What is Torticollis?
By Andy Albrecht, DPT
Kids Place Central Clinic Manager and Pediatric Physical Therapist
Torticollis is a term used to describe a tight neck muscle. Congenital Muscular Torticollis occurs when a neck muscle, often involved is the sternocleidomastoid (SCM), is tight or shortened. This presents with a position of one ear towards the same shoulder, and a rotation in the opposite direction. For example, if a child has torticollis affecting the left side we will typically see a presentation of the left ear closer to the left shoulder and the child preferring to look to the right.
What causes Torticollis?
It is not known what exactly causes this condition, although it is believed to be intrauterine position or an injury before or during the baby’s birth. There are rare conditions when torticollis can be caused by a bony abnormality, neurological reasons or visual impairments. Your physical therapist will help you rule these out.
What are the symptoms?
The typical presentation of torticollis presents as the baby favors looking in one direction and/or presents with a head tilt to the opposite direction. Keep an eye on how the baby moves their head. Do they always want to look the same direction no matter where toys or people are located? Does the baby always have the head tilted to the same side in all positions – tummy time, laying on back, or sitting? If you try to help the baby out of this position, do they get fussy? These could all be indicators of torticollis.
How is it treated?
Your Physical Therapist will treat your baby’s torticollis a bit differently for each patient, depending on what your child needs. The treatment usually consists of 3 phases:
1. Flexibility – stretching the tight muscle/soft tissue
2. Strengthening – making the neck strong enough to hold a neutral position throughout all developmental stages
3. Neural reeducation – teaching where midline is during developmental postures and preventing any asymmetries that may develop with gross motor skills
What is the prognosis?
With a consistent home exercise program along with regular physical therapy, your baby will make excellent gains in his/her range of motion and head position.
Is there anything else I can do to help my baby? (Besides the homework my therapist gives me)
Tummy Time
Regardless of your baby’s age, it is very important to work with them on tummy time. This position does so many great things for them, especially for babies with Torticollis. It works on spinal curvature, elongation of the anterior (front) neck muscles, development of the visual system, sensory integration to their environment. If your baby isn’t tolerating tummy time well, try rolling a blanket or towel and put it under the baby’s chest to slightly elevate their head. For a great read, visit Tummy Time.
Floor Time
Maximize the time your baby spends playing on the floor. Whether on the back, tummy, sitting or rolling this is the best opportunity you can give them to learn their environment and play. This creates a great learning environment for new gross motor skills.
