hempstead valley therapy centre

Infant Torticollis

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Is your baby is struggling to turn his/her head? His/her head is always bent or turned to the same side? Do you suspect torticollis?
Do not wait to see your osteopath.

Torticollis is a common condition that occurs when an infant’s neck becomes twisted, causing their head to tilt to one side. The twisting in the neck is caused by a shortened sternocleidomastoid (SCM) muscle. This muscle runs from the back of your ear to your collar bone, on both sides of the neck, and allows the neck to tilt and rotate contralaterally to the side of contraction. Other terms for torticollis include wry neck or Loxia. Torticollis falls into two categories: congenital torticollis and acquired torticollis.

  • Congenital torticollis – is the most common type of torticollis. It occurs in less than 1-3.9% of infants. It usually occurs as a result of abnormal positioning in the womb or a difficult birth that stretched the SCM muscle.  Signs typically become evident within the first 8 weeks of life.
  • Acquired torticollis – has its onset in infancy or later childhood. It usually results from an injury or inflammation in the sternocleidomastoid or trapezius muscles.
Signs and Symptoms of Torticollis
HTC Blog - Symptoms of Torticollis (1)

Infants with torticollis may have the following:

  • A head that tilts to one side while the chin tilts to the other
  • A flattened area or an asymmetrical shape (positional plagiocephaly) on one side of the head from always sleeping on that side.
  • A soft lump in the neck muscle (this occurs in the first few weeks)
  • Pain or tenderness in the sternocleidomastoid or trapezius muscles
    • Limited range of motion in the cervical spine
  • Asymmetry in your baby’s face: because the body needs to keep his/her look horizontally, he/she will adapt by a facial asymmetry.
  • Difficulty breastfeeding on one side?

When the infant is subject to cervical, cranial, and shoulder tensions, the pelvis tends to move toward the side where the head is tilted to limit muscle tension in the neck. Therefore, the infant’s body is ‘arched’. This mechanism of adaptation is explained by the biomechanical links that exist between the muscular, ligamentous, and membranous elements (core link and fasciae).

Causes of Torticollis

The most common cause of torticollis is muscle injury or inflammation from positioning in the womb or difficult birth. However, there are other possible causes of torticollis that range from minor to severe including infections and cervical spine injury among others.

Many theories have been developed to explain the causes of the infant torticollis but the root cause of it is still uncertain. The fetal position in-utero but also the birth is probably involved.

Indeed, an abnormal fetal position or a baby cramped in the womb can cause extra pressure on the baby’s head and cervical during the pregnancy. Without any treatment, these tensions will remain as a torticollis. The breech position is more often associated with a torticollis at birth. The use of forceps or vacuum during the delivery can also be involved.

Because the causes of torticollis can be severe, it is imperative that signs and symptoms be reported to a medical professional. The doctor will conduct a physical examination, followed by x-rays, imaging tests, and ultrasound scans when necessary, in order to determine the cause of torticollis.

Treatment for Torticollis

The main goal of osteopathic treatment is to reduce the restriction and tensions within the body causing by the different ‘trauma’ experienced by the newborn (in-utero, birth, intubation…).
After a very gentle and complete exam, the osteopath will give the best mobility to the baby’s body using a non-invasive technique.
Most of the time the unbalance is not just in the cervical area but can also be in the pelvis, spine, abdomen, etc.

Muscular torticollis is usually mild and will resolve after a few weeks with treatment of assigned exercises and hands-on therapy by a therapist.

These exercises include ways of encouraging the infant to turn his or her head to the side that or she doesn’t normally turn to. This may mean laying the infant down on the changing table or crib so that people approach on the side they don’t normally turn to. Parents may also be encouraged to feed the baby more often on the side they wouldn’t normally turn to. Finally, giving the infant the proper amount of tummy time will also help to solve their muscular torticollis.

If necessary, the infant may be referred an orthopaedic surgeon or paediatrician.

What can you do at home to help with torticollis?

After an osteopathic treatment, you can stimulate the cervical mobility of your baby at home.

HTC Blog - Infant Torticollis (1)
  • Practice ‘tommy time’ as much as you can while baby is awake and supervised. It is a really important exercise. It helps strengthen neck and shoulder muscles get your baby ready for sitting and crawling.
  • When feeding your baby, offer the bottle or the breast from the side the baby does not normally like.
  • During playtime, place all toys on the side he/she does not enjoy and encourage him/her to turn his/her head by making noise or light.
  • Carrying your child using different ways (carrier, arms, wrap…).
  • You can sit your baby on your lap, his/her back facing you and showing him/her an object. His/her attention on the object will allow you to turn his/her head without manually forcing by moving your body.
  • Minimize time baby spends in containers such as car seats, swings, and bouncers. They constrict the infant’s movements and cause prolonged pressure on the back of the head.
  • During sleep time always place your baby on his/her back. Alternate which is the head of the crib each night to encourage the baby to turn the head to each side to see out of the crib.