As a pediatric physical therapist in the outpatient setting, about 10-25% of my patients are diagnosed with Torticollis. Torticollis is the tightening of one muscle in the neck called the Sternocladeomastoid, or SCM for short. The SCM is the muscle that controls ipsilateral sidebend and contralateral head rotation. This muscle, located on either side of the neck, works to tuck the chin down. When one side works independently, it will work to turn the head to the opposite side and tilt the head towards the direction of the muscle. Torticollis is a serious medical condition, and left untreated, can result in many impairments. I will go over some of the most frequent and serious below.
Possible Results of Untreated Torticollis:
- Plagiocephaly – This is the most common consequence of untreated Torticollis. Plagiocephaly is the mishapening of the bones on the skull, usually resulting in a large flat spot on one side of the back of the head and facial assymetries. Early diagnosis and conservative treatment can be successful in decreasing the severity of the Plagiocephaly. However, late diagnosis must be treated by a helmet or craniofacial surgery.
- Cervical spine contractures into the preferred head rotation and sidebend – These contractures can become ossified over time, significantly impacting functional mobility and ability to interact with peers. Once a contracture is ossified, surgery is required to lengthen the muscle, followed by several sessions of physical therapy to regain full cervical spine range of motion.
- Limited shoulder mobility – Decreased active movement into non-preferred rotation and sidebend can also result in shoulder elevation. This in turn impacts the child’s ability for upper extremity weight-bearing and reaching toward midline with hand.
- Cervical Scoliosis – Persistent head tilt in the absence of shoulder elevation can result in a lateral shift of the cervical spine, which leads to cervical scoliosis.
If you suspect that your child has Torticollis, please contact one of our physical therapists at North Shore Pediatric Therapy for a free screen.
