Eighty percent of torticollis in infancy is determined to be muscular in origin and is correctly termed congenital muscular torticollis. In the remaining twenty percent, the torticollis posture may indicated signs of a more serious underlying condition. Accurate identification of a muscular cause is important in diagnosing congenital muscular torticollis.
Congenital muscular torticollis typically results from tightness in a specific muscle in the neck. This muscular tightness causes a child's head to tilt toward one shulder while causing his or her face to turn toward the opposite shoulder.
Torticollis limits a child's ability to turn the head in order to see, hear and interact freely with his or her environment. Because of these limitations, torticollis may lead to: delayed learning, poor body awareness, decreased muscle strength and poor balance. Babies with torticollis are also very likley to develop a flattening of the back of the head or side of the face. This is called plagiocephaly, which can also lead to dealys in development. Studies show that children with torticollis and plagiocephaly can decrease their risk of delayed development by spending supervised time on their tummies. This playing position helps promote head and neck control.
Congenital muscular torticollis typically results from tightness in a specific muscle in the neck. This muscular tightness causes a child's head to tilt toward one shulder while causing his or her face to turn toward the opposite shoulder.
Torticollis limits a child's ability to turn the head in order to see, hear and interact freely with his or her environment. Because of these limitations, torticollis may lead to: delayed learning, poor body awareness, decreased muscle strength and poor balance. Babies with torticollis are also very likley to develop a flattening of the back of the head or side of the face. This is called plagiocephaly, which can also lead to dealys in development. Studies show that children with torticollis and plagiocephaly can decrease their risk of delayed development by spending supervised time on their tummies. This playing position helps promote head and neck control.
Torticollis and plagiocephaly should be thoroughly evaluated by a physician to determine the cause and whether treatment is necessary. Your child should be screened for: motion and end feel of the head/neck, visual function, head shape, hip symmetry, and age appropriate reflexes. If torticollis is diagnosed, physical therapy is typically recommended.
Studies show that ninety percent (90%) of children achieve a good to excellent outcome with physical therapy. The best results occur if therapy begins as early as possible. Physical therapy will include: stretching for the head and neck, strengthening activities for the head and trunk, and parent education to promote optimal development for the child. For more information contact your local physcian or physical therapist.
References:
1. Burch C et al; Cincinnati Children's Hospital Medical Center: Evidence-based clinical care guidelines for Therapy Management of Congenital Muscular Torticollis, www.cincinnatichildrens.org/svc/alpha/h/health-policy/ev-based/otpt.htm, Guideline 33, pages 1-13,11-19-09.
4. Vimmeren et al; Torticollis and Plagiocephaly in Infancy: Therapeutic Strategies; A Review; Pediatric Rehabiliation; 9:40-46, 2006.
5. Schertz et al; Motor and Cognitive Development: A one-year follow up in infants with torticollis; Early Human Development. 84:9-14, 2008.
6. Ohman et al, Are infants with Torticollis at risk for a delay in early motor milestones compared with a control group of healthy infants; Developmental Medicine and Child Neurology. 51:545-650, 2009.
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