Baby Flat Head Syndrome

Baby Flat Head Syndrome - Treatment & Prevention - Tips & Advice

What You Need to Know About Torticollis Massage for Infants

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What You Need to Know About Torticollis Massage for InfantsWhen your little one is uncomfortable, the world seems like a rough place to live. For young infants, medicine often isn’t an option. Handling their pain may require alternative methods. In babies with infant torticollis, doctors sometimes suggest massage. Here’s what you need to know if your doctor recommends massage for baby’s torticollis:

What is Infant Torticollis?

Infant torticollis is a muscular condition that can restrict movement of the head, and is often congenital (present at birth). In some cases, you’ll be able to feel a lump in your child’s neck in the affected muscle fiber. Often, the only sign of the condition is that your child won’t rotate their head as far or as easily to one side or fails to breastfeed as easily on one side. If untreated, infant torticollis can lead to positional plagiocephaly or brachycephaly; 90% of torticollis cases are associated with positional plagiocephaly.

How Can Massage Help Infant Torticollis?

Massage therapy is a lot more than hot stones, candles, and massage oil. Although the media often downplays the effectiveness of massage, it has a true therapeutic role when administered by a trained professional. Infant massage has the benefit of providing skin-to-skin contact – something babies love and need – while stimulating circulation to the affected muscles and reducing inflammation.

Massage therapy offers a few additional clinical benefits for babies with torticollis – it lengthens the muscles of the neck and strengthens them at the same time. If treated with massage early enough, no other therapy may be necessary for your baby.

Who Should I Trust to Give My Baby a Massage?

There are multiple ways of handling infant massage therapy. Some pediatric massage therapists prefer to train parents to give the massage, while others do the therapy themselves. Never let an unlicensed massage therapist or a machine give your infant massage therapy for torticollis – it’s a very delicate task, and dangerous if done incorrectly.

Before any massage therapy commences, your child needs to have a complete diagnosis of infant torticollis, and the therapist needs to know how the SCM muscle is affected and if your child has a pseudotumor or not. If your therapist is ready to start working on your child’s neck without having all the necessary info, get a new therapist…one who is willing to ask all the necessary questions and keep your baby safe.

The outcome of infant and childhood congenital torticollis is usually quite good – even up to age 4, the condition seems to resolve well with treatment and rarely requires surgery. Although it’s hard to watch your little one deal with the condition, remember that you are taking the right steps to treating it. Soon enough they’ll be rolling their head easily from side-to-side.

America’s First Baby Spa: Float Baby

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floatThere’s a new business in Texas that’s turning heads internationally. Float Baby is a spa designed for infants, but more than just a place to pamper little ones with massage and relaxation, it may be the first step towards a new treatment method for infant torticollis.

The owner of the spa, Kristi Ison, is a certified infant massage therapist with two children of her own. She created the spa as a place where children could come and enjoy the benefits of therapeutic massage, but also as a place where they would be able to experience mobility in a way that isn’t possible elsewhere.

Float Baby allows parents to bring their children to its infant water facilities as early as two weeks of age. Each baby is outfitted with a special donut that keeps their head afloat while they move their arms and legs in the water. The donut fits around the neck, and comes in sizes for preemies through 8 months.

In a recent interview, Ms. Ison stated that “We also have many clients with torticollis [trouble turning the head due to muscle tightness] and have learned that babies can gain five degrees of rotation or more with regular visits.”

The knowledge and focus on infant torticollis is part of what set’s Ison’s facility apart – and why it matters to you as a parent.

Infant swim classes can be difficult to find, and proper flotation devices can also be difficult to procure. If successful, Ison’s facility may inspire other entrepreneurs to follow her lead and create more water resources for younger children – something that could change the prevalence of infant torticollis and help our children heal.

Recommended therapies for torticollis include muscle strengthening activities and play that engages arms and legs – that’s a tough order for newborns and young infants, but one that safe aquatic play can fulfill. Aquatic therapy offers other benefits for children that can help improve the prognosis of torticollis, as well.

