Torticollis, Sternocleidomastoid tumour, Plagiocephaly

Torticollis (wry neck), sternocleidomastoid (SCM) tumour and Plagiocephaly.

The neck (cervical spine) is very mobile; it side bends, rotates, flexes, extends, lateral shift, and can accommodate for compressive forces.

Sometimes the neck muscles become tight which cause the neck to be held in an asymmetric position rather than in the midline e.g if the right SCM muscle is tight the head will sit in position of sideband right and rotated left. This can negatively impact the ability to feed easily as babies need to rotate and sidebend their heads to both sides easily.

Torticollis, also called wry neck, can occur as a result of a genetic factors leading to malformation, or is due to injuries to the sternocleidomastoid muscle from strain, stretching or rupture of the muscle belly which leads to haematoma formation and scarring. It often occurs after a difficult birth. It is often described as a fixed malposition of the head. Because of the dominant head position to one side while lying on their backs and pressure on one side of the head it can lead to plagiocephaly (flat head) and dysfunction in the development of the viscerocranium (facial bones) and also the cervical spine (neck).

Sternocleidomastoid (SCM) tumour also known as fibromatosis colli, occurs in the middle third of the muscle. It is thought to occur as a result of haemorrhage in the muscle. It is estimated that 90% of these tumors are resolved within the first six months of life assisted by stretching exercises and repositioning of the head, and soft tissue massage. Surgery may be recommended if the SCM tumout persists after one year of age.

Plagiocephaly, is described as flattening of the back of the head (occipital region) on one side, and sometimes rounded on the opposite side at the front of the head. It has no pathological significance. It is thought to improve with age and if seen in older infants is suggestive of torticollis. The prevelance increases to 4 months but diminishes as infants grow older. The majority of cases will be resolved by two years.

It has been shown that nonsynostic plagiocephaly is more likely to occur in boys, first born, premature infants, and those who sleep in the supine position. Plagiocephaly occurs in 25% of infants of single birth and in 50% of multiple pregnancies. It often becomes apparent a few weeks after birth. Lying in the same position for long periods may exacerbate the moulding of the head. If the moulding is not severe then it is possible that the normal growth process of the skull will resolve the moulding over the first year, especially when baby becomes more mobile and spends less time lying on babys back. Babies skulls are soft and this means that the skull in malleable and moulding may be benefitted by treatment.

Osteopathy assessment and treatment of the baby will address the skull shape, neck range of movement and muscle tone. Treatment may be necessary over a period of time to adapt to the babys growth spurts.

Osteopathy treatment addresses the tight muscles and their points of attachments on the bones. Improving the range of movement of the neck allows for easier and more efficient feeding, and improves the ability to rotate the head to both right side and left side of the body. It is non-invasive and gentle by using light touch called palpation.