specialty programs

Physical Therapy Program for Torticollis

Torticollis is a condition defined by an abnormal, asymmetrical head or neck position.  A multitude of conditions may lead to the development of torticollis including: muscular fibrosis, congenital spine abnormalities, decreased blood supply to the muscle, difficulty during delivery, and positioning of the baby inside the uterus during the last few weeks of pregnancy.  In addition, infants often develop torticollis as a result of the amount of time spent lying on their back during the day in car seats, swings, bouncers, strollers, and on play mats. They typically have a higher risk for flat head syndrome as well.
It is extremely important to have torticollis treated to prevent a permanent shortening of the involved muscles.  In addition, therapy can help avoid needed surgery and decreases head and neck pain.  When discovered and stretches are implemented early, 80% of children recover completely with no long term effects (www.orthoseek.com).


What does therapy include?

A Physical Therapist will perform an evaluation to assess the child's passive range of motion, active range of motion, muscle tightness, muscle strength, and gross motor skills. She also checks for other conditions that can occur with children who present with torticollis such as plagiocephaly (abnormal head shape), hip dysplasia (misalignment of the hip joint), and spine problems. The therapist then discusses these results with the family and makes appropriate recommendations for physical therapy treatment, if indicated.

The physical therapy treatment may include stretching and strengthening of the child's neck muscles.  It will typically include active and passive stretching of the neck and shoulder muscles as well as positioning and handling techniques to correct the child's posture.  The therapist also instructs the family in a stretching and positioning program designed specifically to the child's needs and may also use other types of assistive technology such as a TOT collar or kinesiotaping.  The parents then perform the home exercises daily with the child and follow-up as recommended by the physical therapist to ensure attainment of all physical therapy goals.

Objectives
  • Improve child's ability to turn head between right and left sides.
  • Improve child's ability to bring chin to chest.
  • Improve child's ability to orient their head to midline against gravity.
  • Encourage child to lift head against gravity while lying on stomach.
  • Achieve normal weight bearing and shifting over upper extremities.
  • Encourage symmetrical use of upper extremities.
  • Allow child to experience proper weight shifting during developmental activities including sitting, rolling, creeping, and walking.
Children Who May Benefit
  • Children who experience decreased neck range of motion and unable to hold head in midline. 
  • Children with muscular fibrosis or congential spine abnormalities.
  • Facial or head asymmetries including "flat head.


“Juli's assertive approach to challenge Ty, born with Spina Bifida L5/S1, puts him on a path to mobility and independence, giving us hope for Ty's future.  She is an integral component to Team Titus.  I love medical professionals like Juli who truly care and love the work they do.” 

Angelica H.