So, you just had a baby, (we'll call him, "Jimmy")...say 3-4 months ago, but being that he was your first, you're busy with the daily stresses of being a new parent. One day, a friend of yours comes to visit you and see the new baby. After the "oh, how cute" conversation, she looks at Jimmy with an eyebrow raised and mentions, "hey, why is Jimmy's head stuck to the left like that?" Then, you notice it yourself, and a surge of panic...and guilt comes on. "How could I have not seen this?!" In a single swoop of the arm, you rush out the door while grabbing li'l Jimmy, throw him in the car seat, leave your friend behind, and manage, somehow, to speak to your pediatrician en route to his office. "My God, Dr. Smith, I have an emergency! Jimmy's head is stuck on his left shoulder!" You get to the office, and in tears tell Dr. Smith about li'l Jimmy's head. He take a glance and dispassionately says, "oh, looks like torticollis". More tears stream down your face as you consider the worst case scenario- Jimmy is gonna be wheelchair-bound, live in a bubble, or be stuck with needles day-in/day-out. "Doesn't look too bad, he says. Let's send him to physical therapy."You arrive at the physical therapist's office 10 minutes later. The physical therapist, with his trained eye, says," Yeah, definitely a left muscular torticollis." You finally gather the courage to ask, "What exactly is torticollis?"
Torticollis, or "wry neck" is a problem that affects the SCM muscles of the neck (see image above). Often times, infants with torticollis demonstrate limitations in turning their head in one direction as well as presenting with their head tilted to one side. Along with torticollis, often times infants will present with "plagiocephaly", which is a flattening of one side of the the head.
So, what causes torticollis and how is it diagnosed? The answers are not clear. Some incidences may be related to larger babies in utero who have less room to maneuver their bodies during the third trimester, in particular. Other incidences of torticollis may be a result of favoring one side, leading to a flattened side of the head (plagiocephaly), making it easier for the child continue preferring one side, especially when on his/her back. The formal diagnosis usually comes from the pediatrician or pediatric physical therapist, though parents, friends and fam may also point out the odd tilt to one side.
How is torticollis treated? The first step is ruling out other possible diagnoses (superior oblique nerve palsy, Sandifer's Syndrome, hemarthrosis, e.g.). The next step is extinguishing the harmful behavior- positioning activities and strategies are simple interventions, but VITAL in diminishing your child's tendency to one side. Stretching exercises, often performed by physical therapists, are reviewed with parents to be performed with their children at home.
Does it go away? Does it ever come back? 80-90% of the time, after 2-3 months of treatment and monitoring, torticollis will full resolve. The key point is getting infants earlier in the game than later!
More questions on torticollis? Contact Dr. Jerry Yoo at 201-977-4441 or via email: info@mavenpt.com
