The most common type of condition requiring pediatric physical therapy is Torticollis.
What is Torticollis?
Torticollis is the tilt or rotation of the head due to tight and weak neck muscles. It occurs when the muscle that runs up and toward the back of the neck (the sternocleidomastoid, SCM) becomes tight, weakened, or thickened. The most common types of torticollis are:
Congenital muscular torticollis (CMT) is the most common. It affects infants and is generally diagnosed within the first 2 months of life. CMT may result from a muscular, skeletal, neurological or inflammatory condition. It is often caused by birth trauma or remaining in utero in one position for a prolonged period of time. After 1992 when the American Academy of Pediatrics recommended that babies be placed on their backs to sleep, there was a dramatic increase in the number of diagnosed CMT cases.
Postural torticollis (CPT) is diagnosed when the infant’s head tilt is intermittent. It is diagnosed within the first 5 months of life and often is the result of a lack of a variety of positions. No muscular tightness or palpable mass in the SCM exists with postural torticollis. CPT has a great prognosis — resolution may occur in as little as three months.
Physical Therapy Services for Torticollis
A physical therapist uses many techniques and forms of treatment to help with torticollis. Beginning with an evaluation to determine range of motion, head position, muscle length testing, hip flexion and more, the therapist develops a treatment plan that includes massage, strengthening the muscles on the weak side through passive range of motion and increasing flexibility.
The therapist will apply gentle cervical traction to free up the movement of the head. The therapist will create a series of stretching movements, trunk rotation, shoulder depression, rolling and strengthening to return the child to age appropriate motor skill levels. Therapy may also include an at-home plan for parents to continue to use for future treatment.