Tongue Ties & Physical Therapy

Amy Graber PT, DPT

Tongue tie and physical therapy – tell me more! At Fit Family Physical Therapy we provide private physical therapy for patients across the entire lifespan – from newborns to seniors! On the infant pediatric physical therapy side of our work, we treat babies with varying physical therapy concerns including torticollis, plagiocephaly, neurological disorders and more. In this pediatric physical therapy work, we have treated pediatric patients post tongue or lip tie release procedures. A physical therapist is not the main healthcare provider to identify or diagnose a tongue or lip-tie in an infant however, physical therapists are often called in to treat infants post tongue tie or lip tie release. Why? Keep reading!

What is a tongue tie or lip tie?

According to Mayo Clinic, a tongue tie is a condition present at birth that restricts the tongue’s range of motion due to a thick or tight band of tissue tethering the bottom of the tongue’s tip to the floor of the mouth. Similarly, a lip tie is a condition that restricts lip movement due to a tissue connecting the upper lip and upper gums.

How do I know if my child has a tongue tie or lip tie?

Often parents suspect a tongue or lip tie in infants if there are feeding difficulties. Typically, latch for breastfeeding or bottle feeding is impacted and there is increased work for the child with feeding. This can lead to difficulty with feeding, caloric intake and also just make feeding a negative experience. A parent may bring their child to a healthcare provider, such as a pediatrician, pediatric dentist, or lactation consultant, who can screen for this condition and make a diagnosis.

Another time that a diagnosis of a tongue or lip-tie may come up is around the time of language development. If a child is delayed with vocalization or speech skills, sometimes this can be a result of oral abnormalities.

Some infants and children may have tongue ties, but have no difficulties with feeding or speech, and in this case, they may go undiagnosed and undetected. This isn’t much cause for concern, as the presence of a tie does not necessarily mean it needs to be addressed. Functional issues associated with a tongue or lip tie are the primary reason a child would have a procedure to release the tie.

What is a tongue tie or lip tie release procedure?

A tongue tie or lip tie is released or revised in a procedure called a frenectomy. In this procedure, the frenulum, the band of tissue involved in tongue tie and/or lip tie, is released allowing for a better range of motion. This procedure is now most commonly done utilizing a soft tissue laser rather than traditional cutting. This quick laser procedure does not require general anesthetic and can be done in an outpatient setting while the child is awake.

Why is physical therapy necessary after a frenectomy?

Once the tie is released, it is so important to continue with oral mobility exercises to ensure that the tie does not return or grow back.

Your procedure provider should instruct you in post-release exercises to perform on or with your child. In addition to maintaining mobility of the mouth, working on mobility throughout the rest of the body is key too. Children with tongue ties commonly have other muscular asymmetries throughout the neck, upper body, and trunk. Ignoring these asymmetries can result in preferential postures that may limit oral mobility.

Oral mobility should be gained during a release procedure and therefore, it’s so important to address all of the surrounding muscular and fascial tissue that can impact posture and potentially mouth position and movement. Many different providers may assist with these exercises post-release, including a speech therapist, oromyofacial specialist, a pediatric physical therapist, or pediatric occupational therapist. A collaborative approach is best for the care of this condition, and may also include a lactation specialist in order to improve feeding technique and skills post-release. Being consistent is important as soon as the release is performed in order to prevent regression or return of the tie!

Have questions about tongue tie physical therapy?

If your child has a tongue tie or lip tie release, we recommend contacting a pediatric physical therapist (like us!) to evaluate ongoing exercise or treatment needs to address asymmetries and prevent the regrowth of tissue. Make sure to ask your procedure provider for immediate exercises and a referral to pediatric physical therapy to get started. While only a few visits may be needed to evaluate and treat, it’s important to get started quickly after the procedure!

Need pediatric physical therapy in Scottsdale? Contact us at Fit Family Physical Therapy for a free physical therapy consultation phone call. We can address your concerns and help you determine appropriate developmental milestones for your toddler. Skip the line with physician and insurance wait times, talk to us, and start your path to pain- and symptom-free activity today!

About the Author

Amy Graber PT, DPT has practiced physical therapy in a variety of settings. She has worked specifically with the pediatric population, assisting infants and young children reach developmental milestones, or rehabilitating young athletes. Amy has also worked extensively with adult patients and finds equal joy in helping adults reduce disability and reach their movement potential. She has specific experience with orthopedics, gait & balance training, and geriatrics.