Infant Torticollis: KidsHealth

Infant Torticollis:

Torticollis is a problem in the muscles of the neck that causes the head to tilt down on one side. The term comes from two Latin words: tortus means twisted, and collum means neck. Sometimes it’s called “wryneck.”

There are two common types of Torticollis; Congenital and Acquired torticollis:

1. Congenital: If your baby has the condition at birth, it’s called Congenital Muscular Torticollis. That’s the most common type.
2. Acquired: Babies can also develop the condition after birth. Then it’s called “acquired torticollis” Acquired torticollis may be linked to other, more serious medical issues.

Causes of torticollis:

You have a long muscle on each side of your neck that runs from the back of your ear to your collarbone. It is called the Sternocleidomastoid, or SCM.

When your baby has torticollis, this long ropy muscle is shortened on one side. The reasons could be; either your baby might have been cramped in the womb or may have been in an abnormal position, such as a breech position. That can put extra pressure on one side of your infant’s head, which can cause the tightening of SCM. If your doctor used forceps or a vacuum device during delivery, those also might have put pressure on your baby’s SCM.

Symptoms of torticollis:

It is difficult to notice in babies for the first 6 or 8 weeks. It’s common for torticollis symptoms to become obvious once an infant gains more control of the head and neck.

Some of the symptoms you might see:

1. Your child’s head tilts to one side with his chin pointed to the opposite shoulder. In about 75% of babies with torticollis, the right side is affected.
2. His head doesn’t turn side to side or up and down easily.
3. You feel a soft lump in your baby’s neck muscle. This is not dangerous and goes away within 6 months, usually.
4. Your baby prefers to look over the shoulder at you.
5. His eyes don’t follow you because that would require turning his head. He has trouble breastfeeding on one side or prefers to feed on one side only.
6. Your baby works hard to turn toward you, struggles to turn his head all the way, and becomes upset because the movement is hard.
7. He might start getting a flat head on one side — or both sides — from lying in one position all the time. This is called “positional plagiocephaly.”

Treatment for torticollis:

Early action can help to prevent any long-term problems for your baby. Without treatment, your baby might get complications, including Less control of his head, limited reach on the affected side and less tracking with the eyes, delays in sitting and walking, problem in feeding, poor balance, crooked crawling, Rolling onto one side only. Treatment may include non-surgical or surgical intervention.

Physiotherapy interventions:

Two things can speed recovery: early diagnosis and sticking to the treatment plan. Once torticollis is diagnosed and the physiotherapy starts, most babies improve within 6 months. Physiotherapy treatment may include;

1. Myofascial releases of sternocleidomastoid and other shortened muscles
2. Slow sustained stretches
3. Spine mobilizations, if needed
4. Positional releases
5. Posture corrections
6. Neurodynamics
7. Functional training and movement corrections
8. Parent education regarding helping at home

Rarely, children with torticollis may need surgery to lengthen the SCM muscle. Doctors will usually wait until the options have failed to help.

Written By- Ms. Sana Nafis, Physiotherapist, AktivHealth