Torticollis (Tilted Neck)
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Torticollis (Tilted Neck)
Can anyone recommend a pediatric physical therapist in the East Bay or SF?
I have a 2 year old son who was born with torticollis and have noticed
that his back muscles are not developing symetrically.
I am looking for someone who is hands on and can offer some sort of
treatment versus an evaluation/suggestions. Recommendations for other
practitioners such as chiropractic and craniosacral are welcome.
Thanks in advance!
Elaine Westlake of Kids Development Studio*
Janet Green-Babb of Developmental Progressions*
Cindi Berry of CPMC's Child Development Center*
are all excellent. Elaine's studio would probably be most accessible
from the East Bay as it's just off 280. Good luck!
I know and could recommend Kaiser PTs but it sounds like you are not
Kaiser so I'd recommend starting with Children's Hospital Oakland,
where they also have lots of great PTs who see lots of kids with
Dr. Paul Walton is a great chiropractor in Orinda. He is also one
of the teachers at the chiropractic college in Hayward. I don't
know if he works with kids or not, but I'm sure he would be able to
point you in the right direction if he feels that it's necessary.
Jason Rabineau is also wonderful. He is a chiropractor as well as a
rolfer and really understands how the body is put together and how
to bring it back into alignment. He has an office in S. Berkeley as
well as S.F.
On an other note, my daughter had torticollis as well and a physical
therapist (in CO.) gave me some daily stretches for her. They did
help, however I think that including some deeper tissue/skeletal
work as well would have been a good idea.
I have 6 month old twin boys and one of them was diagnosed with
torticollis 2 months ago. He has been seeing a physical
therapist, we've been doing stretching exercises and now he is
wearing a collar (which he hates). Overall I don't feel that he
is getting much better, even with the collar. For those who
have gone through this, how long has it taken for the
torticollis to resolve? Any advice on how to entertain a baby
who has to wear a neck collar?? I'm feeling pretty lost here...
My son had torticollis (diagnosed minutes after birth). He did
not have to wear a collar, but we were doing PT with him for
about two years. Part of the PT involved not only neck
stretching, but trunk strengthening (which is a little hard when
they are not at least crawling). I also highly recommend
chiropractic care. Make sure the chiropractor specializes in
children. My son ''graduated'' from PT at 2.5 years. I notice no
tilting. It seems as if it will never go away, and then one day
you see it is gone.....
The most difficult part was stretching because he would fight it
and then tighten what we were trying to stretch!!
My husband did the best...he would cradle him in his arms with my
son on his torticollis side and let my son's body weight stretch
him. It was a very relaxing time if he was in the right mood.
Torso strengthening using an exercise ball....probably all stuff
your PT is doing.
You don't mention if therapy is including things other than the
use of the collar and stretching. I am a pediatric PT with 18
years' experience and find that most babies HATE HATE the collar,
and it does not always give optimal results.Several other issues
need to be addresses and looked at as well. Has your child's
physician also checked his hips? Sometimes a ''torticollis'' is
actually a hip issue that is resulting in shortening all the way
up one side. Does he shorten in the trunk on the side of the
lateral flexion of the neck? Simply stretching the neck and
wearing collar will not generally solve the torticollis problem
if the trunk issues are not dealt with as well. Therapy needs to
include active stretching (i.e. your son moving his own body AWAY
from the position of the tight muscle with facilitated
transitions and activities, AND addressing both aspects of the
muscle tightness (the lateral flexion and rotation
components).One also needs to be aware of whether the muscle is
still restricted as you go along, because babies can work out of
the tightness with PT, but often continue with the torticollis
posture as this is how they have learned to orient themselves
from day 1 -- need lots of constant input at both therapy session
and home as to correct head position. If all of those things are
not being watched and addressed, I would seek a referral for
another PEDIATRIC PT. Best of luck!
