Torticollis (wry neck, or loxia) is one of a broader category of disorders that exhibit flexion, extension, or twisting of muscles of the neck beyond their normal position. The Latin definition of torticollis means “twisted neck.” This official definition of torticollis sounds a little bizarre to me as a physical therapist (twisted neck?! Eww!), so I can only imagine how parents feel when their baby receives this diagnosis. Essentially, a tort is a tight neck muscle that causes abnormal head positioning. Tort can lead to head flattening (flat spot), visual changes, and/or gross motor development delays.
In torticollis, the neck tends to twist to one side, causing head tilt. Infant torticollis is a tight neck muscle that causes a head tilt and/or rotation of the head. This leaves a baby unable to hold their head upright in midline or in the middle of their shoulders. The torticollis usually falls into two categories, either congenital torticollis or acquired torticollis.
What do PTs do to treat torticollis?
Treating torticollis generally involves physical therapy to lengthen (stretch) the shortened neck muscle and to strengthen the longer neck muscles, as well as monitoring progression and compensations regarding movement and gross motor development. During weekly sessions, we work with parent(s) to teach you how to stretch your child’s neck region for their child’s specific tort. We also teach you how to best position your child for strengthening. The tightness resolves quicker, with strength as the later of the two areas to develop. How long your baby is in therapy is dependent on a plethora of things – growth, severity, sickness, and compliance with our child-specific home program. We also monitor and work age appropriate positioning into sessions to ensure that your baby continues to check off those gross motor developmental milestones that are paving the way for a successful future in movement.
What happens if torticollis is not treated?
If untreated, children can develop visual changes and erroneous hand dominance choice, as the neck tightness can cause early preference of a hand use simply out of neglect. A good rule of thumb for children under the age of 3 is if they are doing something with one side of the body (or one extremity), they should be able to mimic it on the other side as well.
What now?If you notice your baby has their head tilted to the side, or difficulty moving positioning their head upright, ask one of our physical therapists to take a look and we will guide you to the best treatment for your baby!