Finding out your baby has torticollis can cause a lot of anxiety, however you’ve heard from various sources the torticollis will resolve on its own, but your doctor recommended seeing an occupational therapist. What do you do? Why do you need to treat it if it will just go away on its own? To answer these questions we need to start at the beginning. Torticollis is a persistent head tilt to one side often accompanied by muscle spasms of the sternocleidomastoid muscle in the neck. This is similar to when an adult has ‘pulled’ a muscle in their neck and they lose their range of motion.With adults we are uncomfortable and often take an anti inflammatory but often that doesn’t even fully relieve the discomfort. This is how it feels for babies with torticollis, it is uncomfortable and limits their ability to look around. For babies being able to move and being comfortable is extremely important to proper growth and development.
The major difficulty we see in children who have had untreated torticollis is unintegrated reflexes. If your baby can only look in one direction the result is that the reflexes triggered by that position remain even after the muscle tightness has resolved. In the clinic this presents as children with severely positive Asymmetric Tonic Neck Reflex (ATNR). The ATNR is the reflex we see activated when a child turns their head to the left or right and their arm and leg of that corresponding side stick out and the arm and leg of the opposite side curl in close to the body. In this position the baby is able to begin rolling over and is able to interact with the world on the side they are looking towards.However, these children often have a limited crawling phase due to this reflex not being integrated and as a result may scoot on their bottoms while sitting up, or may take longer to learn to walk. In children who this is the case they present with weak upper body strength, weak core strength, abnormal hand dominance for their age, discomfort while sitting in a chair, head tilt or paper rotation while participating in schoolwork or coloring, and significant lack of fine motor control in non-dominant hand.
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