What is Torticollis?

Torticollis, or wry neck, is a relatively common condition in new born babies. Translated from the Latin, it literally means ‘twisted neck’. Congenital muscular torticollis, the most common form of paediatric torticollis, occurs because the sternocleidomastoid muscle (SCM) has shortened and contracted. The SCM muscle runs along each side of the neck and controls how the head moves — side to side, and up and down.

What causes torticollis?

There are a few common reasons why the SCM muscle may have become contracted and cause your child’s head to tilt to one side:

  • The way your baby was positioned in the womb before birth
  • Abnormal development of the SCM muscle
  • Trauma or damage to the muscle during birth

You may not notice anything unusual about your baby for the first 6 or 8 weeks. It’s common for torticollis symptoms only to become obvious once an infant gains more control of the head and neck.

Symptoms to look for in your baby

Some of the symptoms you might experience:

  • Your baby’s head tilts to one side with its chin pointed to the opposite shoulder. In about 75% of babies with torticollis, the right side is affected.
  • Your baby’s head doesn’t turn side to side or up and down easily.
  • You feel a soft lump in your baby’s neck muscle. This isn’t dangerous, and goes away within 6 months, usually.
  • Your baby prefers to look over the shoulder at you. Its eyes don’t follow you because that would require turning the head which is difficult.
  • Your baby has trouble breastfeeding on one side or prefers to feed on one side only.
  • Your baby works hard to turn toward you, struggles to turn its head all the way, and becomes upset because the movement is hard.
  • Your baby might start getting a flat head on one side - or both sides - from lying in one position all the time.

At the London Orthotic Consultancy, we have found that torticollis is the primary cause of flat heads in the babies that we examine. It is important, therefore, to take action to treat your baby’s torticollis - either by following some simple, gentle neck exercises at home, or by referral to a specialist physiotherapist.

How can I improve my baby's torticollis?

If we find that your baby has a neck problem at an initial, free flat head consultation, we will advise you on the steps that you can take. We can also refer you to a paediatric physiotherapist. Stretching exercises are most likely to work well if started when a baby is between three and six months of age. But, be aware that even if started at this age, it still might take some months to resolve the condition completely.

If your baby has developed moderate or severe asymmetry of the head, helmet therapy will probably be the recommended treatment option, since the optimum age to start this treatment is between four to six months and after 18 months of age, the treatment becomes less effective. Helmet therapy can be started concurrently with any physiotherapy for torticollis, as the helmet will prevent the baby’s head from getting any flatter. The London Orthotic Consultancy has more than a decade of experience in treating positional plagiocephaly (flat head syndrome), and baby helmet therapy is a proven, effective treatment.

Worried about your baby’s head shape?

You can get a fast, free, flat head diagnosis from our fully qualified orthotics team. Simply attach pictures of your baby’s head to [email protected] and one of our highly experienced orthotists will contact you within 24 hours to give you a free, qualified and impartial opinion on your baby’s condition.

Or, if you prefer, you can book an initial, free flat head consultation at one of our clinics, where we will be happy to make an assessment and offer advice and discuss any necessary treatment.

Plagiocephaly FAQs:

This is very much dependent on how fast your baby is growing. The faster the growth, the more frequently your baby will be seen so that the helmet can be adjusted. In general, reviews will happen at two to four-week intervals.

The price of treatment covers:

  • all your baby’s required appointments from start to the end of treatment, no matter how many are required to achieve the improvement in head shape that you are happy with;
  • the cost of manufacturing the LOCband and supply of appropriate cleaning fluid for the band;
  • all reports to your GP/paediatrician/ cranial osteopath/physiotherapist, including a final scan report with objective measurements of change achieve;
  • full telephone support from your clinician during treatment, and, if necessary, extra review appointments at short notice.

Yes - All babies that have completed their course of treatment with us have achieved a measurable improvement in head shape. However, you don’t have to take our word for it.

Recent independent research conducted by a University Hospital in Germany has endorsed the treatment for babies with moderate or severe plagiocephaly.

A larger, retrospective study has just been published that found complete correction was achieved in 94.4% of babies treated with helmet therapy.

The results were conclusive: repositioning achieved acceptable correction in 77.1% of cases, but 15.8% were moved onto helmet therapy because re-positioning was not working. Meanwhile, 94.4% of the infants who started in the helmet-treated group achieved full correction, as did 96.1% of those who were transferred from the repositioning group into the helmet-treated group.

Further information can be found on our Plagiocephaly Research page.

If your baby has a temperature or a fever due to illness you must remove the band. The band can be put back on once the temperature has returned to normal.

The optimum age for treatment is between four and seven months.

This is because the skull is most malleable at this age and improvements to head shape tend to take less time and are more dramatic. That is not to say that helmet therapy should be ruled out if the baby is older than seven months. Routinely, babies up to the age of 16 months can be treated very successfully.

The cut off age is around 18 months when the fontanelles (soft spots on the head) are no longer malleable. As babies grow and develop at different rates, it is always worth checking if you are not sure. There have been cases where a baby’s fontanelles have not fused yet by the age of 18 months, who have achieved successful, but less-marked results with cranial remoulding therapy.

Torticollis is a condition in which a tight or shortened muscle in one side of the neck causes the head to tilt or turn to one side, resulting in the infant resting its head in the same position. In 2013, we analysed the data from all first appointments in our Kingston clinic and found that 20% of the babies examined had some kind of neck condition that was causing head immobility.

The clinics and clinicians that provide this treatment in the UK will have received similar training and experience. However, we are the only clinic that manufactures its own helmet and our clinicians are closely involved with the process for each individual helmet that we produce.

In addition, we do not restrict review appointments to a set number, we are extremely flexible and respond to individual parents' needs so that the best outcome can be achieved for each baby.

The LOCband is non-invasive and works by applying gentle, constant pressure over the areas of the baby’s skull that are most prominent while allowing unrestricted growth over the flattened areas. The band consists of a soft foam layer inside a thermoplastic shell. As the baby grows, the band will be adjusted frequently to gently guide the skull into a more symmetrical shape.

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