In an article on the North Shore Pediatric Therapy website, licensed physical therapist Bridget Hobbs mentions that aquatic therapy can improve muscle strength, among other benefits, “Once proper range of motion is achieved at a joint, proper strengthening is needed in order for the muscle to perform well at its new length. Using the principle of resistance, muscles are able to gain strength by performing simple actions in the water, such as lifting a leg to the side of the body.”

Assuming that Kristi Ison’s idea takes off, we may soon see more infant spas across the US – a promising sign for all parents, especially those who have a child suffering from infant torticollis.

Torticollis treatment for my baby – a mother’s story

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Torticollis treatment for my baby

The story below comes from Shannon Reich, who has a great blog called My Torticollis Baby, where she has documented her daughter’s diagnosis and treatment of torticollis, and shares many helpful resources on torticollis for parents.  Her story reminds me of my own, as my son had heart surgery right after he was born, and his torticollis and plagiocephaly seemed so minor at the time compared to everything else we were going through.

From Shannon:

Unfortunately, my daughter’s torticollis was not discovered until she was about seven months old.  Now looking back, she was displaying signs of it early on, but her head tilt seemed to be the least of my concerns, given other issues going on.  My daughter was born with an esophagus birth defect, underwent surgery on her third day of life, and spent almost two weeks recovering in the NICU.  After arriving home, she developed colic which lasted until she was six months old.  Considering everything I was going through, her head tilt seemed insignificant at the time.

Around four months old, I noticed that her head and trunk were tilted on a regular basis.  I didn’t want to freak myself out by going on the internet, so I decided my best bet was to consult the pediatrician.  At her six month well visit, the pediatrician suggested doing some neck stretches.  In addition, she suggested positioning her in the crib so that she would be encouraged to look in her non-preferred direction.  The pediatrician did not seem concerned, so I felt less stressed about it.  I incorrectly assumed my daughter would simply outgrow this head and trunk tilt with minimal effort on my part.

About a month passed and I noticed that her head and trunk tilt appeared worse.  Soon after, I casually mentioned her head tilt to my son’s developmental therapist.  After looking at her, she suspected that my daughter had torticollis and recommended that I get it evaluated.  Sure enough, my daughter was officially diagnosed with mild torticollis (and mild plagiocephaly) at her pediatrician’s office.  Unfortunately, receiving these diagnoses at seven months of age was considered a later diagnosis in the “torticollis and plagiocephaly world”.  It seemed that many babies had their condition diagnosed within the first few months of life.

The next month few months seemed like a blur of an insane amount of doctor’s appointments.  My daughter visited the following specialists: pediatrician, outpatient physical therapist, cranial remolding specialist, ophthalmologist, cranial facial specialist, and our state’s early intervention program.  It was a scary, overwhelming, and stressful time of constantly taking my daughter to doctor’s appointments and squeezing in her torticollis exercises whenever we had a free moment.

For several months, my daughter received twice weekly outpatient physical therapy.  She also qualified for in-home physical therapy services three times per month from our state’s early intervention program.  Fortunately, her plagiocephaly was mild enough not to warrant a helmet.  In addition, I spent a significant portion of my daughter’s waking hours doing her in-home physical therapy exercises.  I also purchased various products to help with her torticollis (Snuggin Go, Torticollis Support Kit, and the TOT collar).  In addition, I had kinesio tape applied to my daughter’s neck on two occasions and had her adjusted by a chiropractor three times.   In general, she’s made great progress over the past three months of torticollis treatment.  However, illness and teething caused some temporary tilt regressions for my daughter.

At my daughter’s last outpatient physical therapy evaluation, her physical therapist said she was pleased with our daughter’s progress.  She suggested that we stop her current once-a-week appointments, and just schedule another evaluation in one month’s time.  She instructed us to continue with our in-home physical therapy routine.  After three months of hard work (with many ups and downs along the way), it felt amazing to know that everything was actually paying off.  Her head and trunk tilt significantly decreased and her motor skills have nicely progressed. You wouldn’t even know she has torticollis unless you were specifically looking for it.  God has really blessed our family throughout this treatment process.  He provided our family with outstanding medical professionals, excellent health insurance, and supportive family and friends.  Even though my daughter’s torticollis is not yet entirely eliminated, it’s significantly better than it used to be.  I feel hopeful and confident that she will continue to make excellent progress.

