What is Torticollis?

Torticollis is a term that describes asymmetrical posture of the head and neck. Children that present with this in the first year of life have “congential muscular torticollis,” or CMT. Torticollis literally means “twisted neck.”

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CMT is caused by fibrosis or tightening of the sternocleidomastoid muscle (SCM). For centuries this has been the result of direct trauma during difficult labours. However it has been found that other factors such as neurogenic, and hereditary factors can cause CMT. Another cause is inter-uterine compartment syndrome where the baby holds its head in an awkward position in the birth canal. Tumours of the SCM can also result in CMT.

Features:
CMT can produce a shortening of the SCM which results in the head being held to one side. Typically the ear is held towards a shoulder and the chin rotated to the opposite shoulder. Therefore the neck can’t rotate fully on the shortened side.

Results
This can lead to asymmetry of the face, reduced neck rotation, and flattening of the head termed Plagiocephaly.

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In addition some have hip dysplasia, club foot, shoulder injuries, spinal deformities; such as scoliosis, absence of a vertebrae facet (C1), fusion of vertebrae and herniated discs.
As you can imagine any asymmetry and pain the child is experiencing will delay their development. A child’s balance is compromised, and their awareness of each side of their body. Often these children have problems with tummy time, rolling and progressing to crawling.

Treatment
As you can see from the above Torticollis is definitely worth treating! This can be done through physiotherapy, which can be offered at Stagg Physiotherapy.

Typical treatment will involve:

  • Assessment; with referral for x-ray or further investigation if required.
  • Advice for the parents on the nature of this condition, and options.
  • Help with positioning, passive stretches, and aids (if required).
  • Kinesio taping to help the child move correctly and correct their posture.
  • Help aiding your child to physically develop and reach their milestones; e.g. rolling, tummy time, crawling, standing and walking.
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Research
Research has found that 16% of children treated conservatively before one year of age will require surgery, and typical treatment can be from 3-12 months.

This condition does not only apply to babies, but also children and adults, who can be treated conservatively with physiotherapy.

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