Congenital muscular torticollis (1648)
Key points below
What is congenital muscular torticollis (CMT)?
Congenital means it was present at birth. Torticollis means twisted neck. CMT is a shortened neck muscle that makes the neck twist. It happens on one side. With CMT the head usually tilts to one side and the face turns to the other side (see picture).A child with CMT is at risk for having flat areas on the skull and uneven facial features. They are also at risk for vision problems and developmental delays.
What causes it?
A neck muscle called the sternocleidomastoid (SCM) is shortened or tight (see picture). The exact reason for the shortened muscle is not known. It is thought to be due to the position of the baby before, during, or right after delivery.How is it treated?
Treatment should start as soon as the problem is found.
- A physical therapist will teach you exercises to do with your child. The exercises include gentle stretching of the tight neck muscles. You will learn how to strengthen the weak neck muscles.
- Therapy will help your child develop motor skills to both sides.
- It is important to do tummy time every day. It should be done while your child is awake and supervised. By the time your child is 4 months old, they should play on their tummy 60 to 90 minutes or more each day. This can be spread out in small amounts of time throughout the day.
Correct stretching and strengthening from an early age may prevent lasting side effects. Early physical therapy, playtime working on neck mobility, and aggressive repositioning normally corrects this condition.
When should surgery be done?
Surgery is rarely needed. It may be needed if your child is over 1 year of age and has not improved with the exercises.