This picture was taken early on in her torticollis physical therapy treatment process.  She had been in physical therapy for about 1.5 weeks.  I believe she was about seven months in that picture.

Torticollis before treatment photo

This picture is a current one at 10 months, after approximately three months of physical therapy.  Her head normally doesn’t look as straight as it does in this picture, but I was happy to have one of those great mid line pictures.  However, even when she does tilt now, its a lot less of a tilt than it used to be.

Torticollis after treatment photo

For more information on torticollis and therapies used to treat it, please see Shannon’s blog.  She has posted a lot of great information including videos demonstrating the torticollis stretches she did with her daughter.

My Torticollis Baby – A blog detailing my family’s journey treating my baby’s torticollis.  Hoping to provide resources to parents of children with torticollis.

 

Craniosacral Therapy for plagiocephaly and torticollis – a therapist’s perspective

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My son is now two years old, and although he was treated for his torticollis using physical therapy, I was concerned that the torticollis seemed to be returning and may not have been fully addressed.  At the advice of his Occupational Therapist, I contacted Janet Carstarphen, a Cranial Sacral therapist (also known as Craniosacral therapy) in our area, to do some work on his neck.  Janet was highly recommended and it turns out she had worked on another little boy we know who has Down Syndrome, and was developing a flat head after his heart surgery.  The craniosacral therapy apparently completely resolved his flattening with no need for a helmet.

My son absolutely loves the treatments, and he gets very relaxed and sleepy during them.  My son is quite stiff in the neck and jaw, and his speech therapist felt that this kind of work would also help with his speech delays.  Interestingly enough, after just the first treatment he started using a lot of different sounds and saying more words.  I also had Janet work on my neck, so I could see what the therapy was like.  The touch is very gentle and there was very little actual movement of my head and neck, but it felt like my neck became stretched and elongated during the session.  It was extremely relaxing.

I asked Janet if she would kindly write an article for my blog explaining more about how Craniosacral therapy works, and using it for treating head flattening and torticollis, and the information below comes directly from her.  You can find more information on her website.

My name is Janet Carstarphen and I am a Cranial Sacral Therapist. My practice is the area of Jacksonville including the beaches. I have been a Cranial Sacral Therapist for 20 years. My practice includes problems that sometimes accompany new born babies, such as colic, little ones who suffer from separation anxiety, trouble nursing and inability to thrive. I also work with Flat Head Syndrome (plagiocephaly) and torticollis.

Several years ago I was contacted by a Mom of two little girls ages 20 months and 4 months old. Both babies had Flat Head Syndrome. I began working 3 times a week on the baby and some work on the older little girl as well. The baby was very severe in her misshaped head. After 6 months her head was almost completely smooth and with normal curves. When we began the therapy her forehead was so misshaped that you could not see her eyes. As the therapy continued into the 6th month the sides of her head appeared within normal limits and the back of her head was also perfectly curved. Now you could see her beautiful eyes. The parents were so happy that they had waited and tried another form of therapy more homeopathic.

Since that time I have been contacted by other families with babies with the Flat Head Syndrome. At the present time there are not many options available to help the body create a smoother shaped head. The Cranial Sacral Therapy is light touch on the baby’s head (the sides of the head or the temporal bones) and sometimes concentrating on the back or the occiput. After a few sessions a difference can be seen. As the light touch continues, the process of working with the fluids (blood, and spinal fluid to name a few) and directing them to areas that are more rigid and not as pliable as the other side of the skull. These bones respond to this therapy and soften. The affected bones relax around the cranial sutures and the head begins to appear more symmetrical. The healing process is similar with torticollis. The muscles relax with each session as the fluid flow increases
around this compromised area and the range of motion becomes fuller.

