Torticollis | Physical Therapy Interventions
Torticollis is a common pediatric musculoskeletal condition in which the head is tilted to one side, and rotated to the opposite side due to a tightening of the sternocleidomastoid muscle. Often times, parents will notice flattening of the skull, called Plagiocephaly, as a result of Torticollis.
Congenital Muscular Torticollis is the most common type of Torticollis, which occurs prior to birth often due to poor positioning in the uterus. Another common type is acquired Torticollis, which is seen in infants with a positional preference in sleeping, feeding, or play.
Early detection and treatment is the most significant aspect of Torticollis. Two to six months is an important time frame to achieve success in correcting the shape of the child’s head through positioning while the skull is still growing and forming it’s shape.
Torticollis can still be treated and corrected at six to eighteen months, but the older the child gets the harder and less pliable the skull becomes due to the closing of the fontanels making it more challenging and less likely for head shape correction. If untreated, Torticollis can lead to Scoliosis, strength imbalances, developmental delays, facial asymmetries, and skull deformities.
Typical physical therapy will include gentle stretching, strengthening, massage, positioning techniques, and parent education with a home exercise program to help the infant gain range of motion, strengthen weak muscles, and improve posture and balance.
Pediatric Physical therapy will recommend accessories such as helmets or bands as necessary, but often times they are not needed due to success of positional changes and stretching in Physical Therapy. In most cases, Physical Therapy has a high success rate and a good prognosis for full recovery in two to six months.