Torticollis – no pain in the neck, please!

Does your infant constantly look to one side? Or did you notice a head tilt when they are in the car seat or when you change their diaper? If you try to straighten the neck, does your baby cry or revert right back to his/her original position?  

If so, your baby is not alone, and it could be Torticollis! Torticollis is one of the most common conditions we see in babies coming through our clinic. Some studies report it can affect 3 out of 100 babies. Fear not, in most cases it is treatable!  And the sooner the better – do not wait. 

Torticollis is defined as a twisting of the neck that causes the head to rotate (look to the side) along with a side bend. It is usually due to tight muscles in the neck or tension in the trunk and can be associated with other conditions such as congenital hip dislocation or diastasis recti.  

Why and how does this happen? Congenital muscular torticollis is due to the position of your baby in utero, and you might not notice until 6-8 weeks after birth. Acquired torticollis may have multiple causes, such as sleeping in an awkward position, injury to the neck or shoulder or infection and often can be traced back to birth.

Is it painful? The position itself is not painful, but if you stretch too far or too hard, it will be painful (your baby will let you know!), and afterwards it will be difficult to resolve the tightness because your baby will resist the treatment. Sometimes, the pull or tightness doesn’t even come from the neck, but somewhere in the trunk or pelvis. We use gentle approaches such as pediatric myofascial release, TMR tots and cranio-sacral techniques to resolve the tightness.  It should never be painful, and your baby should enjoy the positions or releases being done.  Positioning of your baby and environmental adaptation is also an important part of the treatment, although sometimes that is not enough. If it pulls or hurts to turn the neck towards the toy or mirror, your baby will find a way by compensating through the trunk or will simply not move the head towards that direction.

What about the flatness you are noticing on the side his/her head? Or at the back of the head? That is called plagiocephaly.  It is simply the skull adapting to the constant pressure of the weight of the head on that spot.  You might notice the ears are not at the same level or one eye is lower than the other. When the skull shifts, the whole head adapts. Treatment for this varies from osteopathy to helmet therapy for severe plagiocephaly. We collaborate on a regular basis with other health professionals to maximize your baby’s success.

Why should you address this? Your baby needs to be able to move symmetrically to map and develop BOTH sides of the body.   As your baby develops and integrates primitive reflexes to make way for more voluntary, controlled movement, he/she needs to be able to move freely, without being “stuck” in order to optimize gross motor development. At On the Ball Pediatric, we always assess and address gross motor milestones since they are almost always impacted by the asymmetry in the neck or trunk. 

The most important thing to remember is not to wait if you notice signs of torticollis or plagiocephaly. The sooner you come in, the faster we can help resolve it. And if your baby is older, there is still a lot we can do. They are very malleable and will respond well to treatment, it might just take a little bit longer. 

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