HOW TO RECOGNIZE INFANT TORTICOLLIS AND HOW OSTEOPATHY CAN HELP TREAT IT
Torticollis is one of the most common issues parents bring their babes in to see me, and while it's often easy to notice torticollis in your baby, many times it goes unnoticed, often with these babies presenting with issues that aren't traditionally linked to torticollis like difficulty latching or breastfeeding, reflux or general fussiness.
WHAT IS TORTICOLLIS?
Torticollis, also known as "wryneck”, can present in adults, children, and babies.
It is a condition that causes the head to tilt to one side and rotate the opposite way.
It can be congenital (presenting at birth or within the first few weeks) or acquired (developing later in life). Pediatric torticollis is a common condition that affects infants and young children.
Congenital torticollis may arise from fetal positioning, birth strains, traumatic birth interventions (ie vacuum, forceps) or ischemia (reduced blood flow).
WHAT CAUSES INFANT TORTICOLLIS?
Torticollis is characterized by a shortening of the sternocleidomastoid muscle (SCM), which runs from behind the ear to the collarbone. This muscle controls the movement of the head, and when it is shortened, it causes the head to tilt and rotate to the other side.
While the SCM is typically tight with torticollis, treatment cannot be isolated to it alone.
Other factors (ie other neck muscles, thoracic tensions or rotations, pelvic torsions) often contribute to or are the root cause of torticollis.
The whole body needs to be properly assessed and areas of asymmetry, restriction, and torsion corrected.
HOW TO RECOGNIZE TORTICOLLIS?
Here are some obvious and less obvious signs that your baby might have torticollis.
They may:
have limited neck movement
have a head tilted to one side
prefer to turn their head to one side
not be able to turn their head one way
have difficulty holding their head in midline/center
** babies may or may not be limited in their range of motion, a motion preference may be the only clue that there is torticollis (seen in 20% of cases)
have a small mass or thickening of the sternocleidomastoid muscle (50% of cases)
have difficulty with latching, breastfeeding or bottle-feeding
have plagiocephaly (flatness on one side of the head)
have facial asymmetry
have digestive issues
have reflux
prefer to play with toys on one side
only roll one way
commando crawl with one ‘active’ side only
have difficulty sitting, always tipping or leaning one way
always lean to one side in their car seat or other containers
may be generally fussy or unsettled
As you can see, torticollis is more than just a neck issue. Many babies with torticollis have lower spine restrictions, rotational preferences, cranial and/or pelvic asymmetries, and hip issues. In fact, 15% of babies with torticollis also have hip dysplasia.
Digestive issues, such as reflux, and difficulties breastfeeding are extremely common issues secondary to torticollis.
WHAT SHOULD I DO IF I SUSPECT MY BABY HAS TORTICOLLIS?
If you suspect your baby may have torticollis, it is important to have them properly assessed by a physical therapist. You should also discuss the torticollis with your baby’s doctor or midwife as soon as you suspect it.
HOW IS TORTICOLLIS TREATED?
In most cases, physical therapy is the first line of treatment for torticollis. Most babies see full resolution sometime before their first birthday, depending on the severity and the time of diagnosis.
Osteopathic manual therapy is a great holistic (whole body) approach to treating torticollis.
HOW CAN OSTEOPATHY HELP MY BABY WITH TORTICOLLIS?
Your baby’s whole body will be assessed for tension, myofascial restrictions, pelvic, spinal, and cranial torsions, and hip/lower extremity issues. If breastfeeding is an issue, a complete lactation evaluation will also be completed. Referral to a lactation/feeding specialist may be recommended.
Muscles that are tight will be gently stretched and released. Cranial asymmetries will be addressed with craniosacral therapy (CST). Hips, pelvis, and spine restrictions, torsions, or other issues will be addressed with the most gentle caring hands.
Parents will be given instructions for stretching and strengthening exercises to do at home with their baby, as well as education on hometime modifications that may need to be implemented. In some cases, a child may also be referred to a specialist.
Disclaimer - The information shared here is not intended for assessment, diagnosis or treatment purposes.
Reference: Gundrathi J, Cunha B, Mendez MD. Congenital Torticollis. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549778/
