What is Torticollis?
Infant Torticollis is a condition which affects the neck and spine in many infants. It is characterized by prolonged tightening (contraction) of the neck muscles that causes the head to turn or bend to one side. It is a very treatable condition, but should be taken seriously.
The condition affects the sternocleidomastoid muscle which connects the base of the skull to the collar bone. This muscle is the main muscle that is used to move the head from side to side. In an infant with Torticollis, the muscle is shorter on the side that the head is tilted toward. With treatment, the muscle will grow and stretch as it should and allow the infant to develop normally; but if left untreated the condition may cause a permanent limitation of the infant's neck movement and keep him/her from reaching the normal developmental milestones. In addition if action is not taken, the infant's head may flatten on one side and the face may become malformed.
- Idiopathic (unknown)
- Genetic (inherited)
- Acquired (damage to the nervous system or muscles)
- Congenital (present at birth - may be caused by positioning of the head in the uterus or prenatal injury)
The first signs of Torticollis may not appear until the infant is 2-3 months old. You may notice that your child stares in one direction. Your child may seem to hold his/her head to the side and you may even notice a sizable lump just above the infant's collar bone. If you suspect your infant may have Torticollis, look for the following:
- Shortened muscle on one side of the neck
- Asymmetry (unevenness) of the infant's head from sleeping on the affected side
- Elevation of the shoulder on the affected side or head tilted to one side
- Stiffness of the neck muscles
- Decreased range of motion in the neck when turning to one side
- Medical History
- Physical Exam (look for shortening of the neck muscles and head tilt to the affected side)
- X-rays and possibly an MRI may be done to rule out other possible causes of the symptom
In infants, Torticollis is usually diagnosed sometime between 2 weeks and 2 months old.
- Stretching of the affected neck muscles
- Positioning of the baby to decrease the tendency to get into shortened muscle postures
- Activities with the infant to insure that their development is on track (sitting, crawling, rolling)
- Possible use of a helmet for head shaping. Your therapist can determine the need for a helmet and can refer the baby to a competent provider
How Physical Therapy Can Help
Physical Therapy can be very helpful for infants diagnosed with Torticollis. Understandably parents worry when they think something is wrong with their child; however Torticollis is often easily cured. At Carson Physical Therapy, our therapists will show parents the proper stretching techniques for the shortened muscles both passively (the parent or caregiver is doing the stretching) and actively, by getting the baby to actively look the other way. We will also demonstrate the proper techniques for infant positioning during feeding, sleeping, eating and playing to help stretch the muscles. Occasionally the infant may need to wear a specially made helmet to help the head return to a normal shape. As stated above, we can determine the need for a helmet and help get your infant fit properly.
Although Torticollis can be worrisome to any parent, it is highly treatable. If your infant seems to be uncomfortable or limited when turning his/her head, see your pediatrician and ask him/her for a referral to Carson Physical Therapy. Or give us a call and we can help you get one!