I would like to solicit som advice about my son's torticollis: I
know there has been some advice in the archive, but my son's case
seems particular. He is one year old now, and since he is 6
weeks old, his head is tilting to one side, mainly the left.
After we took him to OT, his head was straight for like 2 weeks,
then tilting again. Sometimes, his head will tilt to the other
side, for appr. 2 weeks again. The doctor said he would outgrow
it by 6 months, then by a year. His is a year old now, and still
his head is tilting to one side, pretty strongly. The
pediatrician said it wasn't a typical torticollis, as the neck
muscle seems fine. No one seems to know where it comes from.
My son is also delayed in his gross motor skills. It seems like
he has poor trunk control. He also developed a flat head from
sleeping with his head slightly titled to one side.
I am at a loss. If you have any advice or idea, please let me
know. I have already seen a neurologist, a cranio-sacral
therapist and a PT
Have your son's vision checked. Some children tilt their heads in order
to create correct vision. I actually just saw a show on TV about a
child who sounded very similar to your child and, if I recall correctly,
one of his optic nerves (or one of the other facial nerves) was longer
than the other which created double vision that was corrected by the
child through his head tilt. He required surgery and immediately the
head tilt (and other associated gross motor challenges) went away.
My niece as an infant had a tendency to tilt her head to one side. Like
your son, she was evaluated and it was determined that nothing was wrong
with her muscles. Based on a hunch my sister had, the doctors tested
her eyesight and, sure enough, it turned out that my niece was extremely
nearsighted in one eye, but had normal vision in the other -- she was
tilting her head to favor the good eye. She has been wearing glasses
since she was 9 months old and, sure enough, that made the head tilt
problem go away. I didn't know it was even possible to test infants for
nearsightedness, much less to figure out what strength lenses they need,
but apparently they don't need to be old enough to read an eye chart --
measurements can be done with lasers instead. If your son's vision
hasn't been tested yet, you may want to give that a try Diane Fisher
Our daughter had the head tilt and subsequently started to develop a
flat side because she seemed to sleep facing one direction. We were
referred to Children's Hospital by our pediatrician for an evaluation.
The doctor said that while the tilt is no major problem by itself as
they grow it effects how they look at the world, literally. They
immediately scheduled her for OT and fitted her for a neck brace that
she was to wear all day. Then we learned exercise for her, ways to hold
her to help stretch and strengthen the muscles. We were told that the
head braces that you see listed on some sites to fix the flat head part
actually do nothing for the problem which is the result of the weakness
in the neck. She was also developmentally delayed. Initially when we
saw improvement we slacked off only to see her tilt again, so we became
more diligent and unless she is very tired you don't notice it at all
(no one does but us) and she has caught up totally in every way. I
cannot say enough good things about the folks at Children's hopital.
I must admit that looking back on photos, she always had that cute tilt
that I thought was part of the pose and tried to overlook when a doctor
friend advised me to have it checked out. The photos with her in the
neck brace are a little hard to see sometimes but she always had a
smile on her face!
setting the world straight :)
Hi, I'm not sure if you've also looking into getting a
developmental/functional vision evaluation by a developmental
optometrist who is trained in looking at young children's vision.
I am a pediatric occupational therapist and have occasionally referred
children to rule out vision as a possible cause of the torticollis.
(We're moving to Berkeley soon so I'm not sure about WHERE to go but if
you do a google search I think you might find some possibilities in the
East Bay area.) Hope this helps!
Please rule out an eye problem - lazy eye, a nerve palsy, etc., could be
causing your baby's head tilt.
William Good, M.D. in San Ramon, Walnut Creek, Larkspur, and SF is the
best pediatric opthalmologist around.
Since so many of the replies mention checking for a vision related
problem, I thought I'd mention that we've had a very good experience
working with Dr. Deborah Orel-Bixler at the UC Berkeley eye center
(642-2020) on this. Our son's case is mild, but Dr Orel-Bixler is very
thorough, careful, warm and experienced in eye conditions like this for
very young children.
