Asymmetrical arm strength

Motor Development
#1

My daughter has/had severe torticollis and is in intensive PT, seems like all we do is PT, but one thing I haven’t been able to strengthen as much is her weaker arm. Any tips other than blocking the right side and encouraging more use of the non preferred side? Are there exercises I can actually do with a 15 month old for her arm? Even like tiny baby curls with a heavier toy? We try to encourage a lot of crawling, but that’s so hard and she still prefers to claw her hands a bit when crawling.

She had a brain and cervical spine MRI, and other than the thickened SCM, everything was clear as far as that goes.

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#2

Hey there! Thank you for this question. Torticollis can affect bilateral hand use and can sometimes lead to a neglect of the side of the tight SCM muscle. In general, providing sensory input to the neglected side is a good place to start i.e. present toys on that side, massage that arm, position yourself on that side to encourage rotation etc.

Crawling is one of the most effective ways to strengthen the entire arm, from the shoulder girdle to the hands. And even though your daughter is older, you can still encourage crawling through play. I don’t know your little one, but I think you should talk to your PT about the curling of the fingers when in the crawling position. Babies will sometimes curl their fingers or keep them in fists while crawling to either avoid tactile sensation on the palm (possible tactile sensitivity), or to compensate for tightness in the finger and wrist flexor muscles. Check back with your PT and keep us updated :heart:

#3

Thank you so much! That’s everything she has said and I guess everything we are doing :confused:. We even use a portable massage and try to work on the hand extensor. She definitely curls more on carpet than hard surfaces. I’m just getting frustrated we haven’t seen an improvement and we work on it constantly. Thanks for the feedback.

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