Myogenic torticollis of the newborn baby

Index

WHAT IS INFANT MYOGENIC TORTICOLLIS
WHY IT IS CALLED CONGENITAL MYOGENIC TORTICOLLIS
CAUSES
DIAGNOSIS OF MYOGENIC TORTICOLLIS
MYOGENIC TORTICOLLIS AND SWELLING OF THE SCOM
THERAPY AND PROGNOSIS
HOW TO SOLVE TORTICOLLIS WITH PAEDIATRIC OSTEOPATHY
CONSEQUENCES
MYOGENIC TORTICOLLIS AND BREASTFEEDING PROBLEMS
PARENTS' TESTIMONIES

1. What is infant myogenic torticollis

Congenital myogenic torticollis of the newborn is a very common problem in children caused by contractures more or less marked at the neck muscles. These force the child into aflawed attitude of the head which presents itself rotated and/or tilted.

One of the muscles mainly involved in this problem is the sterno-cleido-occipito-mastoid (SCOM). It is a powerful muscle on the side of the neck that connects the mastoid region, the region behind the ear, with the clavicle and sternum.

Nevertheless, a good osteopath must always assess all muscles of the neck, back and shoulders as these are body regions closely related to the cervical region.

In fact, if you want to obtain a optimal resolution of myogenic torticollis, it is essential to have a very broad view of the child's posture.

On this page I explain the causes of myogenic torticollis and how to treat it effectively.

2. Why it is called congenital myogenic torticollis

If we analyse the very definition of ''congenital myogenic torticollis'' we will better understand what this is all about.

Under the term 'torticollis' means an alteration of the correct position of the child's head and a limitation of cervical movements.

Under the term ''myogenic'' it is understood that this limitation of movement is due to muscular contractures in the cervical region.

Under the term 'congenital' it is understood that these contractures have causes preceding or concomitant to birth (see section on causes of torticollis).

3. Causes of myogenic torticollis

It is difficult to establish precisely the cause of torticollis myogenic but certainly this issue has its roots in two factors:

Intrauterine malpositionsA foetal position in which the baby's head was rotated for weeks or months may have contributed to the occurrence of the cervical contractures that account for the myogenic torticollis;
Difficult childbirthObstetrical-gynaecological manoeuvres or particular positions assumed by the baby during labour and delivery may have created stress on the neck with the resulting muscle contractures and joint stiffness.

One only has to think of the difficulties that a baby can face if it is left in the birth canal for a long time, has the umbilical cord around its neck or is born with a suction cup.

4. Diagnosis of myogenic torticollis

La diagnosis of myogenic torticollis should be done as soon as possible, already in the hospital.

In this way, the paediatrician suggests that the mother turn to thepaediatric osteopath to resolve muscle contractures and restore proper cervical movement.

This resolves the stiff neck and prevents the positional plagiocephaly.

To make a diagnosis of myogenic torticollis of the newborn, a clinical evaluation of the child in the clinic.

How is the evaluation carried out for understanding whether the infant has a myogenic torticollis?

The paediatrician or paediatric osteopath lays the infant supine on the cot and observes the resting position of the child's neck and head.

We pay attention if the newborn keeps the head on axis or if it maintains the head always rotated to the same side.

If the torticollis is moderate or severe, you will notice that your child does not keep his head straight but is rotated and/or tilted, a clear sign of myogenic torticollis.

After an initial visual observation, we make a active assessment cervical movements to understand whether the infant has a myogenic torticollis.

In other words, we try to draw the infant's attention to the left and right, trying to get him to turn his head on both sides.

In the case of a myogenic torticollis, the infant will be able to turn his head from one side but will find it difficult to turn it from the other side (or at all).

La diagnosis of myogenic torticollis is made on the basis of the side to which the child keeps his or her head turned; for example, if the child looks to the left and struggles to turn his or her head to the right, it is called a left myogenic torticollis.

Please note: unfortunately, still today, this issue is under-diagnosed. This means that many times it is not noticed in the first weeks of life and the myogenic torticollis procrastinates.