The vision connection can be hard to recognize - I specifically asked at
his 2 year checkup at the clinic if his head tilt was a vision problem
and the drs at that visit (not Dr Orel-Bixler) didn't see it as such,
and it wasn't identified until he was 3.
As others have said, they do have ways of testing the vision of even
babies, but I think the tests get more refined when the child is older
and can answer questions.
A vision problem might not explain what your baby is going through, but
for the sake of the archives I wanted to recommend Dr Orel-Bixler since
she specializes in this area and the UC pediatric eye center is so great
for young kids (singing doctors, lights, toys, movies, something to
entertain every age)
My 16 month old daughter has torticollis. She was diagnosed
when she was 4 months old at which point I started physical
therapy as well as helmet therapy for her misshapen head. All
along everyone told me everything would resolve once she
started walking and that her head would even out. Well, a year
later she is still has a significant tilt and her head is still
misshapen. We were discharged from physical therapy several
months ago however continue to go for osteopathic therapy once
a week. I would love to speak with other parents who have
children with torticollis/misshapen head. My orthopedic surgeon
is talking about potentially operating (the operation is called
a release), I would love to know if anyone has had this type of
surgery and what the results were.
I did not read the original post, but a friend just strongly
encouraged my to reply. I am intending to respond to the person
who is considering surgery for a child with a torticollis
diagnosis. Based on personal experience, which I've detailed
below, I urge you to confirm that the torticollis is not due to
ocular problems. Perhaps you've already done this, and perhaps
you have clear confirmation that the torticollis is due to a
muscle spasm or tightness. But in case you haven't, please know
that a head tilt is a diagnostic hallmark of fourth cranial
nerve palsy,a disorder in which the eye's movement is restricted
and the child tilts the head away from the affected eye in order
to prevent double vision or to preserve binocular vision.
For what it's worth (and partly to vent), here's my expeience.
My daughter was diagnosed with torticollis at 5 months and
endured several months of physical therapy stretching exercises
(which I felt were pretty traumatizing to her). This, all while
I was suspecting that she may have some vision problems,
although our pediatrician tried to allay those concerns. When
she was 12 months, I could no longer ignore the fact that she
continued the head tilt despite the p.t. noting that her
flexibility was fine. I also was becoming increasingly
concerned with her intermittent squinting and the comments from
friends and family that her eyes appeared someone crossed. I
took her to an opthamologist (Dr. William Good), who immediately
diagnosed her with 4th cranial nerve palsy, which is commonly
misdiagnosed as torticollis. We are now treating the problem
with patching and will likely be looking at surgery in a few
years. Had we checked out the vision problems sooner, we could
have avoided all of the physical therapy and begun the proper
treatment sooner, possibly avoiding the need for surgery.
I hope this helps.
Does anyone have experience with a baby with wry neck? Our 6
month-old has been tilting her head to the right for a few
months now. I asked the doctor about it and he said that this
was just a very mild case of wry neck and that he wouldn't have
even noticed it had I not called his attention to it. He said
it probably came after a cold that ''got into her neck.'' The
doctor recommended doing stretching exercises daily, which the
baby hates! What have others done to deal with this condition?
What about baby chiropracters? Is there any chance she'll just
grow out of it? How long should it take for the stretching
exercises to remediate the condition? Thanks!
Wow, you are a great parent for noticing this and being
concerned. However, I worry that your pediatrician isn't taking
this seriously enough. First, are you absolutely sure that your
daughter does not still have an infection of the ear or sinus?
Some kinds of infections can throw off the ''balance center'' in
the inner ear and cause the head tilting that you are noticing.
She should definitely be examined to rule out any type of
infection first. If that turns up nothing, she may actually have
torticollis (although its strange that it would appear so late
after birth, usually it is caused by an injury) in which case
she should be referred to a pediatric Physical Therapist or
Occupational Therapist to intervene now before it gets worse.
