Torticollis

What is it?

A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors.

Statistics:

Congenital torticollis has been estimated to affect approximately two percent of newborn infants. The frank breech birthing position has been reportedly associated with the highest incidence of torticollis, with up to 34 percent of infants born in this position being affected. The most common type of congenital torticollis is that associated with subluxation of the upper cervical spine.

Important Facts:

Congenital torticollis occurs when the neck muscle that runs up and toward the back of your baby’s neck (sternocleidomastoid muscle) is shortened. This brings your baby’s head down and to one side. This is known as congenital muscular torticollis.

Treatment Duration:

Congenital muscular torticollis (CMT) is the most common cause of torticollis in childhood. This condition is usually recognized and successfully treated in infancy, but may persist in adulthood, particularly if not treated.

To treat congenital torticollis, you’ll learn to stretch your baby’s tight neck muscle several times a day. Your doctor or a physical therapist will teach you how to safely do the exercises.

Do’s/Don’ts:

During feeding, hold your child in a way that makes him or her rotate the chin to the correct position. Place toys and other objects in such a way that your baby has to turn his or her head to see them and play with them.

Common Myths:

Torticollis is a localized issue Reality: Is any issue ever just localized? If you have a toothache doesn’t it affect other areas of your body. For every action there is an equal opposite reaction. The only question is where is the opposite reaction in the child’s body. Finding the root issue which may be mid-chest, pelvis, hyoid, or any other area not obviously related to the neck.

Torticollis doesn’t cause delays. Reality: In many programs a diagnosis of torticollis automatically qualifies a child for Early Intervention. They do not need the quantitative % delay as the problem is more qualitative. Just as in Down Syndrome children may not present with many delays initially, but we know that eventually predictable patterns will emerge. In tort we see the predictable patterns of delays in rolling (child may only go one way and struggle with quality of rolling) delays in protective response (one side holds elbow in stiff extension and falls more – usually right side), limited range in right shoulder flexion, unilateral pronation etc. not to mention dental implications of asymmetry which may affect speech and feeding as well as a distorted visual field rotated more to one side affecting spatial awareness.

A small % of tilt isn’t an issue. Reality: Imagine having to work all day long with your head tilted 10 degrees to the side. How would that affect your overall performance? What if you did not yet have good balance skills or had not yet learned to sit up or walk? How would this impact your achievement of these skills? How would this impact your handwriting skills? If this posture became hard wired into your system what would be the effect with your growth spurt at puberty. Might this be the cause of idiopathic scoliosis?