Flat spots, medically referred to as Plagiocephaly and Brachycephaly, is the term used for flattening of an infants skull.
Plagiocephaly is the flattening of 1 side of an infants posterior (back side) skull
Brachycephaly is flattening of both sides of an infants posterior skull
🚨Flat spots are NOT just cosmetic and will likely create issues elsewhere in the body! Here are some ways flat spots can affect infant development:
👉🏼 Creates a preference for one sided head turning leading to more flatness and neglect of using 1 side of the body
👉🏼 Promotes muscle imbalances leading to compensations
👉🏼 Tightness of the neck, trunk, shoulder or hip causing difficulty with movement and avoidance of appropriate posture due to poor tolerance of feeling muscle stretch
👉🏼 Asymmetry with motor skills such as only rolling to 1 side or reaching with 1 hand
Don’t take the “wait and see approach” as head shape is unable to correct after 12-18 months of age due to the fusion of infants skulls as they grow! Positioning is most effective <4 months old as infants don’t have complete head control and aren’t rolling yet. If a flat spot is not treated before this, a helmet will most likely be recommended for infants 4-6 months or older.
How Physical Therapy can help:
Positioning with play
Encouraging caregivers to have baby play in side lying to help reshape the head, but this will be dependent on what side of the head is flat
Tummy time to give pressure relief off of the flat spot and strengthen the muscles attached to the skull bones to help reshape the skull
Supine play placing toys on opposite side of the flat spot to give pressure on the bossing side
Stretching & strengthening
Stretching the neck, shoulders or trunk if there is tightness to make achieving midline easier for infants
Strengthening the neck (front, sides and back) as well as the core
Working on achieving and maintaining head in midline to bring midline awareness
Tracking a toy to both sides from midline to ensure neither side is being neglected
Providing encouragement to caregivers with individualized HEP:
Educating patents on all aspects of the flat spot (tightness? asymmetries? compensations?)
Creating an individualized home exercise program (HEP) for parents to perform daily with their infant. Our PT will review and demonstrate all exercises/activities in session to ensure caregivers feel confident carrying over daily until the next session
Each session will start with a review of the HEP to identify the progress since the previous session to give parents reassurance that they are making a difference!
Updating the HEP as the patient progresses
Identifying the need for an outside referral:
Understanding the cause of the flat spot to rule out the need for additional referrals to include: visual impairment, broken clavicle, palpable mass in a muscle in the neck, craniosynostosis, etc.
Identifying the severity of the flat spot with the age of the patient to determine if a referral for a helmet is necessary
Our physical therapist can help progress patients with flat spots to ensure proper development and head shape! Reach out to our physical therapist Jessie Lanford today for a screen or any concerns!
706-840-0369
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