Torticollosis or the twisted neck is one of the three most common problems, immediately after dislocation of the hips and deformity of the feet with which a number of babies are born. It is a shortened muscle on one side of the neck, which leads to tilting the head to the same side and turning the face to the opposite.
How does appear?
The reason for this phenomenon is the position of the baby in the stomach in the last months of pregnancy. If it is an innate torticollis, a pediatrician in the maternity clinic will enroll this in a dossier with recommendations to parents immediately upon leaving the hospital to contact the physician.
Another possibility of torticollis is a birth trauma. Stretching of the muscle of the neck can occur if the baby’s head come too quickly or too slowly. Then the muscle fibers are broken due to the excessive stretching of the neck muscles, which cannot be seen immediately. The result is hematoma (swelling) within the muscle that is created mainly in the third week of the baby’s life and can be seen and felt on the neck.
How is it treated?
Physical therapy, which means: exercises, head position, paraffin, and electrophoresis potassium iodide. Paraffin heats the muscle and thus prepares for passive stretching. It is used for larger shortened muscles when we cannot get a full range of motion. Electrophoresis potassium iodide is applied when there is a swelling of the neck and in fact it is entering drug through currents.
- After these procedures, the exercises must be performing and they are passive, when the therapist or parent expands the shortened muscle by tilting the head to the opposite side. This exercise can be performed in two positions, when the baby is on the back or on the side, which depends primarily on the age. In the first few months, it’s easier to lay the baby on the back, but later when it starts to turn independently, you can fix baby’s shoulder and tilt his head to another shoulder at the same time, you can do so from the side position.
- The second passive exercise is to turn the face on the same side as the shortened muscle, and you can successfully perform it on baby’s stomach by fix his shoulder with one hand and lowering his head by the other with the chin going to the shoulder. This is the position in which the baby can sleep and that means that all the time shortened muscle stretches.
- In addition to passive stretching, it is necessary for the baby to actively strengthen the other side of the neck with our help. By moving the body, we bring it to a position on the side when it needs to raise its head as if it wants to turn to the stomach.
- Lying position on the stomach with a support on the arms allows for lifting the head and upper part of the body which strengthens the muscles of the neck and back. While the baby is lying on the stomach, point his favorite toy and tell him to turn his head to the side where the muscle is shortened.
What is Head Positioning?
In order for the correction to be successful in addition to passive stretching and active strengthening, we must achieve a good head position. That’s why in a lying position on the back while the baby is asleep, but also when it’s awake while in the bed or strollers we place folded towels on both sides of the head. When baby is sleeping on a side where the torticollis is, a folded diaper or a small towel is placed under the head so that the neck is free. When the baby is on another side, put the towel under the baby’s pelvis. In the stomach position as well as in the exercise, put the baby on the face on a healthy side.
Is all of this enough to correct the torticollis?
It will depend on how much the muscle is shortened, when you started correction, and if you did it to the end.
In the most difficult cases when physical therapy does not produce the expected results, the surgery is needed. Torticollis must be cured completely, as it results in deformity of the spinal column (scoliosis), vision problems (certain corrections are required) and improper development of the jaw (children must wear corrective prostheses).