Torticollis is a term to describe the asymmetrical posturing of the head and neck – often resulting, in a baby, in a head tilt and misshapen head. It is the third most common musculoskeletal condition found in babies and children.
About 1 in 200 babies have Torticollis, and present with a shortening of a muscle (the sternocleidomastoid muscle, or SCM) in their neck causing their head to tilt to one side. Most of the babies who present with Torticollis in the first year of their life have Congenital Muscular Torticollis (CMT). Congenital just means it was present at birth.
So what does that mean and what will I see in a baby with Torticollis?
Usually if a child has Torticollis you notice that:
- baby’s head is usually turned to one side, and they find it difficult to turn to the other side
- baby’s head is also usually tilted so they seem to be looking up as well as to the side. This is due to the shortened muscle on the other side of the neck pulling the head into position.
- sometimes, as well as the muscle feeling tight, there can be a small lump in the middle of the muscle, like the size of a pea.
- baby’s head can be misshapen
The misshapen head occurs to pressure always being on the same part of the movable bones in a babies head, rather than a more even distribution of pressure facilitated by free movement of the neck in all directions. This is called positional plagiocephaly.
It also appears to be occurring more as we now only sleep babies on their backs due to SIDs prevention knowledge. It is essential that parents follow the guidelines about safe sleeping, but also ensure that when baby is awake that they allow baby lots of tummy time (more than 3 times each day) plus supervised play time in side lying. This changes the mechanical pressure on the head causing the misshapen head.
What Causes Torticollis?
The causes of Torticollis are poorly understood still, but research to date has presented the current theories of the usual causes being:
- the position the baby was in the womb before birth
- birth trauma
What can I do to help my baby with Torticollis?
Your maternal health nurse can check for you and refer you to a local paediatric physiotherapist. You are also free to contact a physiotherapist directly to make an appointment. Physiotherapy has been shown to be the effective treatment of this condition. You may like to reassure yourself by visiting your paediatrician and ruling out any other possible (but rare) conditions that can have associated Torticollis. Surgery is occasionally needed.
The earlier you start physiotherapy the better the outcome for your baby. If the muscle is not stretched it could become permanently tight. Physiotherapy will help you in stretching, positioning your baby to play and sleep, and find ways to carry your baby to improve the head position. Your paediatric physiotherapist will also teach you ways to encourage active movement of the head and neck. This is a muscular problem, not spinal, so “adjustments” of the spine will not resolve the problem. Massage alone also does not address the underlying problems.
– this article is based on content kindly supplied Blackburn North Physiotherapy Centre