I would like to thank Sarah for this opportunity to introduce this therapy to the community of families researching a more homeopathic approach for the Flat Head Syndrome and torticollis. For more information please refer to my web page lifeworks-eachday.com.

The letter below is a testimonial from the parent of two little girls that Janet treated, and explains her very positive experiences with Janet and the craniosacral therapy for their flat heads.

Hi Janet,
Here are a couple of pictures of the girls.  I don’t have very many of their heads (they don’t stand still really well).   I would love to recommend you to any client.  I feel like my girls benefitted from your expertise both physically and emotionally/mentally.  I actually considered calling you to work on Mariana because she is having quite a bit of separation and social anxiety and I thought you may be able to assist us with some cranial therapy (if you think it may help, please call me).
As for our past experience with you, I found you to be a joy and comfort to work with my children (and me).  As a therapist, you were approachable, had a great bedside manner and you were also very professional.  During the 6 months to a year that you saw both my children (and me, occasionally) you were either attending educational conferences or reading the latest article/study relating to your felid of study.  As doctors discussed putting a helmet on Jennifer Ann’s head, I found your counsel to be educated, informed and as non-biased as possible.  While you counseled against the helmet, you did were not defensive or frustrated as Paul and I made our decision.  You were honest, gave us through answers and were able to show us visible changes to both our girls as we made our decisions.
From a financial standpoint, you were very fair to us as a family.  You understood our limitations and you were willing and able to work within the budget that we set to resolve Mariana and Jennifer Ann’s issues.
As a person in general, I often find myself wondering how you are doing and missing our conversations as the girls settled into their therapy (often falling asleep sitting up).  You provided me hours of free parenting advice and put to ease several of my concerns as a new mom.
Any of your new or potential clients are always welcome to reach out to me with questions or concerns that they may have.  As you may recall, we received some push back from our pediatrician as we sought more homeopathic remedies to our flat headed girls; thus, Paul and I both did a great deal of research concerning cranial therapies.  We are so pleased with our decision to have you work with our family and we would love to share our experience with any one who is curious about the path we travelled.
As a side note:  Irene, our part time nanny, has often recommended you to parents who have similar issues.  I am not sure any of those referrals have become clients but I know she would also speak highly of you and the treatments you perform.
Sincerely,
Carrie Saunders
If you have used craniosacral therapy to treat your child’s head flattening, please share your experiences in the comments below!

My Experience with Plagiocephaly and Torticollis

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IMG_9589My Experience with Plagiocephaly and Torticollis by Reem Faruqui, who writes on her blog “Doodling through life…one color at a time” (http://reemfaruqi.com).   

From Reem: 

The word therapy scared me. I’d never heard of the words plagiocephaly or torticollis until my daughters 4 month appointment so didn’t know what they would mean for my little one. She needed therapy weekly to help strengthen her muscle tilt (torticollis) and flattened head (plagiocephaly).  I had no idea that she had it so was a big surprise.

Now in hindsight I can reflect on the signs. Being a photographer, I now notice in her early photos her head is tilted to the right ever-so-slightly. She would always sleep with her head turned sharply to the right over her shoulder, further flattening her head. Furthermore, she hated tummy time – most babies (like my first child) dislike tummy time- but my 2nd daughter would mostly scream when placed on her belly and didn’t like playing much at all in her baby gym.

Treatment wise, my daughter received therapy weekly, then biweekly when she wasn’t making enough progress, and now every other week because she’s progressing. We decided to get a helmet because her head asymmetry was borderline severe. My insurance also covered a chunk of the helmet cost so that was a big help. I would have opted for helmet treatment even if insurance wasn’t covered as the helmet has made a significant difference- her head shape is not perfect but much improved!

Regarding asymmetry, her first scan showed the difference in diagonal lengths of her head was 12.8 mm. Anything with 13mm and above is moderate to severe. Her second scan after 6 weeks of wearing the helmet showed her symmetry down to 9.1 mm (mild to moderate asymmetry.) It felt really nice to see a change after such a small amount of time. The third scan 6 weeks later she didn’t have a growth spurt so her head shape hadn’t changed much.

