All parents want the very best for their children and if your baby has a flattened head the first thing to do is to get a diagnosis to ensure the issue can be dealt with effectively.

Plagiocephaly is caused in three mains ways:

1) Plagiocephaly synotosis. This is where one or more of the sutures in your babies skull has prematurely ossified. It is the least common cause of plagiocephaly  but not that uncommon and it needs early diagnosis to prevent time and money spent on unnecessary and futile treatments.  In most cases it can be clinically diagnosed by trained health professionals without the use of X -ray, however, in some difficult cases X-Ray or CT scan will be necessary to make the correct diagnosis.

If a diagnosis of synostosis is made then you will be referred to a neurosurgeon for consultation as how to remedy the issues with this  problem.

2) Plagiocelaphy due to external forces;

Examples of external forces:

• Birth trauma
• Hydrocephalus
• Perinatal Obstetrical intervention
• Torticollis

Other risk factors that can associate to Plagiocephaly:

• Prematurity
• Motor Development delay
• Positional Preference
• Ocular conditions
• Auditory conditions
• Scolliosis of infancy
• Limited abduction in the contra lateral hip and foot anomolies

This means if your baby has any of the above seek an appointment and get checked by an appropriate trained health professional.

In this type of plagiocephaly all the sutures are there and healthy but the head has become misshapen early action is required for best results.

If your baby has any of the above risk factors in its history get your baby checed by an appropriate health professional who has accurate knowledge in order to advise you correctly. 

3) Plagiocephaly due to gravitational forces:

Babies due to evidence generated by research into SIDS( Sudden Infant Death Syndrome)  should always sleep on their backs .

A complication of this ,however, is that your baby may develop some flattening of the back of its head.

In the main this can easily be remedied by regular repositioning whilst baby is asleep. When your baby is awake  lay him or her on their tummy to help baby develop spinal extensors, shoulder girdle strength/ control and head holding strength.

The question' why bother doing anything?'.... if it is essentially only cosmetic. There are two main reasons that have been highlighted:

1). Unfortunatley we still live in a society that has great difficulty in accepting things that look different. Society is viciously cosmetically prejudice; ask any school child teenager read HEAT magazine. It takes an incredibly strong child to suffer the sort of bullying which will sadly inevitably happen and not bear psychological scars as an adult.

2)The Guilt that parents experience when they find out too late that they could have done something for their child if they had known early enough.

3) The NHS are not funded to treat Plagiocephally due to NICE not having done due diligence on the evidence available so you will get the stock answer from your GP unless he  or she is switched on is that baby will grow out of it by 24months. Lots of babies do grow normalise their head shape, but lots don’t either and it is those babies that can and should be helped as early as possible when things can be done. Unfortunately Paediatrians and neurosurgeons will take a similar line as the GP unless they have a particular interest in the condition.

One has to remember that treatment is only ever offered and the choice to go forward with treatment lays with the childs parent legal guardian until the child is 18.

How do we manage plagiocephaly?

• 0 - 4-5 months Cranial Osteopathy, Repositioning, Physical theray.
  These treatment are accessable, non invasive and conservative. For example a course of cranial osteopathy costs approximately £200.00, this will cover all aspects of self help repositioning as well as treatment itself.
• With no or little change then helmet therapy from 5 months to 14months has excellent results in reshaping the head. Treament will not be started after 14 months as the clinicians do not feel there is enough movement in the vault to give enough benefit for the cost of the treatment. They only treat severe plagiocephaly that is defined as a cranial index being 12 percentage points over the normal.
• ( normal being a value of 78- it is a ratio value of the width of your childs' head over the length) If your baby falls with in the criteria for helmet therapy it will be successful and the treatment costs £1995.00.

After long runs the overuse strain and impacts to the feet ankles, Knees , Hips and back create microtissue trauma and the body reacts to this through its natural healing response of inflammation.

