaly (the baby doesn't like turning its neck to one direction and then spends more time in one position) or it can be secondary to the flattening at the back of the skull.

What are the Symptoms of Plagiocephaly?

As described above babies with plagiocephaly will have one side of the back of their head flattened significantly and will often have difficulty turning their heads to one side. 

How is Plagiocephaly Diagnosed?

Plagiocephaly is usually first noticed by parents or health care visitors who will notice that one side of the back of the head of th baby has become flattened. At this point the GP will become involved and likely make a referral through to either a paediatric physiotherapist or a paediatrician who will diagnose plagiocephaly.

Treatment for Plagiocephaly:

Plagiocephaly is ideally identified early, as it is best treated before the bones of the skull fuse and become hard. The exact treatment that will be best for your child with plagiocephaly will depend upon how severe the change in skull shape is and how early the condition is identified. Below are some treatment and management options for plagiocephaly:

1. Early Diagnosis: the earlier plagiocephaly is identified the easier it is to change and to make a difference. So, it is important that if you are worried that the back of your baby's head is flat that you discuss this with a medical professional as soon as possible. 

2. Assessment: having an assessment with an appropriate professional such as a paediatric physiotherapist will give you lots of information on how to manage your child's plagiocephaly and determine how severe things are and what the best management strategy will be. 

3. Tummy Time: (obviously under supervision of the parent) plagiocephaly is caused by too much time being spent on the back and with the head in one position. So, letting your baby have some supervised tummy time and varying position will help.

4. Change Cot/Bed Position: often a baby will have grown used to lying on their back with their head facing towards some toys or the light. Changing this position and moving toys to the other side may help. 

5. Physiotherapy can provide help with plagiocephaly and our paediatric physiotherapist will be able to advise you on appropriate positioning of your baby and strategies to help encourage your baby to be in a good postion. Physiotherapy for plagiocephaly in the form of stretching of neck muscles and exercises to help develop their neck muscles is also extremely helpful to encourage good neck movement and improve skull shape.

6. A Helmet: for children with particularly severe plagiocephaly and for whom conservative management is not working a helmet providing pressure around the skull may be the next step. This is done after consultation with a paediatrician.

Okay, I hope that you have enjoyed this article about plagiocephaly, should you want to find out more or understand how our paediatric physiotherapist can help with plagiocephaly then please get in touch. Our paediatric physiotherapist provides visits at home, school or nursery for help with plagiocephaly and is available in areas such as Lichfield, Tamworth, Sutton Coldfield, Cannock and Rugeley. For more information regarding this service please contact us on 0788 428 1623 or via  enquiries@threespiresphysiotherapy.co.uk