Now she is wearing her helmet for nights and naps. It is nice to not have to wear the helmet in the day anymore! Questions I received while she was wearing the helmet: is she okay? Why does she have to wear a helmet? Was she in an accident? Did she fall? And once even , “Is she clumsy?”! Even if she was clumsy I wouldn’t put her in a helmet! You learn to grow a thick skin when dealing with all the questions. I learned that babies are more resilient than we think- my daughter adjusted fairly quickly to the helmet. It didn’t affect her sleep as much as I thought.

Visiting the children’s healthcare and seeing all sorts of children going through a variety of treatments, I feel lucky in that the helmet is temporary, and I am looking forward to her helmet being off for good: the day before her birthday is her final helmet scan and I think then she’s done! I can’t wait for her head to smell fresh like a baby again :)! Going through this experience has taught me patience and shows me what it is like to have a child who may look different and allows me to empathize with moms of children who wear Orthotics and Prosthetics on a daily basis.

 

blurred face pic reemIMG_8058-2 IMG_9589

My Twins and Their Plagiocephaly Helmet Story

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My Twins and Their Plagiocephaly Helmet Story

This story was shared by a mother of beautiful twin girls and details their experience with plagiocephaly, torticollis, and helmet therapy. Plagiocephaly is very common in both twins and premature births.  She shares some great information and tips, and a series of photos taken before, during and after the helmet therapy.   Thank you so much for sharing!

From Mom:    

I have twin girls that suffered from plagiocephaly and experienced helmet treatment.  Here’s a brief version of our experiences with the torticollis, plagiocephaly, and the helmets.

The girls were born six weeks early and spent some time in the NICU.  By the time the girls were two months old, I noticed that their heads were pretty flat.  I pointed it out to their pediatrician, and she agreed that we should take the girls to see a plastic surgeon for evaluation.

At our first visit to the plastic surgeon, a physical therapist was also present.  The physical therapist identified that both girls had moderate torticollis and should receive physical therapy treatment.  We were taught some basic stretches to perform at every diaper change to help with the torticollis.  The plastic surgeon identified that the girls had moderate to severe plagiocephaly (measurement of 14mm and 15mm).  Additionally, the plastic surgeon taught us some repositioning techniques, such as lots tummy time and pinning a rolled up receiving blanket (I preferred Velcro; pinning made me nervous!) under their shoulders at night to help the girls sleep on the non-flat side of their head.  We scheduled a visit for five weeks later.  Below is a photo of how their heads looked at the time.

pic 1 sherry

                We returned five weeks later after using the “aggressive repositioning techniques” (tummy time, making sure that the girls never had pressure on their flat side, etc.).  Upon evaluation, we could see that the repositioning was helping and that the heads were starting to become rounder.  We scheduled another follow-up appointment to assess the improvement after an additional month.  At this appointment, we found some slight improvement, but not enough to avoid the helmets.  We were given a prescription and the name of the local orthotics company to start the process of getting the helmets.

We scheduled an appointment with the orthotics company.  The girls were about five months old at this point.  The girls each received a 3D head scan, from which the helmet company would form the helmets.  A few weeks after the scan, we received the helmets.  Their grandma helped me decorate the helmets with stickers, mod podge, and a Velcro flower than we could change to match their outfits.

When we first received the helmets, we had a “weaning schedule” that we had to follow.  After this, the girls wore the helmets for 23 hours a day with an hour break, where I washed the helmets and bathed the girls.  We had helmets during the summer months, so keeping the helmets clean was very important!

We ran into a few hurdles with eczema and the helmets not fitting appropriately in the beginning, but once everything was straightened out, the helmet process was pretty smooth.  The girls wore their helmets for three months, and at the three month point, we went for another 3D scan to assess the overall improvement.  One girl’s head started out at 9.4mm difference and improved to 5.7mm.  The other’s head started at 13.3mm and improved to 9.7mm after the three months.  I was slightly disappointed with the improvement because I was diligent with the girls wearing the helmets for 23 hours a day, and I prepared myself to have to continue treatment with the helmets.  Though the “shape” of their heads looked much improved, the numbers weren’t as good as I had hoped, in comparison to what other parents have seen from their children’s experiences.

