Torticollis is neck muscle tightening that causes the head to tilt or turn to one side. For children and adults, it can occur as a result of another medical condition, and may dissipate on its own. If your baby has torticollis, it may stem from womb positioning, mild injury during childbirth or a tendency to turn her head one way before she develops head control. Early physical therapy should reverse or significantly diminish torticollis in your baby.
Evaluation
Your baby's physical therapist will evaluate and assess your baby's range of motion, muscle strength, large motor skills and muscle tightness before developing a treatment plan. He also will check for conditions that sometimes appear with torticollis, such as spinal problems, an abnormal head shape or a misaligned hip joint.
Therapy Goals
For babies, the ultimate goal of therapy is to reduce or eliminate the tilt or turn of her head, but physical therapy also aims to improve a variety of functions that torticollis can impede. Other treatment goals for your baby include an improved ability to turn her head to both sides, to bring her chin to her chest, lift her head against gravity as she lies on her stomach, use her extremities symmetrically and shift her weight properly during activities such as sitting and crawling.
Office and Home Treatment
Your baby's therapist will use gentle stretching exercises to improve your baby's ability to touch his chin and ears to both shoulders. However, proper physical therapy for torticollis involves consistently positioning your baby's body in ways that will encourage muscle lengthening. Much of the physical therapy program will require your active participation. Your baby's therapist will instruct you in massaging, positioning and moving your baby's body to combat asymmetry. For example, she will tell you to place toys to your baby's nonpreferred side, place him on his changing table so that you're on his nonpreferred side and put his toys in places that encourage him to gaze downward.
Results
You may see an improvement in your baby's torticollis if the condition is discovered by about her second or third month and you regularly follow the prescribed home care plan. At this rate, the torticollis should be treated by about age 1. However, she might need muscle-lengthening surgery if her neck muscles aren't at a normal length and she doesn't have an ideal range of motion by the time she turns 18 months old.
References
- Mid-Maryland Musculoskeletal Institute: Physical Therapy and Torticollis; Monica Johnson, DPT
- Children's Memorial Hospital: Physical Therapy for Torticollis
- BabyCenter.com: Torticollis
- Children's Hospital of Wisconsin: Torticollis Clinic
- All Children's Hospital: Physical Therapy for Torticollis
- American Academy of Orthopaedic Surgeons: Congenital Muscular Torticollis