Le consequences of a myogenic torticollis unresolved involve positional cranial deformities (e.g: positional plagiocephaly) and postural changes in the cervical spine and beyond.

5. Congenital myogenic torticollis and scom swelling

As mentioned above, one of the main muscles involved in this issue (but certainly not the only one) is the sterno-cleido-occipito-mastoidmuscle that originates from the mastoid process (behind the ear) and inserts on the clavicle and sternum.

This muscle, due to a intrauterine malposition or trauma during childbirthcan present not only severe contractures but also a swelling (haematoma).

When the SCOM presents a swelling, this results visible e palpable in the anterolateral part of the neck.

The swelling (or haematoma) of the SCOM takes the form of a ball and one soft texture.

The paediatrician should diagnose it in the first few days of life through clinical assessment (observation and palpation) and confirm the diagnosis through a ultrasound examination.

Based on the finding, the patient should be sent to the therapist (paediatric osteopath) to resolve the torticollis.

At intervals of weeks/months, based on the needs of the paediatrician/orthopaedist, follow-up ultrasound examinations will be carried out to assess the reabsorption of the swelling and the resolution of the torticollis thanks to the manual therapies performed.

Nota bene No 1To make a diagnosis of myogenic torticollis, it is not necessary to have a swelling and perform an ultrasound examination; clinical evaluation of the neck muscles (contracted or not) and assessment of cervical mobility are sufficient.

Nota bene No 2Manual therapies (osteopathic treatments) are fundamental in resolving the myogenic torticollis that NOT resolves itself over time.

6. Cures and Remedies for Myogenic Torticollis of the Newborn Child

Therapy for congenital myogenic torticollis is conservative.

By this we do not mean that torticollis resolves spontaneously on its own but that, fortunately, no surgery is required.

Indeed, torticollis is easily resolved with manual treatments (osteopathic massages) and the correct postural recommendations offered to parents.

Once the paediatrician detects a myogenic torticollisthe child is sent to the paediatric osteopath for treatment.

In the studio, thepaediatric osteopath (myself) carefully assess the resting position of the child's head, neck, torso, shoulders and arms.

After an initial clinical evaluation observational, we move on to the evaluation palpatory. In this case, the neck muscles are touched to assess the extent of contractures of the SCOM and any other muscles possibly involved.

The muscles and joint movement of the cervical spine, back and shoulders are then assessed.

Only through a thorough objective examination will the osteopath be able to better planning of manual treatments necessary for the resolution of torticollis.

To treat the myogenic torticollis of the newborn, one must gently decontract the anterior and posterior cervical muscles.

Afterwards, it massage the back and shoulder muscles.

Finally, we perform joint techniques on the spine to restore full cervical mobility and resolving myogenic torticollis.

Osteopathic treatments to treat torticollis are pleasant and delicateperformed by osteopaths specialised in the treatment of infants.

7. Consequences of myogenic torticollis

Effectively resolving a newborn's torticollis is essential but be careful: the paediatric osteopath you turn to must specialise in newborns.

The reason I say this is underlined by the negative consequences of an unresolved myogenic torticollis.

In fact, if the problem is not diagnosed in time or treatment is ineffective, the child continues to keep his or her head rotated incorrectly.

Le consequences of an unresolved myogenic torticollis are:

Positional cranial deformities: Since the child's head is extremely mouldable and grows rapidly, if it is always kept on the same side it will inexorably develop a positional plagiocephaly.

Postural alterationsIn the first year of life, and especially in the first months, the child grows rapidly. This implies that if the torticollis forces it into an incorrect position, the spinal column will grow along the lines of the torticollis.
This is why, if the myogenic torticollis of the newborn is not resolved, it can lead to possible postural asymmetries of the head, neck and back.

This brief analysis further revealed the importance of diagnosing myogenic torticollis early and resolving it effectively.

In the next section, I explain how a myogenic torticollis can negatively affect breastfeeding.

8. How to solve torticollis with paediatric osteopathy

I osteopathic manual treatments are extremely effective in resolving torticollis as they aim to decontract the involved neck muscles and restore the correct joint mobility of the spine.

