Does your baby have torticollis? Here's what you need to know
Have you ever heard of the term torticollis, sometimes referred to as congenital muscular torticollis (CMT) or “wry neck” and wondered what the heck that means? Or maybe you’ve started to notice that your baby is developing a preference to one side? Well, I am here to explain and break down exactly what torticollis is, signs to look for and treatment options. (And don’t worry, it's not as scary as the word sounds)
Torticollis is a common condition that occurs in babies (about 1 out of every 250 newborns), which causes shortening of one of their neck muscles called the sternocleidomastoid or SCM. This muscle shortening results in the baby developing a head tilt to one side with rotation of their neck to the opposite side.
There are three types of torticollis:
1. Positional - baby just has a preference for one side but no muscle shortening or reduced neck movement
2. Muscular - Muscle is shortened limiting neck movement
3. Presence of a mass on the SCM - Increased thickening of the muscle resulting in a mass
Risk factors which increase the likelihood of Torticollis:
1. Baby was breech
2. Multi baby pregnancy
3. Reduced amniotic fluid
4. Forceps used during birth
5. First pregnancy
Signs and symptoms what to look out for when it comes to torticollis:
• Observed head tilt to one side frequently
• Only looks to one side
• Appears to prefer movement to one side
• Has difficulty or reduced tolerance to tummy time
• You notice a flattening on one side of the back of their head (often torticollis might lead to what is called plagiocephaly, which results in the head flattening on one side due to spending majority of the time laying on one side)
What you can do:
If you are starting to see that baby is preferring movement to one side the first thing, I suggest is encouraging baby to look towards oruse the side they are not preferring to turn towards or use.
Example: Baby is tending prefer looking towards the right side and using the right extremity
• Try being on baby’s left side when you are changing him.
• Try moving the car seat so more interesting things (window or toy) are on the left
• Cover the left side of the stroller when on a walk or place toys/mirror on the left
• Carry him over your right shoulder
• When playing with baby or when baby is in tummy time put toys on the L side and encourage use of the L upper extremity
In addition, it is important to emphasize TUMMY TIME. The goal for tummy time is to get in one hour a day cumulatively throughout the day.
You may also try stretching:
1. Lay baby on their back
2. Place on hand on their right shoulder
3. Using your other hand gently guide their head to the left
4. Try to maintain the stretch for 30-60 seconds
5. Perform 3 times a day
How physical therapy can help:
Torticollis is best treated when addressed early! Research shows that 98% of infants achieve normal neck range of motion after just 6 weeks of PT on average. So if you have any concerns about your baby’s movement and/or the stretches and changes in movement aren’t making a difference in baby’s movement, we are here to help.
Physical therapy for a baby includes an evaluation and assessment where we observe baby’s movements and measure their neck ROM. From there we establish a plan to improve their neck range of motion which usually includes: stretching, massage, parent education and skilled handling techniques address any movement asymmetries or delays in their development.
Don’t hesitate to reach out if you have any questions or concerns. We offer a free 15 minute phone consultation where we can answer any and all of your questions to see if physical therapy is right for you and your baby <3 Our therapist Dr. Avonlea Brown is trained in pediatric care and is here to help!
References:
Gundrathi J, Cunha B, Mendez MD. Congenital Torticollis.[Updated 2023 Jan 31]. In: StatPearls [Internet]. Treasure Island (FL):StatPearls Publishing; 2023 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK549778/
Kaplan SL, Coulter C, Sargent B. Physical therapy managementof congenital muscular torticollis: A 2018 evidence-based clinical practiceguideline from the APTA Academy of Pediatric physical therapy. PediatricPhysical Therapy. 2018;30(4):240-290. doi:10.1097/pep.0000000000000544.