Untreated torticollis is a serious condition and can lead to
facial deformities and uneven eyes and features besides the odd
neck tilting which becomes a permanent deformity in itself. The
key to treating it is not only to do the right kind of
stretching, but also more importantly the right positioning in
car seats, bed, swings, etc. A pediatric PT or OT can show you
games to play to work with your daughter to make the stretching
easier. Trust your parent instincts and get a second opinion
from another pediatrician.
a PT and a mom
A first alternative to seeing a baby chiropractor is to see a
specialist in craniosacral therapy. Susan Feldman, at Back in
Action Chiropractic at 2500 MLK Way in Berkeley, is an expert
craniosacral therapist and often sees babies. I had her check
my 6 week old son for anything to watch out for in terms of
stiffness or soreness, especially since my older niece could
only breastfeed from one side because she refused to move her
neck to one side (my son checked out with no issues and enjoyed
the whole thing). I've had it done myself for neck pain and
headaches and found it extremely beneficial yet extremely
gentle. I believe Ms. Feldman may even be advising/consulting
or doing something or other with Children's Hospital of Oakland
(but my memory is not so good now that I'm a mom, so I'm not
s! ure how accurate I am on the latter). Again, it's so gentle
that, as long as an expert who has experience with babies
checks her out, there should be no problem with simply having
your infant looked at.
We needed body work for our daughter when she was born, and were
thrilled to find Nancy burke in Richmond. Nancy Burke
Bodyworker and Craniosacral Massage
237 25th Street
Richmond, CA 94804
Left on 25th
She uses very gentle massage technique called CranioSacral
therapy. It didn't look like much to me until I made an
appontment for myself (becasuse my vertabrae kept rotating after
my daugheter's birth, and I didn't get any help from weekly
chiropractor appts. Finally after 7 months I saw Nancy and it
only took two treatments. Never had another problem) Anyway,
she works with a lot of babies and is a natural with them. You
might look up craniosacral massage for more information about
it; I would basically say it is a gentle technique for releasing
tension in the connnective tissue, with the idea that by
releasing those tissues then the muscles can relax. Our baby
was twisted up and as a result had a very stiff neck and
couldn't open her mouth wide enough to nurse properly. She was
helped in just a few treatments, the nursing worked itself out,
and she's still happily nursing! at 18 mos. CranioSacral sounds
much more gentle to me thase xercises that you and your baby
hate! I urge you to call Nancy and at least chat with her about
the issue; if she cant help you, she knows a lot of other people
that do bodywork with infants. Good luck!
My daughter, now 10 months old, has mild torticollis or a tilted neck, probably from how she was positioned in
utero. I discovered it at about 6 weeks, although it took the doctor a few more months to take it seriously. I've
taken her to an osteopathic doctor and physical therapist, and although she's much better, I'm not sure how
much they helped or if it was just her growing and getting stronger. I'm worried about long-term effects because
I myself have chonic pain from scoliosis and an assymetrical body. I want to try other body work treatments for
her to address her asymetry at this point, before she might deal with the effects it has on her developing body as
she learns to walk, etc. Any one have experience with this or can recommend a really good infant body
6 month old with torticollis
Has anyone had experience with torticollis? Our six month old daughter has been officially diagnosed and
should have been referred to physical therapy earlier. Nevertheless, she will have stretching exercises and be
fitted for a cervical collar soon. We are, of course, worried and would love to hear from anyone whose child
had torticollis as an infant. Any advice, success stories, things to watch out for, alternative therapies, comments
to anticipate from others, other recommendations, etc.? It is pretty uncommon, but the folks at Childrens
Hospital Physical Therapy seem to know how to treat it, hopefully successfully in our case. We are curious at
what point your child was referred on by the pediatrician. It seems they are not as on top of it as they need to
be. Thank you in advance.
