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Torticollis

Torticollis, also known as wry neck, is a twisting of the neck that causes the head to rotate in one direction and tilt in the opposite direction. Baby will have difficulty holding the head and neck straight for extended periods of time. The muscle that is most commonly associated with torticollis is the SCM (sternocleidomastoid), but often, other muscles in the neck and shoulder region are also involved. It can be mild, moderate, or severe, and is the most documented cause of plagiocephaly (flat head syndrome).

Stock torticollis 2

Get the answers When Would I See It?

Because torticollis typically starts in utero, a trained eye can pick up on neck tightness soon after birth. Similar to plagiocephaly, pediatricians often notice the neck tightness at the 1-2 month well visit. Our goal is to bring awareness to this common condition and have it diagnosed as soon as possible. If you know what to look for, you can get help sooner rather than later.

How Will I know?

The earliest indication of a tight neck is baby only wants to look in one direction and may seem uncomfortable when trying to turn the head in the opposite direction. Another indicator is one ear is closer to the shoulder than the other ear. This is what we call a “head tilt.” It’s cute, but if your baby is always in this position, there may be an issue that needs to be addressed!

torticollis
Torticollis

Why Does This Happen?

The most common cause of torticollis is in uterine crowding and this can happen for several reasons: first born, large baby, multiples, and difficult deliveries. With limited room to move, it is very easy for those little necks to get tight.

There are other things that worsen torticollis, including:

  • Increased use of containers
  • Decreased tummy time
  • One sided handling

What Can I Do To Help My Baby?

  • Identify turn preference early
  • Increase supervised tummy time
  • Limit container usage (bouncy seats, boppy loungers, swings, DockATot, carseat)
  • Encourage baby to look in the non preferred direction
  • Change position in crib
  • Switch feeding positions
  • Skilled therapy/home exercise program
how do i know

If My Baby Needs Therapy?

If your baby continues to have a strong turn preference and/or a flat head, despite your attempts to change it, therapy is indicated sooner rather than later. A wait and see approach does not work in this situation. Skilled therapy for torticollis is critical to success. This DOES NOT include stretches you found off a quick google search! Torticollis can have long term effects on spinal alignment, attainment of motor skills, feeding issues, and facial symmetry. It should not be taken lightly.

Therapy for torticollis consists of various stretching/strengthening exercises and manipulation techniques by a licensed physical or occupational therapist.

These are incorporated into play activities and SHOULD NOT be uncomfortable for your baby. The therapist should also give you torticollis treatment activities to do at home. This is your home exercise program and is a critical step to your baby’s success. Your hard work will pay off in the end!

One word of encouragement: torticollis is difficult to treat and takes a while to resolve. This is because growth spurts cause the neck to retighten and it seems like you’re starting from scratch. This is normal but can be very frustrating. Keep up with your neck stretches and hang in there!

We are able to provide skilled therapy for babies and their families in Texas (either in person or virtually). If you’re outside of Texas, we have you covered too! We have helped to train therapists all over the world to help you on your journey and would be happy to put you in touch with one.

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