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What is Torticollis?

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Added on December 9, 2014

Congenital torticollis affects every 1 in 250 newborns. Congenital torticollis, or 'wry neck' occurs when an infant holds his/her head tilted to one side and has difficulty turning their head. An infant becomes accustomed to tilting their head to one side due to a shortening of the infants neck muscles on that side, specifically the sternocleidomastoid muscle. This muscle extends from the skull behind the ear, diagonally down to the front of the neck attaching to the collar and chest bones. Tightness in this muscle causes an infants head to tilt towards and rotate away from the affected muscle.

This positioning often leads to activity limitations including difficulty keeping head in midline, asymmetry of reflexes, neglect of the hand (on the same side), decreased visual awareness of the visual field, interference with the symmetric development of head and neck reactions and possibly delayed and interfered rolling to the side.

The exact cause is unknown, however the most often cause cited is due to child's position in utero. Torticollis can be successful treated by physical therapy, especially if addressed early on. If torticollis goes undiagnosed, infants later in development may need a helmet to address positional consequences such as plagiocephaly, or flattening of the head.

Goals of physical therapy for infants with torticollis include normalizing infant's passive range of motion in the neck and shoulder region, minimizing asymmetry in spontaneous positional and movement preferences, address tight muscles, parent education to the proper positioning and toy placement to help facilitate symmetrical postural responses and increased upper extremity use.

Early prevention and diagnosis, through pediatrician awareness and parent education, is key in the successful treatment of infants with torticollis.

– Lauren De Sio, PT, DPT




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