Congenital Muscular Torticollis (CMT) is a condition in which a child’s head is tilted to one side and turned toward the opposite side. It is caused by having tight muscles on one side of the neck and weak muscles on the other side of the neck. This condition is usually not painful. Congenital torticollis is most often due to tightness in the muscle that connects the breastbone and the collarbone to the skull. (It's called the sternocleidomastoid muscle). This tightness might have developed because of the way your baby was positioned in the uterus (with the head tilted to one side), or because the muscles were stretched during delivery.
Symptoms associated with the condition
A child with Torticollis has difficulty turning his head to one side and favors looking one way more than the other. The head is tilted and one ear is closer to the shoulder than the other side. If the child has spent increased amount of time lying on one side of his head due to the tightness in his neck, he may have developed a flat spot on his head, called “plagiocephaly”, which is often associated with Torticollis.
Gross motor skills (movement skills) may be delayed due to difficulty with head control caused by tight neck muscles. The child may have trouble tolerating time on his tummy.
At the evaluation the therapist will review you and your medical history of pregnancy and delivery and discuss your current concerns. They will then screen your child for problems that can be associated with Torticollis, such as hips, vision, and muscle tone. The therapist will assess your child’s neck movement and strength, neck posture while your child is sitting, lying down, on its tummy, and standing while supported. He will assess your child’s gross motor skills and measure the degree of flatness of the head.
Common rehab treatment interventions:
The physical therapist works directly with your child to stretch tight muscles and strengthen weak muscles. He uses play strategies that help your baby to develop good vision and awareness of their body and improve motor skills. The therapist will teach you how to stretch the child’s muscles, strengthen muscles, develop movement skills, increase time spent on the tummy and position a baby to help shape the head and stretch the muscles. Performing the home exercises several times a day as directed by the therapist is critical for your child’s recovery.