We visited the plastic surgery department following the scan, and they were extremely happy with the progress, which I was very surprised.  They said that one girl’s helmet could definitely come off and that the other’s continued treatment was at our own discretion.  She said that the most improvement occurs after the first three months of treatment and that we would not see much improvement if we continued.  So we left her helmet on for a few days, and after giving it more thought, decided to take it off.

While the girls were wearing the helmets, I took photos every week to document the progress.  I’ve compiled the photos from every few weeks for each girl to show the progress at various points during the treatment.   The photos show that the girls’ head shapes were much improved, despite the measurements.  I feel that, since we were unable to get enough improvement through repositioning techniques, the helmets were very beneficial and worthwhile.

sherry pic 2

 pic3 sherry

Everything You Need to Know About Torticollis

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Torticollis literally means “twisted neck”, and is often referred to as “wryneck”. There are many types of torticollis, with varying causes. A child with torticollis will hold their head tilted to one side with their chin pointing to the other. While the condition looks like it would be painful, in most cases it is not. As noted before, torticollis can cause plagiocephaly, as a baby with torticollis will often keep the head turned in the same position, therefore putting pressure on the same side of the back of the head. In order to treat the plagiocephaly, the torticollis must also be addressed.

Causes & Types of Torticollis

Each type of torticollis has different causes. In order to understand what causes torticollis, you need to know a little bit about the anatomy of the neck and head. In many cases, the development of torticollis occurs because of a problem in the sternocleidomastoid (SCM) muscle. This muscle runs between the head and shoulders, and allows us move our heads up and down and side to side. If one side of the muscle is shorter or there is a problem with the flexibility of the muscular tissue, a baby can develop torticollis. There are numerous less-common causes for the condition, which we will discuss in this section.

Congenital Torticollis

Congenital torticollis is almost always caused by one of three things:

  • Your baby’s position in the womb
  • Birth-related trauma to the SCM muscle
  • Abnormal development of the SCM muscle

Rarely, congenital torticollis can occur as a result of genetics. It can also occasionally be a symptom of other conditions, so if you suspect torticollis in your infant, be sure to have them evaluated by your medical professional.

Frequently congenital torticollis that is not symptomatic of other conditions occurs together with positional plagiocephaly. In some cases, this is the result of the baby’s position in the womb. The conditions can occur concurrently as a result of a difficult birth, as well.

Positional plagiocephaly can occur as a result of torticollis when an infant is incapable of turning their head, and as a result a flat spot develops on the part of the skull that is most commonly laid against a flat surface such as a crib mattress. Approximately 80-90% of infants with otherwise uncomplicated congenital torticollis also have positional plagiocephaly.

Acquired Torticollis

Babies and children can develop acquired torticollis as a result of many underlying conditions. Some of these conditions can be severe, while others are generally mild. They include the following:

  •  Mild viral infections
  • Gastro-esophageal Reflux Disease (GERD, or Reflux)
  • Minor head trauma
  • Minor neck trauma
  • Medication reactions (dystonic reactions)
  • Cervical spine abnormalities
  • Respiratory infections
  • Soft-tissue infections in the neck
  • Spasmus nutans (leads to head bobbing and uncontrolled eye movements, generally benign)
  • Sandifer syndrome (very rare, causes GERD and neck spasms)
  • Grisel’s syndrome (occurs as a complication of pharyngitis, and involves the dislocation of the C1 and C2 vertebrae)

Benign Paroxysmal Torticollis

The causes of this condition aren’t known. It involves episodes or attacks of symptoms which can include vomiting, head tilting, irritability and/or drowsiness. Attacks can last from several hours to several days, and may indicate that your baby will be prone to migraine headaches as an adult.

