 This is a deformity of the neck where the head and
neck are turned and twisted to one side.
 It may be permanent, temporary, or spasmodic.
 Spasmodic torticollis is the commonest.
 Most often, torticollis is secondary to pain and reflex
muscle spasm and recovers once the inflammatory
process subsides.
causes
CONGENITAL TORTICOLLIS
(Infantile torticollis, Sterno-mastoid tumour)
 The sternomastoid muscle on one side of the neck is
fibrosed and fails to elongate as the child grows, and
thus results in a progressive deformity.
 cause of fibrosis is not known
 it is possibly a result of ischaemic necrosis of the
sterno-mastoid muscle at birth
 Torticolis occurs more commonly in children with
breech presentation.
Diagnosis
 The head is tilted to one side so that the chin faces to
the opposite side
 The sterno-mastoid is prominent on the side the head
tilts, and becomes more prominent on trying to
passively correct the head tilt.
 in the first few weeks of life, a lump may be felt in the
sterno-mastoid muscle.
Treatment:
 In a child presenting with a sternomastoid tumour,
progress to torticollis can be prevented by passive
stretching and splinting.
 For severe deformities, especially in older children,
release of the contracted sterno mastoid muscle is
required
 Following surgery, the neck is maintained in the
corrected position in a Callot's cast.
Physical Therapy Management
 Manual stretching is the most common form of
treatment for congenital muscular torticollis