Torticollis as I touched on in last weeks blog comes in different forms. Congentital torticollis, when you baby is born with a twisted neck and the reason may be due to his/her position in utero or a congenital deformation of the bones in the spine or a neurological problem. Congenital torticollis ought to be reviewed by a paediatrician who may chose to send a baby for x-ray or ultrasound scans to rule out any pathological or genetic reason for the torticollis.
Then there is congenital muscular torticollis (CMT) this is develops after the child's birth (usually 2-4 weeks) and involves your baby's head tilting to one side and there chin pointing to the opposite shoulder.
Many practitioners like to subdivide. This can vary but a straight forward guide increasing in severity is:
●Postural – Your baby prefers to have their head in a certain position but can happily move their head in all directions when stimulated by a toy or food etc It is also possible for you to turn your baby's head in both directions. This may be due to a flat patch on the back on the baby's head from lying in one position too long or as a result of natural birth pressures through the child's cranium.
●Muscular – This is when there is tightness in a muscle called sternocleidomastoid (see diagram) your baby cannot move their head fully round in one direction, even if you are gently aiding them. Again this could be as a result of birth strain or assisted birth e.g forceps
●Sternocleidomastoid mass – This is when there is a thickening in the belly of the sternocleidomastoid (SCM) muscle. There is limited range of movement in your baby's neck when they try to move themselves and when they are gently aided. The mass could be due to a tumour but if detected your GP will have referred on for investigation. More likely the mass is due to a rupture (or tear) in the belly of the SCM. The tear could have occurred if the baby's shoulders were stuck and the head and neck wedged against opposing forces during birth, or from forceps/ventouse delivery.
If there is a rupture of the SCM osteopathic treatment and daily exercises for your baby are very important. There muscle looses it's elasticity because of scar tissue from the tear. Next week I will go through the excersises you can do at home with your baby and describe what osteopaths do to help aid the recovery of an SCM injury in CMT.