What is Inflammation? Essentially it s the bodies self contained repair kit and like most hardcore runners is a little too over enthusiastic. Inflammation carries many mediators of healing and other chemicals that are associated with inflammatory response one of these are the prostaglandidns which are associated with the mast cell story but you will be more familiar with the effects the prostagladins have on your pain sensitive nerve fibres - that is the pain!!!
Also the mechanical effects of the fluid which is what inflammation is (remember how swollen your feet were after the marathon). The relevant point is that if this fluid is allowed to sit in and around the joints it tend to congeal and form fibrous tissue that can go on to form tissue called plica ( a common cause of functional knee problems). The fluid sits in and round all the tissues of the joints and create a space occupying lesion and the joints feel tight (like putting high pressure water into a rubber car inner tube eventually it goes rigid, ever twisted or damaged ligaments did it swell or did it swell!!)

Dehydration. Your Hyaline cartilage (leg of lamb for Sunday Roast the smoothness of ballpart of the hip joint that is hyaline cartilage, beautifully smooth and hydrated). Imagine a sponge, brand new plenty of capacity to absorb and retain water, what happens with the sponge in time it gets pulled about bit fall off and it loses it capacity to hold on to water. By running you speed this process up, however you can manage this process with a little knowledge. This is not an excuse to stop exercising either if you are a runner I am sorry to tell you if you stop the process speeds up even faster and the degeneration of your joints will be quicker, this is for a number of reasons but the two main ones being if you are fit and have a high basal metabolic rate your tissues are richly supplied with lots of well oxygenated and nourishing proteins, sugars etc. etc .If this blood supply is then all of a sudden drastically reduces the tissues will soon become redundant. The body is ruthless with tissues energy conservation like a local government department that doesn't spend its budget one year if it doesn't spend it the money the budget is cut. The body is exactly the same if not more ruthless.

If you stop exercising all those tight sinewy muscles that you have built up around the joint to stabilse and support it will waste and you will end up with big bones small muscles and consequently unstable joints. To prevent this keep fit and mobile, ensure you drink plenty of water and take plenty of vitamin C, you can also supplement your diet with Glucoseamine and chondroitn sulphate in the form of cortaflex a drinkable fluid.

If you want more information about anything in this news letter please contact Angus Hellier at Great Dunmow Osteopathic Clinic on 01371 875217 or send us an e-mail via the contact form.

A proteoglycan is a large water loving molecule that inhabits the synovial joints hyaline cartilage matrix and pretty much every connective tissue in the body.

Why are they so important? Its because of their hydrophilic properties they soak up water like a sponge and hang onto it. They do this within the hyaline cartilage matrix. Hyaline cartilage is the cartilage that covers the joint surfaces of all your synovial joints (ankles ,knees, hips and facet joints of your spine being major players)

Great so what's the problem? As we use our joints we squeeze water out of the cartilage matrix, which dehydrates the joint. Whilst we are under 35 that's ok when we rest we have plenty of proteoglycans left to rehydrate, if we are over 35 or participate in an arduous sport or lifestyle hard manual labour marathon running etc etc we increase the ageing of our cartilage. This meas that we do not replace the damaged proteoglycans, there is always a shortfall, over time our cartilage becomes dehydrated roughens and starts to degenerate and hurt.

So there is nothing we can do about this ? No! there's plenty to be done.
Stay fit mobile and active and increase your intake of glucoseamine, chondrotin sulphate. As we get older our digestive tract does not absord the required quantity of GA & CS that we need, we get round this by taking a super concentrate ofGA,CSt in a drinkable form also added to it is a substance called Methylsulphonylmethene (MSM) this is the key to the door and gets the raw material of GA,CS to the processing plant the nucleus of the chondrocyte which is the factory that produces the Proteoglycans, and a molecule called hyaloronic acid.

This is an interesting molecule because within the joint the hylauronic acid (a long thin hair like molecule) forms a felt like mesh next to the synovial membranre and hyaline cartilage and becomes and effective sieve to the mediators of inflammation that happen to quite large molecules, therefore , hylauronic acid is thought to have effective anti-inflammatory properties with absolutely no side effects because it is made in your joints for your joints by your joints, Mother nature knows best.

If you want more information about anything in this news letter please contact Angus Hellier at Great Dunmow Osteopathic Clinic on 01371 875217 or send us an e-mail via the contact form.