Torticollis is a turning and/or tilting of the neck causing restriction in the available range of motion. This can cause the neck to be turned or tilted away from midline and difficult to move the head to a particular side. For example, the neck at rest can be turned towards the right and tilted towards the left, giving the appearance of a “twisted” position. Torticollis with this alignment can make it difficult to move the head in the opposite directions: rotating left and tilting right. The causes of torticollis can be from pain, stiffness, head/neck injury, or muscle spasm.
Torticollis can occur across the lifespan from newborns to adulthood. The difference for newborns and infants is that their skulls are largely cartilaginous and can be shaped. This combination of malleable shaping of the head and torticollis can result in a progressive flattening of a particular side or portion of the head due to any constant turning to a side, away from midline at rest. This flattening is referred to as plagiocephaly. Flattening can be congenital, developed in utero, or can be related to head position (i.e. with toricollis); in the latter case, the flattening is termed positional plagiocephaly and is often linked with torticollis. It is important to note that although toricollis and plagiocephaly affect the shape of the head, there are no direct affects on brain development or function.
If there are concerns with the baby’s neck range of motion or positioning, physiotherapy can help guide stretches and exercises to restore full range of motion. There are additional concerns with plagiocephaly, physiotherapy can help with establishing exercises are strategies to counteract this shaping.
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