Torticollis is a pathology that occurs as a result of unilateral shortness of the SCM muscle. Due to the shortness of the SCM on the held side, the head rotates to the opposite side with lateral flexion to the same side.
It is the third most common musculoskeletal anomaly in childhood.
Difficult births account for 30-60% of the etiology.
Congenital Muscular Torticollis:
1-A tumor that can be palpated in the SCM muscle,
2-Where the muscle is stiff and short, without a tumor
3-Depending on the posture, it can be observed in three different ways, including without a tumor.
3 Important factors affecting recovery in children : The age of the baby to start treatment, the presence of mass in the muscle ,rotational deficit. Almost all of the cases who started physiotherapy in the first months recover.
In the clinic, the asymmetry of the baby’s face and head is examined.Losses in active movements of the neck are monitored. Rotational deficits are measured with an audio toy or engaging materials.The best imaging technique that measures whether there is a mass inside the SCM muscle is ultrasound.This technique is an easy-to-perform examination that does not require anesthesia.
- PHYSIOTHERAPY AND REHABILITATION
The purpose of PT is to prevent contracture of the SCM muscle. To keep the head in a symmetrical position is to make the fibrosis in the SCM shrink.The most important interventions to be made in the treatment are stretching exercises, joint range of motion exercises, proper positioning, family education and environmental adaptations.
Lateral flexion to the opposite side of the torticollis and rotation to the torticollis side should be performed and stretching exercises should be studied.It is recommended to stretch for 10 seconds,15 repetitions,5 times a day.The family should also be educated about this.It is especially recommended to place all sound-colored objects in the child’s house on the side that the child can’t look at.Feeding the child from the sick side and proper carrying on the mother’s bosom can be considered among the simple trainings that will be given.
In infants older than four months of age, if the curvature persists despite the exercises, the orthosis of the tubular torticollis for the neck is recommended.