What is
congenital muscular torticollis?
Congenital muscular torticollis (CMT) is a
shortened neck muscle that causes the neck to twist.
Congenital means that the condition is present at birth.
Torticollis means "twisted neck." Most frequently CMT
involves the muscle that goes diagonally across the neck
from the collarbone (clavicle) to the head just behind the
ear. This muscle is called the sternocleidomastoid muscle.
CMT causes the back of the head to turn
toward and the face to turn away from the affected side.
Your child will not want to move his or her face towards the
affected side because of pain.
What is the
cause?
The cause of torticollis is not completely
understood. One theory is that there is stretching of the
muscle during the delivery of the head. Severe stretching
leads to bleeding into the muscle. If enough bleeding and
swelling occurs, pressure builds up and damages the muscle.
Then, scar tissue replaces some of the muscle. Other
theories are that it is caused by crowding inside the
uterus, a blood vessel problem, or a primary muscle problem.
Whichever theory is correct, the baby keeps the neck turned
in one direction.
How is it
diagnosed?
CMT is diagnosed after an exam by your
health care provider.
What is the
treatment?
Many times children with CMT get better on
their own. You can help your child improve by putting your
child in situations where she has to stretch the affected
muscle on her own. For example, lay the child in the crib so
that if she wants to see what is going on in the room, she
will have to turn her chin towards the shoulder of the
affected side. This will stretch the affected muscle and
help cure the torticollis naturally.
Treatment of CMT involves passive stretching
exercises. This means that you help your baby move her neck.
Exercises to improve CMT are described below. Do these
exercises in sets of 10 repetitions, three times each day.
- Side bend:
Place one hand on the shoulder of the affected side of
the neck (the side with the tight cord-like feeling in
the muscle) and the other hand on the top of the child's
head. Gently move the neck so that the child is looking
straight ahead. With the child looking straight forward,
gently bend the neck so the ear opposite the affected
side goes toward or touches the shoulder on that side.
Gentle downward pressure can also be applied to the
shoulder on the affected side.
- Head turn:
With the hand on the shoulder of the affected side and
the other hand on the top of the child's head, gently
move the neck so that the child is looking straight
ahead. Now gently turn the child's head so that the chin
moves toward the shoulder of the injured side. (The
opposite direction of the way the child prefers to turn
the head.) Gentle downward pressure can also be applied
to the shoulder on the affected side.
Your baby will probably be referred to a physical therapist
to help determine how the treatment is going. If the
condition is still present after the age of 1 year, your
child may need surgery to restore movement of the muscle.
When should I
call my child's health care provider?
Call your child's provider if:
- You need to set a follow up
appointment.
- The torticollis gets worse.
- You have other questions or concerns.
