04/03/2025
Every baby’s body tells me a story.
This little cutie came to me just shy of turning 10 months old.
Parents concerns: always *hated* tummy time, not crawling, not transitioning in and out of sitting. Mother told over and over again that tummy time “would get better” and to “just keep practicing”. I’m glad she didn’t listen.
At initial evaluation, he met the cut-off for gross motor delay based on the Alberta Infant Motor Scales, presented with high degree of postural asymmetry, and layers and layers of myofascial tension (previous tethered oral tissues released). Interestingly, I also identified segmental hypo mobility of his spine into extension, starting at his mid thoracic spine. He had a prominent xhyphoid process at the evaluation, directly across being the hinge point of mobility at his spine, with hypomobility above and below.
Treatment: gentle segmental spine mobilizations to hypomobile segments, TMR Tots releases to address myofascial tension and postural asymmetries, neuromuscular re-education with movement within range of control to normalize thoracic curve, segmental control activities, functional strengthening of hip girdle and trunk, and emphasis on rotational movements of ribcage and pelvis via transitional movements and gross motor skills.
6 follow-up sessions strategically spaced + a robust home exercise program, little man is creeping on hands and knees, pulling to stand, cruising, transitioning between support surfaces, walking with a push toy, and standing alone for several seconds. He’s presenting with age-appropriate gross motor skills and very close to taking his first steps alone.
Take away points:
- If tummy time is hard, there’s a reason
- Myofascial and joint restrictions affect babies and can physically prevent a baby from being comfortable in certain position
- Effective infant treatment often involves orthopedic and developmental interventions
- When performed skillfully, pediatric PT is efficient. In the absence of neuromotor impairment, PT for gross motor delay should not last forever!