TorticollisWhat is Torticollis?

Torticollis, otherwise known as wryneck, is a condition usually seen in infants where there is damage or tightness to the sternocleidomastoid muscle in the neck. This muscle’s action is to tilt the neck to the same direction and rotate it to the opposite direction. Hence, when a child (or an adult) has torticollis, they generally appear to have a head tilt to the affected side (where the muscle is shortened) and chin rotated up to the opposite direction. Other types of conditions, such as infection, tumors, ophthalmologic problems, and cervical abnormalities should be ruled out by the pediatrician prior to a referral to physical therapy.

What causes Torticollis?

There are many potential causes for congenital muscular torticollis. Generally, intrauterine malposition or birth trauma during delivery are ways that torticollis can be caused during pregnancy or delivery. Babies who are born in the breach position, multiples and babies who are delivered with the aid of forceps are at higher risk for torticollis. In addition, positioning after birth can cause torticollis if the infant is always faced in the same direction or positioned in the same way. Plagiocephaly, or flatness to the head of the infant, can in itself cause tightness to the neck muscles and associated torticollis.

How does the condition progress?

If untreated, torticollis can cause problems with balance, facial asymmetry, visual disturbances and muscle asymmetry that can continue to affect a child later in life. Sometimes a mass, or sternocleidomastoid tumor, can be present beginning at 2-4 weeks of life and gradually disappear, generally between the first 5-8 months of a child’s life. Plagiocephaly, or flatness of the head, can be present if head shape is not corrected within the first 18 months of life. A gross motor delay in milestones can also be present, and is often correlated with torticollis, as this condition can cause muscle imbalance, flatness to one side of the head and weakness to the muscles surrounding the neck.

How do I treat Torticollis?

Physical therapy involves gentle stretching of the affected sternocleidomastoidas and strengthening to the neck musculature to achieve a neutral neck position and full range of motion. Close attention is also focused on facilitating gross motor milestones as torticollis can cause a developmental delay if not treated early in life. Often times a therapist will work with a peanut-shaped ball to help facilitate strengthening and balance reactions in an infant. Other techniques, such as gentle massage and positioning techniques are completed during the therapy session. Parents are always given a home program to work on stretching and exercises to help the infant correct the torticollis as soon as possible.

NSPT’s approach

North Shore Pediatric Therapy physical therapists are trained in the treatment of torticollis and will provide your son or daughter with the best treatment possible. Physician communication is something that NSPT prides itself on and enables healthy, frequent communication with your child’s health-care team to ensure well-informed team members. Your therapist will carefully go over your child’s home exercise program and will make sure that you as the parent feel comfortable with all of the home exercises to ensure successful treatment from all angles.