To be more explicit with parents, osteopathic manual treatments consist of gentle and precise massages of the child's neck.

Osteopathic treatments are particularly effective because they not only solve the local problem but also take a 360 degree view of the child, assess and resolve any stiffnesses in related body districts that could concomitant in the maintenance of the myogenic torticollis of the newborn.

To explain further, let me give you a concrete example.

If the myogenic torticollis is due to an intrauterine position in which the child has kept its head turned and tilted, the shoulder and back may also be affected.

In this case, in order to restore correct posture and resolve torticollis, it is not enough to treat only the neck, but it will be essential to improve the mobility of the shoulder itself and of the cervico-dorsal and dorsal spine.

Only in this way can any type of myogenic torticollis.

Of course, in addition to manual treatments, a competent osteopath always offers the best postural recommendations for parents to put into practice on a daily basisThey are necessary to accustom the child to correctly rotating the head.

When the treatments performed are effective, there is always a complete resolution of myogenic torticollis.

9. Myogenic torticollis and breastfeeding problems

Myogenic torticollis may be closely correlated with breastfeeding problemsIn the next few lines, I will explain why.

Myogenic torticollis is caused by neck contractures and joint stiffness, more or less marked.
These tensions are due to intrauterine malpositions and/or a difficult birth, but think about it

If the child has been ''crushed'' or has suffered a ''birth trauma'', contractures may be present not only in the neck but also in the mouth and jaw.

These limitations of movement of the jaw and neck can thewill negatively affect the opening of the mouth and cervical movement, i.e. two fundamental parameters for the child to be able to latch on properly to the breast and feed effectively.

When the contractures are mainly borne by the musculature of the mouth, the child opens it little and often creates pain or fissures in the breast.

When the contractures are present in the neck (torticollis), the child has a weaker and less nutritious sucking; which is why he may often detach himself from the breast, be drowsy and not grow enough.

Furthermore, when a myogenic torticollis is present, the child may preferring to latch onto one breast rather than the otherThis problem is caused by the presence of asymmetrical joint contractures/stiffness in the neck muscles.

Fortunately, both myogenic torticollis and sucking and breastfeeding problems are solvable with specialised osteopathic support.

10. Parents' testimonies

After theory comes practice.

That is why theoretical explanations must be matched by real therapeutic successes.

Read more about 260 Google reviews checked at 5 stars on my profile. ⭐⭐⭐⭐⭐

Daniela and Luca, Tommaso's parents

Mely Sathia

I highly recommend Dr. Silva Matteo. Very professional and competent; in three sessions he completely solved my little girl's flat head and torticollis problem...

Sara Longo

I took my 15-day-old baby to Matteo for an osteopathic evaluation and I am very happy I did. He helped us right away by releasing some small contractures at the cervical and dorsal level, so that the little one could move symmetrically and free from discomfort. We also had another big help in improving sucking, so that breastfeeding also proceeded well and without pain. I recommend all new parents to have an osteopathic assessment of their babies as soon as possible, sometimes a few sessions can be immensely helpful.

Lucia, Maia's mother

My name is Lucia and I am Maia's mum. Maia is a sweet little girl, perfect in my eyes... so much so that I didn't even notice that little flat head on the right side. It was my sister-in-law who noticed it first, when Maia was one month old, and she immediately advised me to see an osteopath. However, I was a bit sceptical and decided to point it out to the paediatrician, who is usually an attentive and scrupulous person. The paediatrician only told me to move the little head to the other side while he slept and that the thing would resolve itself. Unfortunately, I did not see any improvement; on the contrary, as the months went by, the flat head became more and more evident. At the umpteenth reminder to the paediatrician, followed by a bland and annoyed reply, I finally made up my mind: I had to see a specialist! Thanks to a friend's suggestion, I contacted Dr. Silva who immediately realised that Maia had a strong torticollis (this is why, when I moved her, she always put her little head turned to the right) and gave me many suggestions on how to behave and how to position the little one to improve her plagiocephaly. With only three treatments, the torticollis has been completely resolved, but the little head will take a little longer... I regretted not having gone to a specialist straight away, but now I know that we are on the right track.