Click here for photo creditTorticollis is a term used to refer to a head tilt that a baby is born with or develops soon after birth. This condition can be easily treated, and it is not permanent. Contrary to what some parents believe, torticollis does not resolve on its own, it does need treatment to fully go away.
Torticollis is a stiff neck that is hard to turn. The muscle that is affected by torticollis is the sternocleidomastoid muscle, which connects the head and neck to the breastbone. When this muscle is contracted, it causes a head tilt.
When torticollis is present in newborn babies, it’s called congenital muscular torticollis, and this is the most common type of torticollis. However, torticollis can sometimes appear up to six months after birth and this is known as acquired torticollis.
Congenital muscular torticollis responds very well to physical therapy, especially when it’s started early. Sometimes it is associated with plagiocephaly, a common and treatable condition in which there is asymmetry in the shape of the head and face.
Acquired torticollis typically occurs in the first four to six months of childhood or later. It may come on quickly or slowly. In contrast to congenital muscular torticollis, there is usually no facial asymmetry with acquired torticollis. Acquired torticollis may be harmless (benign) or it may be a sign of a more serious health issue.
Congenital muscular torticollis may be due to the infant's position in the uterus. It may also occur (though this is rare) during birth, especially if it’s a breech birth or a difficult first-time delivery.
Experts aren’t certain why some babies are affected by torticollis, but some contributing factors or possible causes of infant torticollis include:
For children who have acquired torticollis, the causes vary widely and range in severity from benign (not serious) to very serious. Some causes of acquired torticollis include:
You'll probably notice that your baby holds their head to one side and has limited neck movement or you might notice a small bump on the side of their neck.
Congenital muscular torticollis is usually diagnosed within the first two months of a baby's life. Even if you don't spot it, an experienced health care provider will. Infants with torticollis may also develop positional plagiocephaly (asymmetrical head shape) because they'll often sleep with their head turned to the same side. Click here for more information on plagiocephaly.
During the examination, your baby’s healthcare provider will check to see how far your baby can turn their head and will typically search for a lump in the contracted sternocleidomastoid muscle on your baby’s neck. In addition to a physical exam, the doctor may need to order X-rays of the neck to determine which form of torticollis your child has. The doctor may also order other tests, such as an ultrasound of the hips or kidneys, depending on the type of torticollis or they may refer you to a physical therapist, neurologist or orthopedist.
If you suspect your baby might have torticollis, speak to your healthcare provider. The condition can usually be detected in the first six to eight weeks after birth.
Once your doctor has determined that your child has congenital muscular torticollis, you and your child will begin a program of physical therapy designed to lengthen the shortened neck muscle.
Physical therapy programs will include specific exercises you can do at home on a set schedule, such as during diaper changes. In addition, you will learn how to hold your baby and tailor the environment to encourage them to turn their head and stretch the neck muscles. You'll need to perform these exercises on your baby several times a day. You'll want to provide as many opportunities as possible for your baby to turn their head to the side that they normally don't turn to.
If your baby was recently diagnosed with torticollis or you suspect your baby might have torticollis, don’t wait to get in touch. Give us a call and let us help!
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