A torticollis, which manifests itself as a permanent or temporary inclination of the head on one side and simultaneous rotation on the other side, can occur in children and infants for different reasons. It can be caused by the musculature (M. Sternocleidomastoideus), congenital or caused by birth trauma. A torticollis can then be treated physiotherapeutically.
A torticollis can also be caused by bony malformations, can be triggered by muscular spasms in the case of neurological diseases or can occur spontaneously as a symptom in the case of an acute problem of the cervical spine. There are several other causes of torticollis that occur less frequently. A permanent head torticollis can lead to a malposition in the long run, infections or scars can be responsible for the malposition of the head. Physiotherapeutically, mainly muscular, but also some other forms can be treated.
Physiotherapy
A torticollis in an infant can have a very negative effect on the child’s development and should be treated as soon as possible. In the shoulder, neck and cervical muscles there are many sensors that are very important for balance and perception of one’s own posture. Therefore, if disorders occur in this sensitive area, coordinative and vestibular functions are also at risk; this is not only a cosmetic treatment.
The treatment includes several basic approaches. Firstly, the treatment of the affected structures themselves, through light massages and gentle stretching exercises. Also important is a global movement and mobilization therapy.
Since the physiological neutral position of the head is often painful or uncomfortable for the child, the child adopts a gentle position. Physiotherapy for children with a torticollis attempts, through targeted movements and exercises, to dissuade the child from the relieving posture and to accustom it to moving symmetrically in everyday life. Exercise concepts that help to achieve this goal are the concepts according to Bobath and Vojta.
These are concepts that have a holistic effect and should be integrated into the child’s everyday life. Therefore, it is still very important to involve the parents in the physiotherapy of the child’s torticollis in the therapy. They should be instructed to carry out the daily exercise program correctly and be made aware of certain manners in everyday life (this is also called correct “handling”). The furnishing of the crib and the apartment should also be checked and adjusted. Manual therapy techniques can also be used, but these should only be carried out by experienced child therapists.
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