TorticollisWhat is Torticollis?

Torticollis, otherwise known as wryneck, is a condition usually seen in infants where there is damage or tightness to the sternocleidomastoid muscle in the neck. This muscle’s action is to tilt the neck to the same direction and rotate it to the opposite direction. Hence, when a child (or an adult) has torticollis, they generally appear to have a head tilt to the affected side (where the muscle is shortened) and chin rotated up to the opposite direction. Other types of conditions, such as infection, tumors, ophthalmologic problems, and cervical abnormalities should be ruled out by the pediatrician prior to a referral to physical therapy.

What causes Torticollis?

There are many potential causes for congenital muscular torticollis. Generally, intrauterine malposition or birth trauma during delivery are ways that torticollis can be caused during pregnancy or delivery. Babies who are born in the breach position, multiples and babies who are delivered with the aid of forceps are at higher risk for torticollis. In addition, positioning after birth can cause torticollis if the infant is always faced in the same direction or positioned in the same way. Plagiocephaly, or flatness to the head of the infant, can in itself cause tightness to the neck muscles and associated torticollis.

How does the condition progress?

If untreated, torticollis can cause problems with balance, facial asymmetry, visual disturbances and muscle asymmetry that can continue to affect a child later in life. Sometimes a mass, or sternocleidomastoid tumor, can be present beginning at 2-4 weeks of life and gradually disappear, generally between the first 5-8 months of a child’s life. Plagiocephaly, or flatness of the head, can be present if head shape is not corrected within the first 18 months of life. A gross motor delay in milestones can also be present, and is often correlated with torticollis, as this condition can cause muscle imbalance, flatness to one side of the head and weakness to the muscles surrounding the neck.

How do I treat Torticollis?

Physical therapy involves gentle stretching of the affected sternocleidomastoidas and strengthening to the neck musculature to achieve a neutral neck position and full range of motion. Close attention is also focused on facilitating gross motor milestones as torticollis can cause a developmental delay if not treated early in life. Often times a therapist will work with a peanut-shaped ball to help facilitate strengthening and balance reactions in an infant. Other techniques, such as gentle massage and positioning techniques are completed during the therapy session. Parents are always given a home program to work on stretching and exercises to help the infant correct the torticollis as soon as possible.

NSPT’s approach

North Shore Pediatric Therapy physical therapists are trained in the treatment of torticollis and will provide your son or daughter with the best treatment possible. Physician communication is something that NSPT prides itself on and enables healthy, frequent communication with your child’s health-care team to ensure well-informed team members. Your therapist will carefully go over your child’s home exercise program and will make sure that you as the parent feel comfortable with all of the home exercises to ensure successful treatment from all angles.

Client Reviews (9)

My daughter Clara started seeing Leida in the Evanston office at 4 months old for Torticollis. From the first phone call I made to NSPT I was impressed with level of service and care I received. The care and clear communication has carried through each of our treatments. Leida has been a pleasure to work with and she has educated me on Clara’s condition and progress regularly. Clara began to improve almost immediately and we are so thankful for Leida’s professional expertise and kindness.

Beth

Thanks to all the staff at NSPT for helping our daughter Emma to correct her torticollis. Throughout the 9+ months we went, Leida, Marci, and Emily were great with Emma and really made us feel comfortable throughout the process. Emma’s smile when we went to therapy is a testament to the care and warmth everyone showed us. Thank you for your professional care and heart felt concern for our daughter.

John, Denise and Emma

My daughter who is now 1.5 years old and she started physical therapy when she was 6 months old and was discharged at 1 years old. We was reevaluated and needed therapy a few months later, and that’s when we met Marcy. She was very professional and compassionate towards my daughter. In the beginning hannah was very fearful of leaving my hands and had many meltdowns, a few weeks later hannah was eagerly jumping into Marcy hands. It only took a few months for hannah to come walking out to me in the office and it was a dream! Hannah is now meeting with devorah for speech and she’s absolutely great with it. I’ve recommend this place to friends and neighbors because hoe fantastic the staff and services are. Very highly impressed!

Jill

Our daughter saw Sarah Friedman in Glenview (now in Lincolnwood) for gross motor delay. Through our time with Sarah, she made tremendous progress. Sarah worked hard to keep our baby happy during sessions and cheered with us when she did her first roll and her first independent sitting session. We are so grateful for Sarah’s expertise and encouraging support. We still email her with questions and she happily responds. We highly recommend Sarah and the PT at NSPT!

