By Rebecca Rudisill, PT, DPT, Board Certified Pediatric Specialist
What is Torticollis?
Torticollis is a disorder, commonly seen in infants, in which tight neck muscles cause the head to twist and/or rotate sideways. The most commonly affected muscle is the sternocleidomastoid (or SCM for short) – a large muscle that runs from behind the ear to the breast bone and collar bone. The SCM causes the head to tilt to the same side and rotate to the opposite side. In addition, the tightness of the SCM can cause a cascade of tightness throughout the body. The incidence of torticollis has greatly increased over the past 30 years due to the Back to Sleep (now Safe to Sleep) program. Now that babies spend more time on their backs, they don’t naturally turn their heads to clear their airway, which stretches the neck. Returning to sleep is extremely important for the safety of infants and Sudden infant death syndrome (SIDS) prevention, but torticollis is a possible result. The good news is that with early recognition and treatment, torticollis can be completely resolved!
How do I know if my baby has torticollis?
Look behind your phone for pictures of your baby. Do they tilt their head the same way in every photo? This is a major indication that something is wrong. Another indication is if your baby only looks in one direction and gets agitated if you turn his head the other way. If you notice that your baby is developing a flat spot on their skull, their eyes or face look asymmetric, or if all the hair has rubbed off in one spot on one side of their head, they may also have torticollis. If you notice a lump or lump in your baby’s throat, bring it to your doctor’s attention. This lump is probably a band of tight muscle tissue called fibromatosis colli or pseudotumor. It is a sign that your baby has torticollis.
Should I be looking for something else?
Plagiocephaly, a fancy clinical word for the flattening of the skull to one side, is a condition commonly seen with torticollis. You may see a flattening of the back of the head on one side, an ear pushed forward, a smaller eye or cheek on one side, or a shift in the alignment of the jaws. When identified and treated early in life, plagiocephaly is corrected with conservative treatment in physical therapy. If not caught early, babies may need to wear a helmet to correct their head shape. Helmets are very light and usually do not bother babies at all. Plagiocephaly treatment, whether conservative or more, is highly recommended to help your baby develop a round head shape. A round head is essential for the proper fit of glasses, bicycle helmets and sports helmets.
I think my baby has torticollis. And now what;
If you think your baby may have torticollis and/or plagiocephaly, ask your pediatrician for a referral to physical therapy. The sooner the better! Treatment is shorter and more likely to result in complete resolution of symptoms when treatment is started earlier. It is best to start physical therapy before 3 months, but it is never too late to make a difference.
A physiotherapist will assess your baby from head to toe, come up with a comprehensive treatment plan and give you exercises to work on at home. Treatment for torticollis may include:
- Stretches of tight muscles in the neck and trunk
- Increase active movement in the neck
- Neck and torso reinforcement on both sides
- Visual tracking of people and games in all directions
- Development of age-appropriate symmetrical gross motor skills
- Environmental changes to promote contralateral rotation
- Education of parents and/or caregivers
- Hydrotherapy for children 1 year and older
Parental involvement and completion of a home exercise program is a very important component of physical therapy treatment for torticollis. Your therapist will give you a combination of stretches, strengthening exercises and developmental play to complete at home with your child. Completing these exercises regularly will stretch and strengthen your baby’s muscles helping to relieve torticollis.
For more information or to schedule an appointment with one of our therapists, please visit us Website or contact the Woman’s Center for Wellness at 225-924-8450.