Ocular torticollis

Ocular torticollis is not a result of musculoskeletal problems in the neck or spine. The condition occurs when a child has a problem with vision in one eye, and cranes their neck to improve their sight. The condition often indicates muscular problems of the eye itself.

Frequency

Approximately 1 in 300 infants is born with torticollis.

Diagnosis

Torticollis is usually diagnosed within the first four months of a child life, with most cases being noticed within the first month by either a caretaker or the baby’s pediatrician. The tilting of the neck may be very slight, but the presence of a lump on the baby’s neck in the sternocleidomastoid muscle can indicate the presence of torticollis.

Your baby’s pediatrician will want to rule out the rarer and potentially dangerous causes of torticollis. To do this, they may request diagnostic imaging and other tests. If it is clear that your child’s torticollis is related to their position in the womb, or a rough delivery, the doctor might skip this step.

Effects on Development

Torticollis that goes untreated in babies can lead to other musculoskeletal problems. Babies with torticollis may experience some delays in motor skills and coordination. These effects can linger into childhood, making a child seem ‘clumsy’. Children with torticollis may develop problems with sucking and swallowing, can be prone to having their mouths hang open. They may also go on to develop more severe conditions such as scoliosis. For this reason, it is essential to follow your doctor’s advice and to seek out treatment for your child’s torticollis.

Treatment

The treatment of torticollis depends on its severity. Mild cases can often be resolved by repositioning, tummy time, stretching, and targeted exercise of the shorter muscle. For more severe cases, physical therapy may be recommended. The picture to the left shows a common posture recommended for carrying infants with torticollis to stretch the shortened SCM muscle.

In about 15% of cases, neither physical therapy nor repositioning and exercise prove effective. The next step is an orthotic device called a TOT collar, and if this also fails, surgery may be recommended. Surgery for torticollis is rarely necessary, although it is fairly simple, and involves loosening the tighter neck muscle. It should always be followed by physical therapy and exercise to encourage the muscle to grow properly again.

Physical Therapy

If your doctor has recommended physical therapy for your baby’s torticollis, you might be curious about what to expect.

If your child has torticollis, one of the best steps you can take as a parent to begin correcting the condition is to exercise your baby’s neck muscles gently as directed by your doctor or therapist.

At-home exercises and repositioning can be incorporated into your daily routines, as well. This can make it easier for your baby, and feel more like play time rather than therapy. Place your child’s favorite toy on the side opposite to the one they normally keep their head turned towards. Encourage your baby to look in the direction opposite of their torticollis by making it interesting visually and with music or lights. Praise your baby every time they turn in the correct direction.

You can also help alleviate your baby’s torticollis when driving in the car. Use padding or positioning devices to adjust your child’s head position to front or to face the opposite direction from the affected side.

Physical Therapy Techniques for Torticollis – What to Expect

Your baby’s physical therapist will design a comprehensive treatment plan that will most likely include heat applied to the affected muscle, postural and positional training, stretching, targeted muscle strengthening, and massage.

Physical therapy for torticollis has been poorly studied to date, and its usefulness is unknown, although it does appear to be effective in the majority of cases. Another technique frequently used by physical therapists is therapeutic taping, a technique developed in the 1980’s for athletes recovering from sports injuries. The effectiveness of taping is unknown.

If physical therapy does not work, they may suggest either traction or a Tubular Orthosis for Torticollis (TOT) collar. TOT collars are not worn at night, and in some cases are only used for a few hours each day.

What happens if torticollis goes untreated?

Failure to treat torticollis can result in limited neck movement as well as cranial and facial deformities including flattening of the head and face on the side affected by torticollis. Infants and children with torticollis may exhibit a preference for using one side of the body, and as a result may be slower in achieving motor skills milestones. This preference for one side of the body may also lead to musculoskeletal adjustments that cause other physical problems. In extreme cases, untreated severe torticollis can lead to scoliosis.

If your child has been diagnosed with torticollis, please seek treatment right away. Torticollis treatment is most successful when it begins by 2-3 months of age.

For more information, please see our articles on what torticollis looks like and torticollis treatment.

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