Torticollis

What is torticollis? Torticollis (wry neck) is a congenital or acquired condition of limited neck motion in which the child will hold the head to one side with the chin pointing to the opposite side. It is the result of the shortening of the sternocleidomastoid (neck) muscle. In early infancy, a firm, non-tender mass may be felt in the midportion of the muscle. The mass will go away and be replaced with fibrous tissue. If untreated, there can be permanent limitation of neck movement. There may be flattening of the head and face on the affected side.

How is torticollis treated? Treatment consists of gentle stretching exercises (see below). The face is turned away from the affected muscle while the head is tilted in the opposite direction with the neck extended. This position is held for a count of 5 and repeated 10 times twice daily. The baby can be placed in the crib or playpen in a way that encourages turning the head away from the deformity in order to observe activities and interesting or favorite toys. When placed in a car seat, padding may be placed on the affected side forcing the head to turn in the opposite direction. Long term follow up is important to assess for abnormal head shape. Follow up may be necessary in six months with pediatric surgery to assess for the necessity for head molding. Please do not hesitate to call the office if you have any questions.

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This child has torticollis with this head tipped towards his left side (1). Exercises involve gently rotating his head to the left (as shown in 2) and gently stretching his head and neck towards the right (as shown in 3 & 4).
1)	2)	3)	4)
This child has torticollis with this head tipped towards his right side (1). Exercises involve gently rotating his head to the right (as shown in 2) and gently stretching his head and neck towards the left (as shown in 3 & 4).

Where can a parent get help and talk with other parents about torticollis? TorticollisKids is an organization of parents who have or have had infants with torticollis. Their web site, www.torticolliskids.org, has explanations of torticollis and its treatment options, helpful hints on dealing with the condition, and links to obtain support from those who have really "been there". Interested parents can join an email support group and participate in forums on the condition with other parents.