congenital torticollis

Congenital Torticollis: Disorder in Newborns (Exercises)

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine

Parents may start to worry if their baby's head begins to tilt to one side, or if they prefer to look in one direction - and your doctor may even have noticed this during their last check-up. your baby. the torticollis Infant pain, called congenital torticollis, is easily diagnosed by tight muscles on one side of the neck, which leaves your baby's head tilted or spinning.


You should also know that torticollis in infants is common. Some studies report that it affects 3 out of 100 babies. Fortunately, in most cases congenital torticollis is treatable. If your child is affected by this condition, or if you know someone with an affected child, this article may be useful to you.

Definition and anatomy


In very simple terms, it is a problem that is in the neck of your child and this disorder has settled long before the birth of your child. Specifically, an infant's neck muscle is shortened, causing twisting. Moreover, etymologically, congenital torticollis means a torsion of the neck present at birth.




First, a difficult childbirth can cause congenital muscular torticollis. This is because the baby is delivered breech, or if forceps or suction cups have been used.


During childbirth, if the sternocleidomastoid muscle, the muscle in the neck that extends from the jawbone (mastoid) to the collarbone (clavicle) and sternum, is overstretched, it can tear, causing bleeding and bruising in the muscle. The latter develops scar tissue, which causes the muscle to tighten and shrink. Then this constriction pulls the infant's head to one side.


Besides birth trauma, other causes of congenital torticollis include:


  • Hematoma in the cervical muscles
  • Fibrosis
  • Klippel-Feil syndrome
  • Atlanto-occipital fusion (i.e. the fusion of the first vertebrae at the bottom of the skull)
  • Pterygium Syndrome
  • Infection
  • Tumor
  • Neuromuscular disorder



Signs and symptoms


When your baby has congenital torticollis, the reason may be due to the positioning of your child in utero. In some cases infants develop torticollis after birth (acquired torticollis, which is normally caused by some sort of trauma or infection), but most cases date back to birth. Understanding the symptoms of torticollis, congenital or acquired, will help you understand how to help your baby.


Even though most parents who deal with this type of torticollis all start to panic, it is important to know that this disorder can be treated.


Symptoms of congenital torticollis


Although your baby was born with a torticollis, you may not notice any signs or symptoms until he is 6 to 8 weeks old. Around this age, most infants begin to have better head and neck control. At this point, you may begin to notice the following symptoms:


  • The head tilts or turns to one side
  • Limited range of motion in the head and neck
  • Asymmetry in your baby's head and face (flattening of one side of the head)
  • Breastfed babies may prefer side to side
  • Musculoskeletal problems may be present (hip dysplasia)
  • A small, soft bump in your baby's neck


The most common symptom observed is plagiocephaly, or a flat patch appearing behind one ear and on the side the child likes to look


Acquired torticollis


In order to complete your knowledge, here are also the symptoms of acquired torticollis:


  • The head tilts to one side
  • Limited range of motion in the head and neck
  • Recurrent episodes of head tilt. During these episodes, your child may also experience drowsiness, irritability, or vomiting.





As for how this disorder is diagnosed, typically, physical examination of the infant may show the characteristic tilt of the head and tightness of the sternocleidomastoid muscle, as well as the presence of a mass in the midsection of the muscle. . In addition to a complete medical history and physical exam, diagnostic procedures for congenital muscular torticollis may include the following:




A diagnostic test that uses beams of invisible electromagnetic energy to produce images of internal tissues, bones and organs on film to check for abnormalities in the bones of the neck and shoulders.


Ultrasound examination


Here, doctors and staff use sound waves to create images of blood vessels, tissues, and organs to assess the muscle around the lump. In addition, ultrasound is extremely useful, as it can shed light on blood flow and the functioning of internal organs.


Make an appointment with your doctor if your baby's torticollis treatment doesn't seem to help or if he develops new symptoms. Also, if your child's torticollis develops after an injury or illness, see a doctor right away.





 The best way to treat torticollis is to encourage your baby to turn his head back and forth. This helps loosen tight neck muscles and tighten loose ones. Rest assured that babies are unlikely to hurt themselves by turning their heads on their own.


In addition, the exercises are a good way to allow your child to have total mobility at the level of his head. For this, laying your baby face down for brief periods when awake is an important exercise, as it helps strengthen neck and shoulder muscles and prepares your baby for crawling. This exercise is particularly useful for a baby with torticollis and a flat head (plagiocephaly) – and can actually help treat both issues at once.


Here's how to proceed:


  • Lay your baby on your chest to do this exercise
  • Position your baby so that his head is turned away from you. That is, you need to be the opposite of what your child is looking at.
  • Then talk or sing to your baby and encourage him to turn to you
  • Practice this exercise for 10 to 15 minutes several times a day
  • Once your baby lays their head down for 10-15 seconds, they are tired and need a rest.


Stretching exercises for torticollis are more likely to work well if they start when a baby is between 2 and 6 months old. If you find that your baby's torticollis does not improve with stretching, talk to your doctor or physiotherapist (physiotherapist).


In addition to tummy time, do what you can to encourage your baby to move to the affected side. For example, if your baby normally turns her head to the left, stand to her right when you change her. Do the same when placing him in his crib. For breastfeeding mothers, encourage your baby to nurse on the side he normally doesn't like. All of these movements can strengthen your baby's neck.


Here are some other exercises to try:


When your baby wants to eat, offer him the bottle or your breast to encourage him to turn to the favored side. (Use your child's desire to eat to encourage them!)


When you put your baby to sleep, place him facing the wall while facing the direction he likes to look. Since babies prefer to look around the room, your baby will actively turn away from the wall, which stretches tight neck muscles. Remember to always lay your baby on his back.


During play, engage your baby's attention with toys and sounds to spin him back and forth


In some cases, the doctor may suggest taking a baby to a physical therapist (physiotherapist) for more intensive treatment. Once treatment has started, the therapist may check your baby every 2 to 4 weeks to see how the treatment is going.


During these follow-up visits, the physiotherapist will measure how many degrees the baby can turn their head and then help relax the muscles in their neck so they can increase their range of motion. They will also track any head shape issues and make recommendations on how to reduce any flatness that may be present (plagiocephaly). Some children will need a helmet, but most will not.


When home therapy and exercises don't correct your child's head tilt, surgery may be needed. Fortunately, this rarely happens with babies who have persistent torticollis that does not respond to conservative treatment. Very few children with congenital torticollis will need surgery.


The surgery lengthens the sternocleidomastoid muscle and corrects torticollis. Typically, your doctor will wait until your child reaches preschool age before recommending surgery.

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