The Physical Therapy for Pediatric Torticollis

Torticollis, also known as wry neck, in children is mainly caused by abnormal fetal positioning or breech delivery, resulting in fibrosis and shortening of the sternocleidomastoid muscle. The symptoms and physical therapy methods are described as follows:

Clinical symptoms:

• The head is bent to one side and turned to the other. If the right sternocleidomastoid muscle is contracted, the head will bend to the right and turn to the left.
• There is a lump in the sternocleidomastoid muscle.
• Asymmetry in the face and head.

Physical therapy methods:

• Passive stretching of the contracted sternocleidomastoid muscle, first stretching in the direction of lateral bending, and then stretching in the direction of rotation.
• Inducing active rotation of the head for correction: using visual cues or the tonic neck reflex to induce the head to turn or bend to the other side.
• Massaging the lump or contracted sternocleidomastoid muscle.
• Positioning and carrying posture, appropriately adjusting the head position or slightly pulling it.
• Heat therapy: using a heating pad, warm towel, or ultrasound.
• Support brace.
• Postoperative physical therapy: After the surgery, which usually involves sternocleidomastoid tendonectomy, physical therapy includes wearing a brace or neck collar until the child can maintain their head in a central position, and starting exercise therapy and stretching 36 hours after the surgery.