What is Torticollis?
Congenital Muscular Torticollis is the twisting of the neck causing tightness on one side and resulting in a limited range of motion. Particularly, it is tightness in the sternocleidomastoid muscle (SCM) of the neck.
Torticollis can be postural, muscular, or cause a sternocleidomastoid mass. Postural torticollis is the simplest form when the baby favors one side, but has no muscle tightness. In this case, one side of the neck is stronger than the other, and the weaker side needs to be strengthened. Muscular torticollis is tightness in the sternocleidomastoid muscle. This is most comparable to sleeping in a bad position and waking up to a sore neck where it is difficult to turn your neck to one side. Finally, the most severe form is a sternocleidomastoid mass where there is a thickening of the muscle or fibrosis.
Depending on the severity, torticollis is not painful for the child. However, it can cause some lifelong effects if not treated. Untreated torticollis can lead to plagiocephaly (flat head), asymmetry in the facial features, scoliosis (twist in the spine), and effects on your child’s motor development milestones.
When addressed within the first year of life, most cases are treatable and result in no lifelong effects.
The cause of torticollis is not completely known, but can sometimes be influenced by the baby’s position in the womb or difficult birth.
Symptoms
The most obvious symptom of torticollis is the twisting of the neck to one side. Your baby’s range of motion will be limited. They might not be able to follow you with their head past a certain point. They might get fussy or upset because they feel restricted by their body’s ability to move. They may favor one side, especially during breastfeeding. In some cases, you may notice a lump or knot in the neck muscle.
Treating Torticollis
If you notice any of the above symptoms, be sure to see a pediatrician. The pediatrician will be able to diagnose torticollis, and either give you stretches and handling advice or provide a referral to go see a physical therapist. A physical therapist (PT) will be able to treat torticollis and will be seen weekly, sometimes more frequently. The therapist will work on stretching the neck and increasing the range of motion.
One of the PT's jobs is to provide parent education on daily handling and exercises in order to improve torticollis. They will be able to provide you with an at-home plan that must be done daily in order to help treat this condition. They will also be able to answer any questions you may have and monitor your child’s improvement.
Some things that you can do at home to help increase your child’s range of motion and stretch their neck is tummy time for 10 to 15 minutes every day. This helps to strengthen the muscles in the neck and shoulders. You can also attract your baby’s attention and try to get them to move their neck on their non-preferred side. This can be done with toys, mirrors, or movement. With time and daily stretching, their range of motion will improve.
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Clark, Kathy, “Torticollis: Five Simple Steps to Improve Your Baby’s Movement and Development,” South Shore Health, 19 March 2021, https://www.southshorehealth.org/wellness/blog/how-to-treat-torticollis-physical-therapy-for-babies.
“Congenital torticollis,” Physiopedia, 29 November 2021, https://www.physio-pedia.com/Congenital_torticollis.
“Infant Torticollis,” Nemours Kidshealth, accessed 1 June 2022, https://kidshealth.org/en/parents/torticollis.html.
Luxford, Bernadette K, Leigh Hale, and Jan Piggot. “The Physiotherapy Management of Infants with Congenital Muscular Torticollis: A Survey of Current Practice in New Zealand,” New Zealand Journal of Physiotherapy. 37, no. 3 (2009): 127–35. https://login.ezproxy.uakron.edu:2443/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=105266405&site=eds-live.