Torticollis is a common diagnosis we treat here at Milestone Therapy Clinic. It is often seen in children younger than one, but not uncommon to see in older children.  Torticollis may sound like a daunting diagnosis, but it is usually treatable without any medicine or surgical intervention. 

A child with torticollis presents with his or her head tilted towards one side, while the chin is turned in the opposite direction.  Typically children with torticollis also present with a limited range of motion in their necks. 

There are two main types of torticollis: congenital (present at birth) and acquired (occurring later in infancy or childhood).  Other causes, that are less common, can be bony deformities in the spine, neurological imbalances, or vision problems. The most common type of torticollis and the focus of our blog today, is Congenital Muscular Torticollis or CMT. 

Causes of CMT

  • Abnormal position or lack of space in utero
  • Low amniotic fluid
  • Traumatic birth process
  • Multiple babies (twins, triplets, etc.) 

Overtime, the muscles on the side of the neck with the tilt become tight and shortened. Where as the muscles on the side opposite the tilt, become weak and lengthened. Once this occurs, intervention is needed to stretch the tight muscles and strengthen the weak muscles. 

 

Signs and Symptoms of CMT

  • Head tilt to the side of the tight muscle, with the chin turned toward the opposite side.
  • Limitations in range of motion (turning head side to side, looking up and down).
  • Palpable lump in the muscle on the shortened side. 
  • Rolling towards one direction only. 
  • Prefers to look over one shoulder instead of turning to follow with his or her eyes.
  • Becomes frustrated when unable to turn his or her head completely. 
  • Favors one side during active play.

Signs and symptoms may go unnoticed early on due to limited head/neck control. Once a parent or caregiver notices a limited range of motion, head tilt, or a strong preference to turn, look, or play more on one side; steps for proper care and treatment should be started right away. 

 

Treatment

Parents or caregivers typically notify their pediatrician about their child’s head tilt or limited range of motion. Pediatricians are able to diagnose and recommend a course of treatment for the child’s torticollis. In general, torticollis is best treated through physical therapy intervention. 

It is important to take a more comprehensive approach to treating Congenital Muscular Torticollis. Physical therapy interventions include positioning, active movements, proper handling, and reciprocal inhibition to promote gross motor activity and facilitate appropriate movement of the affected muscles. Other interventions used are active head turning to improve visual engagement, fixation, tracking, and sensory-motor control. 

If left untreated, children can develop other conditions

  • Plagiocephaly: flattening of the skull causing a flat pot on the side of the head the child tends to put more pressure on while lying down. 
  • Facial asymmetries: eye, cheek, mouth, ear and jawline 
  • Delayed motor development: muscle imbalances, balance deficits, postural shifts
  • Scoliosis
  • Delayed cognitive development: limited ability to turn head to see, hear, and interact
  • Developmental hip dysplasia 

 

A well rounded approach to treating congenital muscular torticollis is beneficial for children with torticollis. They are able to improve neck motion and position, meet developmental milestones on time, and parents are able to understand how to care for their child. 

If your child or someone you know is experiencing any of the above signs or symptoms then please call our office today. We would be happy to answer your questions and discuss your concerns. 

 

Photos: Canva + Pixabay 

 

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