THREE THINGS YOU DIDN'T KNOW ABOUT TORTICOLLIS
Torticollis literally means, “twisted neck” in Latin. Also known as “wry neck” or “loxia,” Torticollis
is a fixed or dynamic tilt, rotation, or flexion
of the head and/or neck. This is usually manifested by a baby’s head
being tilted to one side with their chin towards the opposite side.
The First Thing You Didn’t Know About Torticollis
There are actually three types of Torticollis. The first type is called, Congenital Muscular Torticollis. Although not completely clear, it’s most
thought to be caused by trauma to the neck
during birth or abnormal positioning of the baby while in the uterus (for example,
a breech position).
This kind of Torticollis is usually discovered between
six to eight weeks after birth when a baby begins to have more control over his
head. The sternocleidomastoid
muscle (SCM), a muscle in the neck, becomes excessively shortened and
causes the baby to be unable to turn and/or tilt his head. If the shortened muscle is caused by trauma,
the SCM will develop scar tissue as it heals, restricting the baby from turning
his head. The second type of Torticollis
is Acquired Torticollis. This type usually develops after the baby has
reached its first birthday. A child
might develop it if he or she sleeps in the wrong position or injures his head. The SCM and other muscles of the neck may
spasm, causing the head to tilt to one side.
This type of Torticollis may also be caused by an upper respiratory
infection when the lymph nodes in the neck swell. The third type of Torticollis
is Spasmodic Torticollis (ak.a.
Cervical Dystonia). It is caused by a
dysfunction of the brain which causes the muscles around the neck to contract
intermittently or all the time. This type of
torticollis may be extremely painful and cause the shoulders to be uneven. This type of Torticollis is mainly seen in
adults.
The Second Thing You Didn’t Know About
Torticollis
Did you know that Tortocollis is described depending on the
position of the neck? There are four positions:
- laterocollis : This is when the head
is tipped to the side towards the shoulder. (think this: the ear is trying
to touch the shoulder)
- rotational torticollis : This is when the head
is actually rotated to one side.
- anterocollis : This is when the head
and neck is tilted forward (think this: chin to chest).
- retrocollis : When the head is tilted backwards
The Third Thing You Didn’t Know About Torticollis
Physical Therapy provides
treatment of Torticollis! It is always
a good idea to get an evaluation by a pediatric physical therapist if you
suspect that your child has Torticollis. This type of therapist is specially
trained to handle pediatric diagnoses.
He or she will assess and measure the range of motion of your child’s neck and
evaluate any muscle tightness. S/he will
also evaluate your child’s muscle strength and gross motor skills. Lastly, he or she will check for other conditions
that can occur with torticollis such as plagiocephaly (abnormal head shape),
hip dysplasia (misalignment of the hip joint), and spine problems. The therapist
will then discuss these results with the family and make appropriate
recommendations for physical therapy treatment. If it is indicated, the
physical therapist will then perform a stretching program to the neck and
instruct the family in a stretching and positioning program designed
specifically to the child's needs. He or she will also educate the parent in
how to perform a daily home exercise program.
Why is Early Treatment
Important?
Receiving
early treatment for Torticollis is important.
It can prevent a permanent shortening of the involved muscle, avoid the
need for surgery and prevent plagiocephaly (flattening of the head on one
side), delayed developmental motor skills and facial asymmetries.
At
Rapha Physical Therapy, our pediatric therapists use a hands-on method to treat
Torticollis coupled with health education and internet resources. We typically see significant results between
6 to 8 weeks and complete recovery within 12 visits. When Torticollis treatment is implemented
early, the majority of children recover completely in a short period of
time. Don’t go it alone. If you see that your child’s head is tilted
towards one side, talk to your doctor about treatment and ask for a referral to
a pediatric physical therapist.