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Pain > Torticollis Physiotherapy
Torticollis refers to a medical condition that happens when the muscle that runs from
the breastbone and collarbone up and toward the back of the neck
- or thickened
causing the chin to point toward
one shoulder, while the head tilts toward the opposite shoulder.
most common form of the condition is congenital muscular torticollis
(CMT), which affects infants and is generally observed within the first 2
months of life.
In 1992, the American Academy of Pediatrics began their "Back to
Sleep" campaign to reduce Sudden Infant Death Syndrome (SIDS). The
campaign successfully decreased SIDS by 40% in the United States, but it
had an unintended result of contributing to the development of CMT in
approximately 1 in every 250 infants.
Torticollis also can occur in adults. Head tilt in children or adults
also can accompany other symptoms of more serious conditions.
If symptoms such as
- trouble breathing
- trouble swallowing
in the arms or legs
- impaired speech
- difficulty walking
- pins-and-needles feeling or numbness in the arms or legs
- urinary or
fecal incontinence accompany the head tilt
seek immediate medical
first of all, What is Torticollis?
Torticollis is the tilt and/or rotation of the head because of tight
and weak neck muscles.
It happens when the muscle that runs up and toward
the back of the neck (the sternocleidomastoid muscle) becomes tight,
weakened, or thickened.
There are 5 forms of the condition:
- Congenital muscular torticollis (CMT) is the most
common form of the condition. It affects infants and is generally
diagnosed within the first 2 months of life. CMT is often caused by
birth trauma, or by sleeping or remaining in 1 position for a prolonged
period of time.
- Postural torticollis is diagnosed when the infant’s
head tilt comes and goes. It is diagnosed within the first 5 months of
life and often is the result of a lack of a variety of positions, such
as when the child is consistently placed in a car seat or other baby
“container” for extended periods of time.
- Ocular torticollis is caused by a vision problem in one eye, causing the individual to tilt his or her head to see better.
- Spasmodic torticollis (wryneck) occurs in older
children and adults. It can be caused by infection, inflammation,
trauma, or the side effects of certain medications and/or drugs, such as
- Acute torticollis occurs when a child or adult
bends or twists the neck too far, or experiences some type of trauma.
There may be pain when the head is moved from side to side or up and
down; the neck muscle may be tender to touch.
Abnormalities associated with torticollis include:
- Osseous abnormalities, caused by improper alignment
of the cervical spine (at the spinal points C1-C2) when ligaments are
damaged due to an infection. The types of infection that can cause this
condition include severe upper respiratory, ear, or sinus infections;
cervical adenitis; or cervical abscess. Any inflammatory process that
irritates the muscles, nerves, or vertebrae—including surgery or
trauma—can produce a reflex spasm resulting in this form of torticollis.
- Neurogenic abnormalities, such as a spinal cord
tumor or progressive spinal cord diseases, which can cause an acute
episode of torticollis, usually in older children. Children may
experience headaches, vomiting, and positive neurological signs, like
limb weakness (either one side or both sides) and speech difficulties. Seek immediate medical attention if any of these symptoms occur.
Torticollis may lead to additional problems, such as:
- Flattening of the skull (plagiocephaly or brachycephaly) in infants
- Movement that favors one side of the body, affecting the arms,
trunk, and hips. This can lead to strength imbalances, such as an
elevated shoulder and side-bending of the trunk. This movement pattern
can lead to delayed gross motor development
- Developmental hip dysplasia
- Limited ability to turn the head to see, hear, and interact with surroundings, which can lead to delayed cognitive development
- Delayed body awareness or lack of self-awareness and interaction
- Difficulty with balance
- Asymmetrical vision changes
Signs and Symptoms
An infant, child, or adult with torticollis may keep the head tilted
and toward one side of the body and rotated to the other side of the
body, as attempting to straighten the neck is difficult or painful.
example, if the muscle on the left side of the neck is shortened, weak,
or in spasm, the head may tilt toward the left shoulder and rotate
toward the right.
There may be tightness in the neck or a noticeable lump in the neck
muscle called a pseudotumor. Pain may or may not be present, depending
on the type of torticollis involved.
How Is It Diagnosed?
Torticollis in adults is generally diagnosed by a medical doctor.
Experienced pediatric physical therapists may diagnose the need for
treatment of congenital muscular torticollis and positional torticollis
in infants and children; however, most states in the United States
require a prescription from a physician in order for the physical
therapist to provide treatment.
Once the type of torticollis is determined, your physical therapist
can provide treatment. In most cases, torticollis is a muscular problem,
and physical therapists are musculoskeletal experts.
how our senior physiotherapists can help
Regardless of the patient’s age, physiotherapy is the main and primary
treatment for all forms of torticollis.
Our senior physiotherapists provide
treatment to address the impairments caused by torticollis, and like all medical conditions, early
torticullis treatment produces the best outcomes.
If not treated, torticollis can
become a permanent condition.
Our senior physiotherapists will work with a child’s caregiver or an adult
patient to develop and reach mutual goals.
design an individualized treatment plan to:
- Strengthen neck muscles
- Correct muscle imbalance
- Gain pain-free movement (range of motion)
- Improve postural control and symmetry
- Improve the body’s alignment by easing muscle tension
These goals may be achieved through:
- Gentle stretching of the neck and back muscles
- Strengthening of the neck and back muscles
- Massage of the affected area
- Guidance for correct positioning of infants
- Taping to elongate the muscles to facilitate stretching
- A home-exercise program to continue gentle rehabilitation at home
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Phoenix Rehab physio Services
Phoenix Rehab Group works with specialist
physiotherapists and rehab therapists who are highly
trained, qualified, experienced and passionate to provide high level of
expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
HAND THERAPY & SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand
following injuries or post-operations as well as custom made hand splints.
Commonly treated hand pain injuries includes
CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on
- core stability
- flexibility and
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to
- accelerate recovery and
- shorten downtime / recovery period required
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
Done regularly, it will keeps your muscles healthy and fit with body/movement-confidence. Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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