What is Torticollis?
By definition, torticollis (also known as wry neck) is a twisting of the neck and/or tilting of the head. Infants are primarily diagnosed with torticollis though older children can develop the condition as well. While there are several types of torticollis, and a number of potential causes for the condition, early diagnosis and treatment is best. The sooner torticollis is treated with physical therapy, the better the outcome and the fewer potential complications your child will have.
The most common type of torticollis we see at PPTS is called Congenital Muscular Torticollis (CMT) which is seen more frequently in first born children. CMT can occur due to the way the baby was positioned in the womb, due to abnormal development of the cervical bones or muscles, or as a result of trauma to the neck muscles during birth. The second type of torticollis is called acquired torticollis. This type occurs following illness or injury but can also be caused by an imbalance of the eye muscles or as a side effect of gastrointestinal reflux. In either case, torticollis often leads to limited range of motion of the neck and a preference for a particular position, including turning the head in one direction and/or a tilt of the head to one side. Plagiocephaly, or asymmetries of the head and/or face, are also commonly seen along with torticollis and, occasionally, a small lump may be found in the sternocleidomastoid muscle. Regardless of the cause, torticollis during infancy can impact more than your child’s head position, and when not treated early, a head tilt or rotation preference can lead to a number of complications including a delay in achieving milestones, visual problems, balance problems, and prolonged treatment time.
So how do you know if your child has torticollis?
Any time your child is demonstrating a preference for turning or tilting their head to one side, it is a good idea to see your pediatrician and seek out physical therapy services. Your pediatrician will assist in assessing your child and help to facilitate physical therapy services. As movement experts, a physical therapist can help determine the root cause and level of severity of your child’s condition, assess the impact of the torticollis on your child’s development, and create a comprehensive treatment plan to address any areas of need.
Often, caregivers will try to stretch their baby at home without the guidance of a physical therapist, or they will “wait and see” if things correct themselves. While stretching may help improve passive movement of the baby’s neck, it may not help the baby use the proper muscles when on their belly and trying to lift their head or when holding their head up in sitting. This can lead to further muscle imbalance and worsening of the torticollis. Because, no torticollis case is exactly the same, working with a physical therapist will help you provide individualized activities specific to your child and their torticollis.
What do I do if my child has torticollis?
If left untreated, your child could be at risk of developing a number of related problems that can impact more than just your child’s head position. When not treated early, a head tilt can lead to a delay in milestones, visual problems, balance problems, and longer treatment time. Early recognition and treatment generally lead to shorter treatment time and a reduction in motor delays that can be associated with torticollis. Your physical therapist will provide stretches to help improve your child’s range of motion and therapeutic activities to help them gain strength so they are able to hold their head upright and better explore their environment. Early recognition and treatment also generally leads to shorter treatment time and a reduction in motor delays that can be associated with torticollis.
If you notice that your child often holds their head tilted to the side, or that they prefer to turn their head in one direction more than the other, or even if you simply suspect that your child has torticollis, visit your pediatrician. Together you can determine a course of action and get the physical therapy your child needs.
Written by Jen Leonard, PT, DPT
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