Understanding what causes Congenital torticollis takes a quick anatomy lesson. There is a muscle located on each side of the neck called the sternocleidomastoid muscle (pronounced STER-no-KLY-do-MAST-oid). It is somewhat of a strange muscle because it attaches in three separate places namely at the sternum (the breast bone), the clavicle (the collar bone), and the mastoid (the jaw bone). It allows us to turn the neck.
As the muscles develop in the baby while inside mom, there is an influence the baby's position has on that development. Usually, the baby has some room for movement which allows the muscles to stretch and contract. This stretching and contracting is necessary to allow for the muscles to grow to the proper length. Occasionally, the baby's neck may get tilted to one side for an extended period of time. This is usually due to an unusual positioning of the baby within the mom's uterus. However, it may also occur when the baby seems otherwise to be lying in a normal position. When the neck remains tilted, the muscles on one side of the neck get stretched while the other side never receives this stretching. Therefore, the sternocleidomastoid muscle develops in a position of contraction. Then when the baby arrives, he is unable to turn his head to one side because the contracted sternocleidomastoid muscles doesn't allow it.
Think of being on a long trip in a compact car which has very little leg room. When you first get out, you have to stretch a bit before you can walk normally. This is essentially what occurs in the baby who develops torticollis. The muscles are all there; they just haven't been used much. And because this process occurs over several months during pregnancy, getting the muscles to work properly takes a stretching regimen that takes weeks or months to fix.
With proper technique, stretching the contracted sternocleidomastoid muscle about six times per day will cure the problem within a couple of months. Occasionally, if the muscle did not completely develop properly or if there was injury to it either while in mom or during delivery this physical therapy may not completely correct the problem and surgery is required. With good instruction from your doctor, the stretching exercises can be done by you at home. However, if your doctor is unsure of the proper technique or if the torticollis seems particularly severe, he may suggest you go to a licensed physical therapist knowledgeable in this particular problem.
I hope this helps.
Kathie Stehr RN
One of the most helpful things that parents can do is to learn how to massage their baby-there are many good books on the subject.
Placing the baby on their tummy is important.
Put favorite objects and mobiles on the affected side so baby will turn their head that way more often.
Keep time in carseats and bouncy seats to a minimum.
A physical therapist that is familiar with Congenital Torticollis is worth their weight in gold.