Torticollis / Brachial Plexus
Torticollis is the shortening of the muscles on one side of the neck, resulting in the head being tilted to one side and rotated to the other side. There may also be associated tightness of the upper back/shoulder muscles, spinal abnormality, facial asymmetry, flattening on one side or the back of the head, and/or hip dysplasia.
The muscle that is most commonly tight is the Sternocleidomastoid Muscle (SCM), which runs from behind the ear to the collarbone. Physical Therapy is often needed for stretching and positioning so the muscle(s) can regain normal length thus allowing the baby to have normal neck movements. Treatments are most effective when rendered early in the first months after birth.
Left untreated poor and asymmetric neck mobility can impact motor development delaying mastery of motor milestones like rolling, sitting and reaching for toys. Positional plagiocephaly in which the child develops an asymmetrical head shape (or a flat spot on the head) is often seen in children with untreated muscular torticollis. If the underlying reason for the positional plagiocephaly namely the Muscular Torticollis is treated early on the positional plagiocephaly will often be reversed without interventions like molding helmets or in rare cases surgery.
If you suspect that your baby has Torticollis it is important to contact the baby's pediatrician and to seek intervention from a pediatric Physical Therapist with training in treatment of Torticollis.
Brachial Plexus Injury is damage to the peripheral nerves of the arm and hand leading to partial paralysis of the limb. Therapy includes range of motion, strengthening, Neuromuscular Electrical Simulation, Kinesio Taping, joint mobilization, aquatic therapy, the use of orthoses, and handling techniques to facilitate age appropriate motor skill acquisition and weight bearing onto the involved extremity.