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Torticollis and Physical Therapy

Congenital muscular torticollis is a term used to describe the shortening of a muscle in the neck known as the sternocleidomastoid. This muscle is responsible for bending your neck to the side and rotating your neck to the opposite side. This condition occurs commonly in infants due to a number of factors including positioning in utero, reflux, and positioning after birth. When this muscle becomes tight and shortened, a baby will tilt their head to the affected side and rotate their head to the other side. This positioning can affect the strength of their neck and eventually even prevent certain motor milestones from being attained. Additionally, torticollis can contribute to and often co-exists with a condition known as plagiocephaly, a flattening of the head.

It is important to correct torticollis as early as it is detected. If the condition was due to positioning in utero, this can be as early as 2-3 weeks of birth. Not correcting this condition early can lead to more complications including severe flattening of the skull and facial asymmetries. These conditions require further interventions including helmets which are costly and time consuming.

The majority of treatment for torticollis, particularly in very young infants, involves positioning. It is important that babies consistently change positions and are not left in a position for a long period of time. While it is important for babies to sleep on their back, as this has been found to decrease the risk of sudden infant death syndrome, tummy time when awake is one of the best positions to prevent torticollis and strengthen a child’s neck.

Along with positioning, your therapist will likely give you gentle stretching and strengthening exercises for your child. Depending on severity, treatment for torticollis is usually very quick if caught early. The majority of the treatment will be done at home through a home exercise program performed by the parent, with subtle changes made depending on your child’s age and severity. Additionally, your therapist will look for any red flags indicating that your child is falling behind in their motor milestones.

If you notice your child has a head tilt, only rotates his/her head to one side, or has flattening of the back or sides of his/her head, contact your physician and get referred for PT right away.

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