Matt Galin

First of all I want to thank NSPT for allowing me to come to Glenview to have a clinical rotation with the pediatric population. My first two clinical rotations were with the geriatric population at a SNF and an outpatient orthopedic clinic. This has been a fantastic experience and I’m sad that I have to say good bye. I had the privilege to be overseen by Colleen McCloskey. She was very skilled and educated in her field. I was able to learn so much about the pediatric population, therapy techniques and interventions, as well as learn about other health professionals. She was consistently making sure I was constantly developing as a physical therapist. I also had the opportunity to work with other physical therapists when a kid cancelled or had extra free time. Each therapist ensured I was active in the therapy session. This allowed me to expand my knowledge by observing and learning other skills from a variety of people. Colleen was always active in my learning experience by providing me with great research articles and setting up an appointment to observe a company called Cranial technologies in which I was able to see the process of how helmets are created and adjusted for infants with plagiocephaly. Not only were the physical therapists great, so were the other professionals. Within the first two weeks I was able to interact in sessions with occupational therapists, social workers, speech therapists, and behavioral therapists. Everyone at NSPT made my experience fantastic with their personalities and overall attitude at work. This experience ensured that I look for a work environment filled with positivity and comradery like NSPT. Besides the great people at NSPT, I fell in love with pediatrics. I was able to treat infants to teenagers at the clinic. I was exposed to a variety of diagnoses including torticollis, spina bifida, idiopathic toe walking, cerebral palsy, and general gross motor delay for all ages. Each treatment was new and exciting. I never had to follow a specific routine which allowed flexibility and freedom, which I enjoyed. Each day was filled with laughter, fun, and a sense of accomplishment when I was working with the kids. I never had a day in which I didn’t smile. I am so happy and appreciative of this experience at NSPT. I have learned so much and I owe it all to Colleen and the other therapists at NSPT. Thank you again for these wonderful 10 weeks!

Shayla Seim

Flexible, professional and always encouraging our daughter to reach to levels at all times. Updated information on performance reviews and adjustments to therapy goals.

Ben

I want to start off by thanking you for affording me the opportunity to work/learn here at NSPT for the past 12 weeks, especially on such quick notice. I have wanted to do a pediatric clinical since I started PT school so naturally NSPT was an easy choice for me to make. The thing that really drew me to NSPT was the clientele. My other area of focus is outpatient adult orthopedics, and after looking over your site I realized that many patients at NSPT come in with orthopedic issues. Having no prior pediatric experience before attending this clinical, I felt that this would make for an easier transition. I was right. I have learned a lot here, from both Judy and all the other clinicians. The aspect of pediatric care that I initially had the most trouble with, and thus am most proud of, is client management. I have 3 younger siblings and many young cousins so I figured that I would definitely be able to handle pediatric PT. I was rudely awakened during my first couple weeks as I had trouble controlling the kids. I learned how to engage children better, focusing on building a positive report with them but at the same time not letting them act out. I learned how to persuade the kiddos to not only complete the exercises but REALLY WANT to complete them in a correct way. I learned how to better handle infants thanks to Judy. This clinical rotation also helped improve my organizational and planning skills as the clinicians have more responsibilities than other clinics I have been in. It was initially challenging trying to stay on top of all the paper work: progress notes, re-evaluations, initial evaluations, thank you notes, treatment session updates, intake info, managing the schedule independently, and responding to many parent e-mails. I am so grateful for everything I have learned here and I want to thank you everything who had a hand in placement here. I want to give a special thanks to Judy Wang for taking on her first student and being as patient as she was with me. She is a great C.I. and I’m sure that will only get better with more experience.

Nick Lefere

My son (now 4) has only been receiving physical therapy at North Shore Pediatric Therapy for about a month, but already we are seeing so much progress. My son took to his therapist immediately and so he views his sessions as a highlight of his week; his time to play with Miss Sarah is always a joy. He had trouble hopping, balancing, etc… and now he is gaining so much more strength and confidence in his own abilities. My son also has Type 1 Diabetes and I always know he is in good hands as Sarah is well versed in diabetes care and always asks about his blood sugar before his sessions. Thank you!

Jennifer N

Andrea is a wonderful Physical Therapist! Her work with our son is always engaging and fun for him. She is always very helpful with things we can do at home to help him improve and the exercises she does with him, he thinks are games, so he is more willing to do them more often. I’m so glad she is working with him, it is easy to see the improvements over a short period of time!

Anonymous

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