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Treatment Recommendations for Cranial Deformities: To Be Frank

Chin and Partners introduce STARband, the following is an overview (an honest one) on treatment recommendations for cranial deformities.

Disclaimer: Images are courtesy of Orthomerica our partner in providing you STARband.
Warning: The following information may contain elements of mild humour and images that are not suitable for audience sensitive to paediatric or medical topics. Accordingly, viewer discretion is advised.

People say it is easier to understand a situation when you can relate. I don’t relate to you because I am not a parent (yet). However, who I can potentially relate to is your baby. So, who am I? I belong to an elite group of people known to have cranial head shape deformities. I am also an Orthotist who can assess, correct, and monitor cranial deformities.

In advance, I do not apologise for playing the victim but reflecting on the days when my parents would lose me in a shopping mall I think it is safe to say I could not trust them to identify if my head shape was abnormal or not. Please refrain from doing this to your child and refer to the link at the end of the post to learn more about cranial deformities and how to identify them.

Let’s get to it:

Treatment Recommendations

Abnormal head shapes should resolve naturally in 6 to 8-weeks after birth. Indications of a cranial deformity present within the first 3 to 4 months, therapies should be introduced as soon as possible. Usually, these therapies include repositioning by a Physiotherapist and adjustments by a Chiropractor. Early intervention allows for the best clinical outcomes as parents should be educated on the significance of tummy time during the first year of a baby’s life.

To assess and monitor the head growth during therapies, the Orthotist (Me) will record measurements and compile a comparative report documenting the changes in the head shape using the SmartSoc® scanning system. A corrective helmet will be prescribed only once a cranial assessment indicates the cranial deformity not responding to therapies. The Orthotist (Me) will provide the corrective helmet and guide cranial growth throughout the program.

The following example are treatment recommendations explained in a timeline following the story of the 10-month-old Frank.

Frank’s Story

2 months old, Frank’s parents noticed an abnormal head shape.

3 months old, the abnormal head shape did not resolve naturally, Frank also struggled to keep his head up during tummy time and had preferred to keep his head in one position.

A paediatrician was consulted and diagnosed Frank with Torticollis (neck muscle imbalance) and Plagiocephaly (most common head shape deformity), Frank was referred to start therapy immediately.

5 months old, with therapies there was a gradual reduction in the comorbidities (more than one medical condition present).

6 months old, an Orthotist was consulted to conduct a cranial assessment and confirmed Frank had a moderate to severe Plagiocephaly which required the use of a corrective helmet.

Frank’s parents were sceptical of effects of the corrective helmet, but the orthotist educated them on cranial deformities, treatment recommendations and the importance of correction.

As a multidisciplinary approach, consultations were scheduled for the therapist and the Orthotist to adjust and monitor the head growth. Frank was fitted with a canary yellow helmet (because gender neutral)

8 months old, during treatment there was a significant reduction in the comorbidities. The therapy coupled with the use of the corrective helmet achieved correction over a 4-month period.

10 months old, Frank no longer required therapy and graduated from the use of the helmet.

Franks Real Story

2 months old, Frank’s parents noticed an abnormal head shape.

3 months old, the abnormal head shape did not resolve naturally, Frank also struggled to keep his head up during tummy time and had preferred to keep his head in one position but Franks parents did not feel the necessity to consult with a paediatrician immediately.

5 months old, the paediatrician was consulted.

6 months old, Frank started therapy.

8 months old, the therapist reported minor progress. An Orthotist was consulted to conduct a cranial assessment which confirmed Frank had a moderate to severe Plagiocephaly and required the use of a corrective helmet.

After receiving information about the treatment, Frank’s parents remained sceptical to proceed and wanted to attempt a few more weeks of therapy instead.

9.5 months old, since Plagiocephaly is not life threatening and deciding to embrace the long-term effects of the cranial deformity, Franks parents did not proceed with the Cranial Remoulding treatment.

10 months old, Frank’s Plagiocephaly still resisted therapy and did not resolve.

What Happens Now?

The worse the head shape the uglier the baby. (Just joking all babies are cute bundles of joy).

Clinical and evidence-based practice suggest, Frank is at risk of delayed developmental milestones, decompressed brain growth, jaw malalignment, visual disturbances, abnormalities of the eustachian tube, asymmetries in facial appearance and neck muscles and migraines (usually in adulthood).

In the case of Frank at 10 months of age, correction will take longer but can still be achieved. After 18 months of age the cranial bones fuse and no longer accommodate growth spurts. Considering this, the corrective helmet is indicated between 3 to 12 months of age and depends on the age of the baby and the severity of the deformity.

If you suspect your baby has an unresolved cranial deformity, I encourage you to consult with the paediatrician to refer you for the necessary treatment in time to achieve optimal correction.

Once again, I don’t mean make this about me, but I believe my sensory disturbances, malocclusion and delayed development could have been prevented if there was someone to correct my cranial deformity.

After various medical visits throughout my years of development you may ask,

“Did you live a normal life?”

Deep in my journey of self-awareness I evade a secret that haunts me and to be frank…I am afraid to be bald.

Sincerely, a health care professional who can correct Frank’s head.

Diabetic Wound Offloading

In this Blog I am going to talk about how we can offload your diabetic wound and why it is important that we achieve as much offloading as possible.

What is offloading?

Offloading is the redistribution and reduction of the pressure that is exerted on the underside of your foot by means of wedging the inner of the shoe, making use of mobility aids or modifying the sole of your shoe/boot to have a rocker bottom. A rocker bottom sole allows a smooth transition from heel strike to toe off on the weight bearing leg while walking. We as will evaluate you as an individual to determine the best method or product to help offload your foot/diabetic wound to ensure we get the best results we possibly can.

Why is offloading important?

When it comes to a someone who has a diabetic wound or ulcer, they always have reduced wound healing capabilities due to the blood circulation system that is not working as intended or because of the diabetic neuropathy that causes them to loose sensation on the foot so they don’t even know they have a wound or how much weight they are putting onto the sole of the foot.

Wounds heal much faster if they are kept undisturbed and protected, thus by offloading the specific area, we keep the pressure away from the wound site and ensure that the healing process can begin undisturbed. Healing of diabetic wounds doesn’t happen overnight, it may take up to a few weeks or even a few months, depending on the size and severity of the wound. This is why we provide orthotic interventions, to help assist you during those difficult times and give you the peace of mind, knowing that the wound is being offloaded while you carry on with your day to day life.

How we offload

There are many methods of achieving offloading, ranging from simple walking aids to custom orthotics that fits into your shoes. The best and most simple way to offload the foot completely is by using crutches, walking frames when walking short distances or a wheelchair when you want to travel a bit further. This type of serious offloading is mostly necessary when you have a severe wound that needs immediate offloading while you are still undergoing wound care.

If we want to offload your foot ulcer or wound while you are walking, we have a new product called the SBi Motus Boot. This boot is a high leg – foot walker that secures the foot in a neutral position and comes standard with a fully rocking sole that helps redistribute the pressure under your foot while walking. The Motus Boot is equipped with a very durable, breathable, and soft inner that can be heat moulded to your leg shape for added stability and comfort to ensure that we keep the leg and foot as stable as possible.

Please have a look on our website for more information on the Motus Boot or tune in for our next blog where we will focus mainly on the Motus Boot and its many features and benefits.