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All you need to to know about congenital muscular torticollis.
Congenital muscular torticollis
Torticollis is commonly known as “wry neck”. The cause of wry neck in babies is unknown but it is thought to be related to the baby’s position in the womb.
- A child with torticollis will present with his/her head tilted to the right or left.
- He/she may also have a preference for right or left rotation of the neck.
- This head posture is due to tight muscles on the right or left side of the neck.
- Your baby may also have a soft lump in the belly of the Sternocleidomastoid (SCM) muscle.
- There may be flattening of the child’s head and face due to his/her preference of head position.
How can torticollis be resolved?
Studies have shown that torticollis can be resolved through appropriate positioning, simple stretching, active correction and strengthening exercises.
This condition usually resolves within a year if you carry out the prescribed exercises daily.
If your child’s condition do shown that torticollis can be resolved through appropriate positioning, simple stretching, active correction is not resolve by this time, your doctor may recommend surgical treatment to release and lengthen the tight muscle.
What happens during the physiotherapy session?
The physiotherapist will assess your child’s condition and prescribe the appropriate positions, exercise or a combination of these for your child.
You or your child’s caregiver will be taught exercises which target the affected neck muscles. These exercises must be carried out several times every day at home.
The physiotherapist will review your child as needed depending on the severity of your child’s condition.
- If your child has a SCM lump, he/she will be reviewed 1 to 2 times per week for at least 6 sessions. After which, your child will be reviewed weekly until the lump has resolved.
- If your child has a tight muscle without a SCM lump, weekly therapy for a month and then fortnightly for 2-3 months is recommended.
Do the exercises cause pain to my child?
The exercises are gentle and when performed correctly should not cause pain.
Why does my child cry every time we do the exercises?
Your child cries because the exercise puts his/her neck in an unusual position. To experience the stretch, you can try bringing your ear towards your shoulder to reproduce the stretch your child feels. It is uncomfortable but does not cause pain.
If my child is unwell, should I continue to do the exercises?
Stop doing the stretching exercises as it may cause your child to be more irritable. However, do continue with the positioning and strengthening exercises.
When is it a good time to do the stretching exercises?
Wait at least an hour after feeds, before carrying out the stretching exercises. Positioning may be done at any time.
How long does my child need therapy?
Usually torticollis resolves within 6 - 9 months of commencing therapy. The physiotherapist will assess your child at every session and discharge your child from therapy when your child’s condition resolves.
Torticollis is resolved when your child is able to hold his/her head in the centre in all positions and there is no imbalance of the neck muscle strength.
What you should do on the day of your appointment?
- Please come to the department 10 minutes before the scheduled time for registration.
- Remember to bring along your child’s birth certificate and health booklet for the first appointment.
- IMPORTANT: Do not feed your child just before the appointment. If necessary, feed your child at least 30 minutes before the appointment.
- Each therapy session lasts between 5 and 30 minutes depending on the severity of your child’s condition.
- Please reschedule the appointment in advance if you are unable to attend. We need at least 3 days’ notice. When you call us, please have your child’s Birth Certificate or Patient Reference No. with you as we need it to locate your child’s appointment.
What else can I do to help my child?
- We encourage you to be actively involved in your child's therapy.
- Your therapist might require you and other caregivers of your child to participate actively during the therapy session. Home exercise programmes will be given to you.
- You are encouraged to carry them out at home to ensure that your child benefits maximally from each therapy session.
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