Torticollis is More than just a Neck Problem

The door opens and in walks a new mother lugging her baby bucket car seat. Her facial expression is a mixture of exhaustion, bliss, and concern. While her baby has been born healthy, he has torticollis. The doctor has told her that the physiotherapist will show her how to stretch her baby’s tight neck, which can be painful at times, thus the concern on her face.

Congenital torticollis is a condition in which a baby’s neck is tight on one side (in the area where the pink tape is in the picture), causing the head to be held tilted to one side and rotated towards the other. It can vary in severity but parents usually notice right away that the baby’s head is always turned to the same side. This can interfere with breast feeding if it is pronounced enough.

Position in utero is thought to be a factor in torticollis. Injury to the muscles on one side of the neck at some point during birth has also been proposed as a cause. Whatever the cause, the tightness needs to be addressed.

Traditional physiotherapy treatment involves little more than stretching the tight side of the neck. As you can imagine this can be painful for the baby and thus traumatizing for parents. Treatment also involves giving parents suggestions on how to encourage their baby to turn its head in the other direction. This treatment approach can drag on for months, sometimes with little result other than stressing everybody out.

Torticollis is not a Localized Neck Problem

The issue is that torticollis has traditionally been seen as a localized neck problem. I can assure you it is not. It is part of a total body pattern of movement in which the poor neck is just the part that is paying the price. Let me explain further.

Under any conditions, when a muscle is tight it is holding for a reason. Muscles don’t just decide to randomly tighten up to give us a hard time. Muscles hold on to compensate for something else.

In the case of torticollis, every single baby I have ever seen with the condition also had asymmetries through the pelvis and hips. This is most evident when the parents put the baby in their car seat. They often tell me that the baby always seems crooked in the car seat and no matter how much they fiddle, they can never get them in there straight. The baby is always falling over to the same side. The head is just the last pearl on this falling-over string. The problem starts from lower down.

Treat the Cause not the Symptoms

In my experience, treating and freeing the pelvis and hips to restore symmetry there is the quickest and most effective way to address the neck tightness. Once the hips and pelvis are squared up, then releasing the tight neck muscles can usually be achieved very quickly. Here the issue is not so much that the neck muscle is short, it’s that it is stuck to its neighbours below and literally needs to be peeled free. Stretching by turning the neck to the end of its range isn’t going to achieve this, but rather will only serve to create discomfort with little result. Although this part of the physiotherapy treatment where we separate the stuck-together muscles can be painful for baby, it is usually over in a few minutes.

No repetitive, painful (for baby), and traumatizing (for parents) stretching is necessary. Once the root cause of the problem has been addressed, then freeing the tight neck muscles from their neighbours produces lasting results. I rarely need to treat a baby with torticollis more than two or three times.

So if you or someone you know has a baby with torticollis, find a practitioner who sees this as an issue involving the whole body. For if the root cause is not addressed, then stretching will gain you all a whole lot of stress with limited results.

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