Written by: Mikella Gauthier, Physiotherapy Resident, MHSc PT, BSc Kin

Torticollis has become more and more of a conversation topic in the Pediatric world.

Let’s look at history for a moment. Back in 1994, the Back to Sleep Campaign (now the Safe to Sleep Campaign) began as a recommendation for babies to sleep on their backs to decrease the risk of SIDS (sudden infant death syndrome). With the decrease of SIDS also came an increase in torticollis.

 Why is that?

With babies now recommended to sleep on their backs, the neck is often being neglected. With parental and baby preference, babies will tend to place their heads in a certain rotation or tilt and can develop or progress torticollis and plagiocephaly (flat head).

An association has also been made with increase torticollis in kids who have a tongue or lip tie and show difficulty with bottle or breastfeeding.

When a baby spends time on their stomach they are stretching neck muscles that may have been shortened in utero. Babies are curious little ones! When on their stomachs, babies will increase their neck strength by looking around. This means that tummy time can help to prevent and treat torticollis.

What does this look like?

The sternocleidomastoid muscle (SCM) is the responsible muscle for this condition. This muscle is located in front of the neck and attaches from behind the ear to the clavicle. The muscles action is side tilting the head and turning the head to the opposite direction. When a baby presents with torticollis, they may present with a side tilt, a decreased ability to look to one side, or a combination of both.

Early intervention can help to decrease unwanted secondary effects, improve feeding and ensure proper motor milestones are reached.

Written by Jonah Blatt, Registered Phsyiotherapist, MScPT, BScHK

I’ve been a pretty big sports fan for a while now (particularly the NFL), which means that well before I was a Physiotherapist I heard about professional athletes getting that big scary knee injury and tearing their ACL. This always meant that they were out for the rest of the season, and if they were on a team that I liked usually meant I was going to have a minor meltdown of sorts.

What exactly is the ACL though? PCL? MCL? Um, there’s an LCL too? These are the 4 ligaments of the knee, and their job is to stabilize the knee joint.

Ligaments connect bones to other bones, so they stabilize the knee by holding the femur (thigh bone) and tibia/fibula (shin bones) together. If the ligament is torn, damaged, or stretched, it can cause increased joint laxity or looseness. This makes the 4 ligaments of your knee important for the function of the knee, as well as pain.

The 4 Main Ligaments of the Knee

Let’s highlight the 4 ligaments of the knee and what they do to keep us moving well.

ACL stands for Anterior Cruciate Ligament. It sits inside the knee and keeps your tibia (shin bone) from moving forwards in comparison to your femur (thigh bone).

PCL stands for Posterior Cruciate Ligament. It sits inside the knee as well, but behind the ACL. It keeps your tibia from moving backwards in comparison to your femur (thigh bone).

MCL stands for Medial Collateral Ligament. It connects your tibia and femur across the inside of your knee, which keeps the knee from collapsing towards the opposite leg.

LCL stands for Lateral Collateral Ligament. The LCL is the opposite of the MCL. It runs across the outside of the knee, and prevents the knee from buckling towards that side.

What do these ligaments do?

All of these ligaments are important for the knee to be at it’s best. Ligaments are important to the knee because they provide support and stability to the joint, which allows us to move safely and with confidence.

These 4 ligaments are in place to protect the knee. They hold the joint together and in it’s proper alignment by stabilizing the two bones that make up the joint.

If we don’t have these ligaments holding our knee together, movement can become much more challenging and uncomfortable. An activity that may have been simple and pain free before will be met with apprehension and discomfort.

What if I hurt one?

The first thing we want to know when a ligament is damaged is which ligament was affected. There are 4 ligaments we discussed today, so understanding which to focus on is important. Manual testing, clinical reasoning, as well as diagnostic imaging are all extremely helpful here.

Ligaments become sprained, or torn, when damaged. The extent of the sprain or tear tells us a lot about how long we expect recovery to take. Mild sprains may take just a few weeks to recover, while significant sprains or tears may require much longer.

Working with a Physiotherapist and other members of your healthcare team is a great way to diagnose and manage knee ligament injuries. They can help you to understand if you injured a ligament, which one it is, and what to do about it!

Written by: Jonah Blatt, Registered Physiotherapist, MScPT, BScHK

So, you may have heard someone say they hurt their rotator cuff at some point. Maybe you’ve even been told that your rotator cuff could be what’s causing those nagging shoulder problems you’ve been feeling.

Great, but what does that even mean?

The rotator cuff is a group of 4 muscles that sit right around the shoulder, are incredibly important in helping it function, but can often be involved when we’re experiencing shoulder pain.

Those 4 muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis.

Supraspinatus helps you lift your arm to the side, and overtop of your head. Think reaching up to get something off the top shelf.

Infraspinatus and Teres Minor work together to rotate your arm away from the center of your body. An example here would be reaching into the backseat of the car to get something.

Subscapularis primarily rotates the arm towards the middle of the body. This may be used when pulling something towards you, or reaching behind you to reach your belt loops.

The most important thing about the rotator cuff though? These 4 muscles working together to stabilize your shoulder! Each of them is responsible for their own movements, and we use these movements as part of our shoulder assessment to help us understand which one may be more involved, but the most important function of the rotator cuff is how they interact with each other to stabilize the shoulder joint.

How the rotator cuff holds the shoulder in place when you’re resting, or while you’re doing movements, can be a really important part of proper shoulder function and avoiding pain. If the rotator cuff isn’t holding up it’s end of the bargain and stabilizing the shoulder the way we want it to, figuring out how to create that stability through specific movements and a tailored exercise program can be REALLY helpful!

If you’ve been told that your rotator cuff is a part of your shoulder pain, or have injured your shoulder in the past, having a Physiotherapist assess and treat your shoulder may help you reduce your pain and get back to doing the things you care about.