Torticollis

What is Torticollis?

Torticollis, sometimes referred to as “wryneck”, literally means “twisted neck” because in this condition, a child’s head is tilted to one side with the chin turned to the other side. Congenital torticollis is usually diagnosed within the first two months of life, although it can develop in older children or adults following an injury. In 80% of cases in infancy, torticollis is muscular in nature, most often due to tightness in the sternocleidomastoid muscle which connects the breastbone and the collarbone to the skull.  

Generally, therapists consider three possible types when evaluating infants with torticollis: sternocleidomastoid tightness, a tumor in the muscle itself, or postural (or positional) torticollis. While torticollis is often caused by birth trauma or abnormal positioning or lack of space in utero, positioning after birth is important, as well.  

Beginning in 1992, the American Academy of Pediatrics (AAP) recommended that all babies be positioned on their backs for sleeping to prevent Sudden Infant Death Syndrome (SIDS). The “Back to Sleep” program resulted in a significant decrease in SIDS-related deaths, but also an increase in babies with torticollis and plagiocephaly (“flat head”).  A newborn infant doesn’t have the strength to hold her head in the middle when she’s sleeping on her back, so in the first few months of life she will tend to lay her head to one side or the other, resulting in tightness on one side and/or a flattened head on one side at the back of the skull.

Although torticollis is not painful to the infant, if left untreated it can lead to further flattening of the skull, movement favoring one side of the body, a limited ability to turn the head in order to see, hear, and interact with his environment, difficulty with balance, and delays in development. Some other conditions, such as scoliosis and hip dysplasia, have been known to occur in children with torticollis.

 How Is Torticollis Treated?

Physical therapy is the primary treatment for torticollis. Over 90% of children achieve a good to excellent outcome with conservative treatment initiated during the first twelve months of life, especially before 4-6 months of age. A treatment plan may include stretching, strengthening, massage, positioning, taping, and a home exercise program with the aim of strengthening neck muscles, correcting muscle imbalance, increasing range of motion, and improving alignment and postural control. Physical therapists who are experienced in treating infant torticollis will also take care to determine if there are any other associated conditions. The therapists at Kid’s Creek Therapy also work closely with the child’s parents and/or caregivers to teach positioning, give written and illustrated instructions, hands-on training, and other activities to improve outcomes.

Do you think your child could benefit from physical therapy for torticollis? Contact us for a free consultation.

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