One of the reasons which drives me to write on a topic is when I there is sudden surge of a particular condition of patients. That’s exactly what’s happening these days; I am seeing a lot of patients with Torticollis.
What is Torticollis?
Torticollis is a condition involving the muscles which cause twisting of the neck. The term comes from two Latin words: tortus, which means twisted, and collum, which means neck.
Torticollis is caused by shortening of Sternocleidomastoid, a muscle which runs on the back of the ear to the collarbone.
- Shortened Sternocleidomastoid will cause the neck to bend to the same side and turn to the opposite side.
- Difficulty breastfeeding on one side and preference for other side mainly
- Flattening of face on one side and fullness on other side
- Facial asymmetry
- Looking at one side more with head turned to that side
- Flattening of back of the head on one side
- Mild delay in rolling, sitting, gross motor activities
So you may ask, why would this muscle shorten? It’s mainly due to the position of baby in the womb wherein it may be either cramped up or in abnormal position like breech. It can also occur due to injury during birth process by the shoulder getting stuck or forceps/vacuum delivery.
Pediatric Physiotherapy works wonders on improving the position of head and neck and avoiding/covering the delay in gross motor and sensory milestones. Early Intervention wherein the baby/child is screened and treated as early as possible has the best results.
What would your physiotherapy sessions look like?
- On the first day, I typically assess the baby/child in detail wherein I go through the history, presentation and symptoms of the baby/child, different system assessments like Musculoskeletal, sensory, rule out other systems like cognitive to ensure nothing is missed out. After a thorough assessment, goals are set by discussing with parents and caregivers and a treatment plan is chalked out.
- In follow up sessions, treatment strategies are devised based on neurodevelopmental and sensory integration principles with play therapy.
- Goals are achieved and reset with ongoing modifications in treatment strategies.
- Families are given an exercise program to carry out at home to see faster results.
Most infants/babies when diagnosed and treated early especially within first 3 months, respond well and gain appropriate positioning within few months of therapy. However, in rare situations especially when intervened at an older age, may require surgery to lengthen the sternocleidomastoid muscle.
Written by: Shivangi Trivedi (Pediatric Physiotherapist)
BPTh, C/NDT, CMP
MATRIX PHYSIOTHERAPY TORONTO