Torticollis
What is Torticollis?
Torticollis describes an abnormal neck posture in infancy which may be muscular in nature and that proper tummy time helps to improve. We will help you to understand the diagnosis, recognize the signs, and learn about the treatment in this workshop.
How Kids in Motion can Help!
Understanding your child’s development and behaviors can be challenging and overwhelming. With many different opinions and suggestions on what your child should or shouldn’t be doing can be stressful and confusing. Although, having the proper resources and education is important to improve your knowledge on ways to help your child develop to the best of their ability and Kids in Motion is here to help.
***************************************************************************************************************************
Objectives
-Understand the diagnosis and causes of torticollis
-Recognize signs and symptoms of torticollis
-Learn appropriate treatment interventions for torticollis
What is Torticollis?
Torticollis is a common diagnosis seen in infants that often results in an abnormal position of the infant’s head and neck (Seattle Children’s Hospital, 2018, p.1).
What Causes Torticollis?
Torticollis can be either congenital or acquired. Congenital torticollis is present at birth and is the most common type of torticollis. Your child may have torticollis at or shortly after birth due to their positioning within the womb or an injury that had occurred when coming out of the birth canal. Additionally, it may be caused by abnormal development of a muscle within the neck called the Sternocleidomastoid (SCM). However, most often the cause of congenital torticollis remains unknown. Acquired torticollis is much less common but may be indicative of a medical issue such as a viral infection, gastroesophageal reflux (GERD), abnormalities in the cervical spine, or vision problems (Seattle Children’s Hospital, 2018; Torticollis, n.d.). It is very important to discuss with your doctor the cause of your child’s torticollis. To identify the cause, your doctor will examine your child’s head and neck range of motion. If acquired torticollis is suspected, imaging techniques such as x-rays or ultrasound may be utilized to gather more information.
**************************************************************************************************************
Signs and Symptoms
It is common for signs and symptoms of torticollis to appear within the first two months after birth as the child gains more strength and control of their head and neck. With congenital torticollis, it is very common for the Sternocleidomastoid muscle in the neck to become tight. As a result, you may notice any or all of the following if your child has torticollis (Seattle Children’s Hospital, 2018; Torticollis, n.d.):
- Demonstrating a strong preference to look to one side
- Head tilting to one side with one ear closer to their shoulder than the other
- Difficulty breast feeding or bottle feeding or feeding on only one side
- Misshapen or flat spots on your child’s head
- Facial asymmetries (one ear is more forward or higher than the other, cheeks appears fuller on one side, etc.)
- A soft bump or thickening in your child’s neck muscle. This bump is not dangerous and will typically resolve on its own within a few months!
How is Torticollis Treated?
Physical therapy is utilized to develop a stretching and strengthening program to address your child’s neck muscles. With torticollis, the Sternocleidomastoid muscle is often shortened, tight, and strong on one side. As a result, the opposite side is often lengthened and weak. The goal of physical therapy is to address these muscle imbalances to help your child gain the ability to hold their head upright in the middle of their body while allowing them to easily look in either direction (Goodman & Fuller, 2009; Matson, 2016).
Because of your child’s limited ability to move his/her head, it is common for infants with torticollis to strongly dislike tummy time (Seattle Children’s Hospital, 2018). As a result, their gross motor development may become delayed. A physical therapist will also assist in addressing any gross motor delays to get your child back on track as quickly as possible!
If your child has a misshapen head (plagiocephaly) that accompanies their torticollis, the physical therapist will also assist with developing a positioning program to assist with correcting your child’s head shape. As an infant, the bones of the skull have not yet attached to one another. Through positioning techniques, these bones can be influenced to move into the proper place up until approximately one year of age. If your child is deemed to have moderate to severe plagiocephaly, a cranial molding helmet may be utilized to further assist with correcting your child’s head shape (Plagiocephaly helmets, n.d.). This helmet may be obtained as early as 3-6 months if needed.
What Can I do to Help Treat my Child’s Torticollis?
With guidance from a pediatric physical therapist, your child’s torticollis will resolve quicker if there is good follow through with your provided home exercise program. Many parents find it helpful to incorporate their child’s stretches and exercises into their daily routine such as with each diaper change or during naptime. Often infants with torticollis may become fussy when working on stretching and positioning techniques, therefore, it may be beneficial to complete stretches when your child is asleep and more relaxed.
You are invited to a Zoom workshop on Torticollis & Tummy Time.
When: May 10, 2022 06:00 PM Eastern Time (US and Canada)
Register in advance for this meeting:
https://us06web.zoom.us/meeting/register/tZYlcOmgrDgpE9dEpgQr7FMz-PBGZjDYRkgF
After registering, you will receive a confirmation email containing information about joining the meeting.
***************************************************************************************************************************
Kids in Motion Pediatric Therapy clinic provides services in all areas from speech, occupational, and physical therapy to address the signs/symptoms stated above related to Torticollis.
Speech therapy will help improve your child’s communication skills by learning verbal and/or nonverbal skills. A speech therapist will engage your child in a variety of auditory and verbal stimuli such as story books, picture cards, interactive games, actual objects, etc. using different approaches and techniques to improve language skills. A speech therapist can also teach the use of an augmentative communication devices, Picture Exchange Communication System (PECS), and American Sign Language. These devices and techniques can improve communication by using pictures and symbols to ask and answer questions when interacting with others.
Occupational therapy will use creative therapeutic activities to increase independence and success in ADL, fine motor, visual motor, and sensory processing skills. Occupational therapist will introduce innovative methods to improve self-dressing, self-hygiene and self-feeding skills. Your child will engage in client centered activities to increase strength and coordination/control in hands and upper extremities to complete age appropriate fine motor and visual motor skills with greater success. Occupational therapist will demonstrate and educate family on variety of sensory diet strategies specific for your child’s needs to improve regulation to perform optimally in everyday activities.
Physical therapy will help improve your child’s strength, coordination, and balance through therapeutic exercise and activities to increase success in age appropriate gross motor skills. Child will also engage in tasks such as obstacle courses incorporating variety of gym equipment to improve motor planning skills. Physical therapist may target gait retraining if toe-walking is present by working on your child’s range of motion, strengthening and incorporating different sensory techniques. Consultation with an orthotist can also be provided if needed.
Still have questions and concerns?
We are committed to helping children of all abilities achieve and live their full potential. With experienced and compassionate Physical, Occupational and Speech Therapists and four locations to serve you, we feel confident that you will be more than satisfied with the care and support your child receives.
Check out our free Interactive Online Screener – once completed, it will respond with ideas to help your child in the areas you specify they might be having trouble with or contact us at 248-684-9610.
References:
- Goodman, C.C., Fuller, K.S. (2009). Pathology: Implications for the physical therapist (3rd ed.). St. Louis, MO: Saunders Elsevier.
- Matson, Laura. “Torticollis.” Phoenix Children’s Hospital, 25 Oct 2016. Family education handout.
- Plagiocephaly Helmets (Cranial Molding Helmets). (n.d.). Retrieved February 12, 2019, from https://www.uofmhealth.org/conditions-treatments/rehabilitation/plagiocephaly-helmets
- Seattle Children’s Hospital. Patient and family education handout. (2018). Torticollis and your child. Seattle, WA: Author
- Torticollis | Boston Children’s Hospital. (n.d.). Retrieved February 12, 2019, from http://www.childrenshospital.org/conditions-and-treatments/conditions/t/torticollis