What is Torticollis?
Torticollis is a condition that occurs when the muscle that runs from the breastbone and collarbone up and toward the back of the neck becomes tight, weakened, or thickened, causing the child to look over one shoulder, while the head tilts toward the opposite shoulder. In 1992, the American Academy of Pediatrics began their “Back to Sleep” campaign to successfully reduce Sudden Infant Death Syndrome (SIDS), but it had an unintended result of contributing to the development of torticollis in approximately 1 in every 250 infants. Torticollis is generally diagnosed within the first 2 months of life. Congenital Muscular Torticollis (CMT) is often caused by birth trauma, or by sleeping or remaining in 1 position for a prolonged period. In most cases, torticollis is a muscular problem, and physical therapists are musculoskeletal experts!
“Right” sided Torticollis
Why Seek Services for Torticollis?
Physical therapy is beneficial when diagnosed with torticollis in order to assist patients in reducing tightness of muscles around the neck, stay on track with performance of gross motor activities with both sides of the body, and assist in vision development as well as prevention of head shape complications. If torticollis is left untreated, it can cause issues as the child ages such as chronic headaches, vision deficits, decreased shoulder mobility, head shape deformity, scolliosis, and jaw malalignment.
What are the benefits of PT?
With skilled physical therapy services, children with torticollis show improvements in their ability to move their head and neck in all directions. As the torticollis can be from tightness of the muscles of the neck, skilled PT can assist in loosening these muscles to allow the child to look and move, instead of being in the same position for an extended period of time. Physical therapy not only addresses the tightness of the muscles, but also the weakness that may result on the opposite side of their neck from decreased movement. We perform exercises to assist the child in strengthening the muscles of their neck to improve their ability to look around their environment when in any position (on their stomach, back, or side, in sitting, etc.).
An area of flatness can develop on one side of their head from preferentially resting on that spot for a young child who has not begun to roll by themselves. During skilled physical therapy sessions, education is given to the parents and caregivers assist with positioning of the child to improve the head and neck alignment to assist in head shaping.
Some children with torticollis display strong preference for using one side of their body secondary to their head and neck positioning. Because of this, children sometimes need to be taught how to perform movements in both directions. These movements can include but are not limited to rolling, creeping, crawling, moving from sitting to hands and knees and back to sitting, pulling self to stand over either leg, walking along a surface, and walking independently.
When should it be addressed?
Early treatment is key. Infants that receive early physical therapy, and regularly stretch and reposition at home, have better results and spend shorter time in therapy. Studies show best results for infants that start physical therapy between 2-4 months of age.
- Early treatment for torticollis (earlier than 2 months) can greatly reduce treatment time to as little as 4-6 weeks.
- Delayed treatment of torticollis (after 3 months) can increase treatment time to more than 6-9 months.
Ask your pediatrician about torticollis if you see any of these signs:
- Turning or tilting head to one direction
- Sleeps with head only to one direction
- Feeding to only one side, especially with breastfeeding
- prefer looking at you over one shoulder instead of turning to follow you with his or her eyes
- Hair loss or flattening of head
- Small bump on side of neck
- Facial asymmetries (higher check bone, ear alignment, smaller eye)
For more information regarding torticollis, here are some helpful links:
Torticolis: Baby Center
My Baby’s Head Shape: Cranial Tech
Infant Torticollis: What Parents Should Know
Importance Of Tummy Time
Guide To Positioning
Infant Carriers
6 Must Knows of Torticollis