What is Torticollis?
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 baby’s neck muscles on that side, specifically the sternocleidomastoid muscle. This sternocleidomastoid muscle extends from the skull behind the ear, diagonally down to the front of the baby’s neck, attached to the collar and chest bones. Tightness in this muscle causes the baby’s head to tilt towards and rotate away from the affected muscle, further contributing to a twisted neck.
This positioning often leads to activity limitations including difficulty keeping the child’s 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, which can limit a baby’s ability to experience the benefits of tummy time.
The exact cause of infant torticollis is unknown, however, the most often cause cited is due to the child’s abnormal positioning in utero. Torticollis can be successfully treated by rehabilitation physical therapy, especially if addressed early on. In fact, for the best results, a baby with torticollis can start treatment as early as 3-6 months of age. If a baby’s torticollis goes undiagnosed, infants later in development may need a helmet to address positional consequences such as positional plagiocephaly, or flattening of the baby’s head.
Physical Therapy & Torticollis
Goals of physical therapy as a form of treatment for infants with acquired torticollis include normalizing infant’s passive range of motion in the neck and shoulder region, minimizing asymmetry in spontaneous positional and movement preferences, address muscle tightness, parent education to the proper positioning and toy placement to help facilitate symmetrical postural responses and increased upper extremity use.
Simple Exercises To Help Encourage Movement:
- Tummy time: For any baby, tummy time is essential. But, for babies experiencing torticollis symptoms, this activity helps strengthen the neck and shoulder muscles, as well as prepares the baby to crawl.
- Sleeping position: Babies prefer to look outward as opposed to inward, meaning that when placed in their crib, position baby on his or her back with their head facing the wall. Your baby will naturally want to turn his or her head to face the room, which will help strengthen the neck muscle over time.
- Feeding position: Whether feeding with a bottle or by breast, change up the feeding position to exercise the neck muscle. This will prevent the baby from becoming too comfortable with a favored side.
Early prevention and diagnosis, through pediatrician awareness and parent education, is key in the successful treatment of infants with moderate to acute torticollis. Contact an Ivy Rehab clinic near you to discuss your child’s torticollis symptoms and receive the proper treatment by a trusted pediatrician and physical therapist.