Pediatric Physical Therapy Treatments For Torticollis

When handling newborns we are always told to “support the head”, as babies have weak neck muscles for a number of weeks after birth.

There is a wide range of what’s considered “normal” at this age, but by three months of age most babies will have neck muscles that have developed enough to lift up their head and take a good look at the world around them.

But what if you see your baby having neck issues or their posture as they grow just doesn’t seem quite right?

Perhaps you notice that your child seems limited in their range of motion, or that their head is always turned to the side at the same angle in photos.

Torticollis, also called “wry neck”, is a condition of the neck muscle that can be observed in children as young as two months of age but occurs in adults as well.

The most common form of torticollis in infants is congenital muscular torticollis, otherwise known as CMT.

In 1992, the American Academy of Pediatrics ran a campaign to reduce cases of sudden infant death syndrome (SIDS). SIDS death occurs when a baby is sleeping and was found to be twice as common when babies were sleeping on their stomachs. The campaign to reduce SIDS worked, but more babies sleeping on their backs caused a rise in torticollis cases.

Torticollis requires immediate medical attention by a pediatric physical therapist.

Don’t panic, though. Torticollis is much easier to correct in infants than in adults. Most infants respond very well to pediatric physical therapy treatment for torticollis, and grow up to be healthy adults.

Let’s have a look at this condition, how to recognize it, and how pediatric physical therapy treatments for torticollis can help.

The muscle that runs from your breastbone to the back and side of your neck is called the sternocleidomastoid muscle.

Torticollis occurs when this muscle becomes weakened, thickened or tight. This causes your baby’s head to tilt and/or rotate. The result is a “twisted neck”, where the top of your baby’s head tilts to one side while their chin tilts to another.

Torticollis can be present at birth, or it can develop over time, often as a result of damage to the neck muscles or a lack of blood supply to the muscles.

In adults, torticollis often causes debilitating pain and limited mobility. Physical therapy and medication are used to reduce symptoms. Surgery is also an option.

In infants, torticollis is best if treated immediately. The condition does usually go away but there could be relapses. If you suspect your child could be suffering from this condition, it’s best to seek treatment from an infant physical therapist as soon as possible.

As with many conditions related to infants, be it pediatric physical therapy, pediatric occupational therapy, or pediatric speech & language therapy, early intervention is key.

There are five types of torticollis:

1. Congenital Muscular Torticollis (CMT)

Congenital muscular torticollis is the most common form of torticollis and is usually diagnosed in the first two months of life. If your baby is suffering from congenital muscular torticollis, they may have developed the condition from birth trauma or by sleeping in one position for a long period of time.

Congenital muscular torticollis is the result of scarring or tight muscles on one side of the neck.

2. Postural Torticollis

Postural torticollis is a temporary form of torticollis that comes and goes. It’s usually diagnosed in an infant’s first five months of life. It could develop as the result of a cold, ear infection or injury.

3. Spasmodic Torticollis

Spasmodic torticollis, also called cervical dystonia, is more common in older children and adults. Causes include infection, inflammation, trauma, or the side effect of a number of medications. Spasmodic torticollis causes the neck muscle to spasm, and the head to twist painfully to one side. It is most often diagnosed in women or men ages 40 to 60, and as a result is rarely dealt with in pediatric physical therapy.

4. Acute Torticollis

Acute torticollis occurs as the result of trauma, which could happen when a child or adult twists or bends their neck too far. Your baby’s neck muscles will be tender to the touch, and it might hurt them to move their head from side to side.

5. Ocular Torticollis

Ocular torticollis is caused by a vision problem in one eye. Because of the vision issue, your baby will tilt their head to allow them to see better. This can cause issues with their neck muscles.

In children, symptoms of torticollis can sometimes come on slowly and worsen over time.

Your child’s face may appear unbalanced, and they may have problems with hearing, vision, or motor skills.

The most common symptoms of torticollis are:

• One shoulder is higher than the other
• Chin tilting to one side
• Swollen neck muscles
• Headache and neck pain/stiffness
• Inability to move the head normally

Torticollis can develop in the womb, or it can be hereditary. Injury to your baby’s neck muscles or nervous system is another known cause.

But torticollis is often considered idiopathic, meaning the cause is unknown.

A rare condition known as Klippel-Feil syndrome also causes torticollis. With Klippel-Feil syndrome, the bones in a baby’s neck do not develop properly and vertebrae become fused together.

Children who suffer from this condition often have problems seeing and hearing as well.

Although Torticollis is easier to correct in infants than in adults, it can cause developmental problems.

As a result of their holding their head in one specific position for so long, torticollis and flat head syndrome often show up together. It can also lead to delayed motor skills, and difficulties in speech development and cognitive development.

For this reason, it’s not uncommon for children with untreated torticollis to later have to seek learning disabilities therapy.

If untreated, torticollis can also lead to more serious conditions like scoliosis, hip dysplasia, balance difficulty, and vision problems.

Torticollis is usually diagnosed in infants by a pediatrician or a pediatric physical therapist. But the primary treatment is physical therapy, no matter what age the patient. If your child has received a diagnosis of torticollis, we can help.

At District Speech we provide pediatric physical therapy treatments for infants and young children. Our physical therapists will work with you to create a treatment plan that works best for your child.

When you first contact District Speech about your infant’s condition, we’ll start with a detailed consultation. During this consultation, you’ll speak with your pediatric physical therapist about the issue. They’ll ask you about your baby’s health history, when you first noticed the problem, what seems to make it worse, and whether they have been diagnosed with torticollis or another condition, among other things.

Depending on your individual child’s needs, your pediatric physical therapist will focus on exercises including:

• Gentle stretches of your baby’s neck and back muscles
• Exercises to strengthen your baby’s neck and back muscles
• Gentle massages of your baby’s neck and back muscles
• Guiding them into the correct posture
• At-home exercises you can use to help their progress at home

Your child may be encouraged to perform simple exercises to encourage movement, including tummy time, rolling, and sitting up. You can repeat these exercises at home.

Initially, you may see your pediatric physical therapist weekly. As your child improves, they may suggest a monthly checkup.

Every child is different, but with early intervention, most show great improvement within about six months.

If you need a physical therapist trained to treat torticollis in infants, then look no further than District Speech.

We not only specialize in speech language therapy, we also offer other integrative pediatric developmental therapy solutions to assist your child in overcoming their challenges.

Our physical therapists are trained in pediatric conditions and will work with you to help your baby develop into a happy, healthy child.

Contact District Speech today for a consultation.