This may be helpful for practitioners treating torticollis in their consulting rooms.
It is important to understand the mechanism behind the neck stiffness. Where many practitioners go wrong in the treatment of this condition is that they wrongly assume the stiffness is only in the neck.
It is true that we see the effects in the neck but we so readily forget that the baby has a chain of muscle, covered by fascia, extending from the feet right the way up to the head.
In simple Torticollis there is an imbalance of the two long chains of muscles either side of the spine.
In Torticollis one side will be better at stretching than the other. (In order for any human to rotate the head one way, the muscles contract on one side and lengthen on the opposite side.
In the case of Simple Torticollis the baby has difficulty in lengthening the muscle that allow head rotation to the opposite side.
This inability to lengthen (or blockage to lengthening) can occur anywhere up the length of the chain.
The most dramatic changes I have in my children’s clinic when treating babies with torticollis occur when I have hold of the baby’s ankle or calf, release the blockage to lengthening, and instantaneously the baby rotates the head to the opposite side for the first time in their life. I sometimes don’t even have to treat the baby’s neck!! This is invariably followed by a tearful reaction of relief in one or both parents!!
We would recommend that you see a specialist in pediatric cranial osteopathy or pediatric physiotherapist. They should provide you with advice, treatment and exercises.
The treatments of choice include
- physiotherapy stretching, (very slow response in my view)
- exercises to try and encourage movement in the opposite direction, (almost pointless in my view)
- cranial osteopathy by a paediatric cranial osteopath (if treated by an experienced practitioner the simple form of torticollis usually responds very quickly, say two or three treatments),
- Surgery to elongate the muscle.
This is sometimes the best treatment if the baby has shortening of the sterno-mastoid muscle. (It can be spotted in babies because the baby appears to be listening to their shoulder, i.e. the ear will drop one side and the head rotates to the other.
Babies with Torticollis are likely to develop postional Plagiocephally (commonly referred to as Flat Head Syndrome) as a consequences of lying repeatedly on the same side of their head. As stated previously, invariably a flat spot will start to occur as early as a few weeks old.
The secondary problem is with the baby having a flat spot on the back of the head at one side at the back the effect of gravity will always tend to pull the head back onto the flattened area. (Hence: why does a bucket have a flat bottom?!) This means that when the baby has enough strength in the muscles to move the head freely he or she will always be fighting against gravity thereby making the flattened area worse.
How to avoid positional Plagiocephaly developing.
The safely advice to parents is to lie a baby on a firm flat surface on their back. It is recommended to worried parents research the alternatives. The medical advice is to avoid positioners or inserts in cots as this is a (very low) suffocation risk. It is recommended that parents look into placing their babies on an ergonomically designed mattress, which is shaped to fit their baby’s head, ie. SleepCurve mattressses. This puts less pressure on the soft skull bones of the baby.
These mattresses have been clinically trialed and results published in medical journals showing a 'significant improvement in head shape' in the treatment of plagiocephaly.