a concerned mother
My son had a tilted neck, presumably from positioning in utero. It wasn't diagnosed by our pediatrician, but I
noticed him looking only to one side, and pretty much ignoring the other side of his body. I talked with my
excellent physical therapist about it, and she said we weren't doing him any favors by ignoring it...and sent me to
another excellent osteopath who works with babies. Her name is Catherine Henderson, and her office is on
Solano. She was trained as an osteopath in Britian, where the practice is much gentler, and sees a lot of babies
and kids. She is not licensed as an osteopath in the US, so insurance doesn't pay. Anyway, she saw Alex for 2,
maybe 3 sessions...and the problem was gone! I highly recommend her, and my husband and I are not generally
into alternative medicine, especially for kids. But she showed me what she did, and I could hardly feel it. Alex
did cry, which she attributed to emotional release. But I could see the progress easily, so it was definately
working. The PT who referred her, by the way, is Edie Murphy of Lakeview Functional Rehab in Oakland,
who also has a good reputation in the East Bay. She works with disabled kids and has a disabled kid herself. If
I had been to children's and had a brace, I would still have gone ahead with Catherine, and hopefully shortened
the treatment time. Good luck. If you have any more questions about this, feel free to write.
I was a chiropractic assistant for several years, and have also been a patient for a long while. I have seen many
people, both children and adults with torticollis helped. I have an awesome chiropractor who is dedicated to
helping people. She has reasonable rates, and a family plan ($200 a month for a family of 3, and you can come
as often as you need to). She's well trained with babies, and my daughter just adores her. Now- don't everyone
expect this, but my husband was laid off after we'd been patients for a year. We had a hard time meeting our
finanical obligations, and she treated us free, for 7 months! She's dedicated to helping people get well.... Her
name is Geraldine Mulhall, and she's in the city- but I know she does some work ing the east bay on Wed. her
number (415) 831-8719
I do not know of a infant bodyworker but I do know of a great gentle, noninvasive technique. Orthobionomy.
There are a few on Solano Ave. I have not tried them personally but I studied the technique myself and it is
fantastic. I had to stop when the new ''massage therapist/healer'' career I was trying caused a final flare of
fibromyalgia that never went away. I do have a friend who got sesions from me and then went to a woman on
Solano due to the results from our sessions when I was learning and she loved her.
My daughter had torticollis. I noticed it at about 3 months -- because in all the pictures I took, her head was
always flopped to the right. I mentioned it to our pediatrian, who sent me immediately to a physical therapist.
The physical therapist told me to say a special thank you to my doctor the next time I saw her. The PT said that
many doctors will not send a child with torticollis to PT. Rather, they have a habit of waiting to see if in a few
months the natural strengthening of the neck will take care of it. The PT said that in some cases that's okay, but
in others, if the child hasn't had any PT until she begins to walk, then it's alot harder to correct, painful for the
child, and sometimes requires surgery. (Our pediatrician was 3 years out of medical school and I attribute her
willingness to treat my daughter immediately to the fact that she wasn't ''old school''.) We went to PT once a
week for about 3 months, then tapered off to about once a month. By the time she was 10 months, she was
''cured'' (although I still look at her regularly to make sure there's no re-lapse, she's 26 months old now). It did
not affect her crawling or walking. The PT session itself was 45 minutes of tilting her body in ways to make her
head go the opposite direction of the torticollis. The PT made me learn how to do the exercises, and made sure
that I did them between PT visits at least twice each day. The difficult thing was that she was diagnosed with
right torticollis but after a couple weeks of PT she started to slip into a left torticollis - the treatment then shifted
to strengthening both sides of her neck equally. The exercises themselves were not complicated - just shifting
her body in certain ways so she was forced to use her neck muscles in different ways. The PTs know all kinds
of tricks to make it interesting for the kids too. I'm afraid I can't give any advice about where to go in the East
Bay, because we lived in Washington, DC when this happened. Our PT was at Children's Hospital in DC, and
so I'm sure that the Children's Hospital here is equally wonderful.
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