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Patient Education

Torticollis Treatment for Children

Torticollis is a condition where the child’s head is tilted, and it is caused by the tightening of muscles of the neck, flattening of the back of the head, or both. This condition refers to tightening of sternocleidomastoid (SCM) muscle, i.e. the muscle that runs from the base of the neck, at the level of the collarbone, to the base of the skull behind the ear. The tightening pulls the head sideways towards the shoulder. As a result, the face is turned toward the opposite shoulder, bringing the head forward on the chest. Torticollis limits the child’s ability to turn the head freely to interact with other people or perform daily chores. But the problems caused by torticollis can be minimized with the help of right physiotherapy solutions.

Passive Range of Motion

Goals: To open up the joint space, allow children to move their head freely, and reduce the range of motion limitations.

- Address the head rotation and lateral flexion.

- Target the range of motion of the child's head and neck.

- Begin with a range of motion exercise with a little gentle cervical traction.

Side-Bending (Ear to Shoulder)

- With child positioned comfortably on the back, either on a softly padded floor or your lap, begin tilting the head to the opposite side.

- If you are trying to stretch the muscles on the left side, place your right hand on the child’s left shoulder.

- Press down as you use your left hand to tilt the child’s right ear to the right shoulder.

- Hold this stretch for 10-15 seconds.

- Gradually increase the duration of the stretch to the child’s comfort level and tolerance.

Rotation (Chin to Shoulder)

- Place your one hand on the child's shoulder, cup child’s head with the other hand.

- Slowly turn the child’s head bringing it to the chin to shoulder.

- Hold this stretch for 10-15 seconds.

- Gradually increase the duration of the stretch to the child’s comfort level and tolerance.

Lower Trunk Rotation (Guided Rolling)

Goals: Promote transitional movements, encourage symmetry in rolling, and activation of both sides of the child's body.

- Use the pelvis of the child to guide from supine to side-lying to prone on both sides.

- Begin by building momentum with gentle rocking side-to-side.

- Your handling should decrease as the child rolls independently to gain mastery. 

Sidelying (or Child Positioned on Side)

- Encourage side-lying so that your child’s head and neck are turned away from the restricted side. You can use rolled up towels or pillows to the position of the kid.

- Keep the child engaged in this position and allow them to use both the arms while playing.

Prone (or Tummy Down Position)

Goals: Encourage head, neck and upper body strength, facilitate pushing off the surface, vertical visual gaze, promote fluid head rotation and range of motion.

- Encourage "tummy time" by placing the child on the stomach.

- Slowly increase the duration as the child builds strength and tolerance for longer intervals.

- Using tummy time mirror, fun toy, or even your child’s favourite pet.

- Encourage the child to look away from the restricted side.

Most babies with torticollis get better on their own with constant physiotherapy exercises. Before you start any of these physiotherapy exercises on your baby, take the help of the physiotherapist to assist you with the exercise.