Torticollis - Treatment and Condition Flashcards
What is Torticollis?
An abnormal positioning of the head and neck relative to the body.
What is Acute Acquired Torticollis (AAT)?
Painful unilateral shortening of neck mms resulting in an abnormal head position.
What are symptoms of (AAT) Acute Acquired Torticollis?
Client is in the typical Tort position.
Pain is pronounced, worse on movement, client may be apprehensive to move.
What are the causes for (AAT)?
Activation of latent TP’s, Subluxation of C1-2, Gacet joint irritation, Infection, Disc related pain.
What are the causes for (AAT)?
Activation of latent TP’s, Subluxation of C1-2, Gacet joint irritation, Infection, Disc related pain.
What is (CT) Congenital Torticollis?
Contracting of one SCM mm resulting in an abnormal head position, present from infancy.
Unless corrected through stretching or surgery, the condition will continue to worsen into adulthood.
What are the causes for (CT)?
Idiopathic,
Trauma in birth process causing inflammation, then fibrosing of the SCM.
Torsion of the fetus cranial bones.
What are the Symptoms of (CT)?
Typical head / neck position.
Contracture, thickening and shortening of SCM and Scalenes and associated fascia.
Unable to move neck normally, not described as painful.
What is Spasmodic Torticollis?
Involuntary spasm of cervical mms and an abnormal head position.
What are the causes for Spasmodic Torticollis?
CNS lesions.
Postural Dysfunction.
Trauma.
Could be linked to severe stress.
What are the Symptoms for Spasmodic torticollis?
Adult onset.
Typical Tort position.
May be intermittent or permanent.
Factors that exacerbate the condition, changes in position or being in public or stressful situations for too long.
What Observation can be made when assessing a client with Torticollis?
Postural assessment.
With typical Torts, the cervical scoliosis convex to the unaffected side.
When palpating a client with Torticollis, What can be felt?
Acutely spasmodic mm may reveal heat, point tenderness and firmness.
Contracture may be tender and feel cool / hard and fibrous.
What is involved when testing ROM of a client with Torticollis?
AF and PR rom on neck, thorax and shoulders are indicated for every type or Tort.
With (AAT) and (ST) AF rom movement is painful and very restricted when attempting to take neck out of Tort position.
What does PR rom of Torticollis look like?
Movement away from the affected side is restricted.
With (CT), AF movement away from the affected side is very restricted.
What special test can be used for Clients with Suspected torticollis?
Cervical Compression and Distraction.
Used to differentiate between Cervical nn root compression that may underlie an (AAT).
For AAT, what position should the client be in for treatment?
Supine / Sid-lying on unaffected side.
For Congenital Tort what position should the client be in?
Supine.
What position should the Client be in for Spasmodic Tort?
Supine / Sid-lying on unaffected side.
What are the Treatment goals for a client with AAT?
Decrease pain, spasms and abnormal positioning.
What are the Treatment goals for a client with Congenital Tort?
Lengthen contracted structures, reduce abnormal positioning, Restore ROM of the head and neck, Strengthen weak structures.
What are the Treatment goals for a client with Spasmodic Tort?
Reduce SNS firing and spasm, normalize head position, restore ROM.
What techniques should be done on a client with AAT?
Direct pressure may be too painful, if so use agonist contraction.
GTO / O & I.
What techniques should be done on a client with congenital Tort?
Fascial work to the affected SCM, Scalenes, pecs, upper trap and Lev scap.
Gentle stretching of the affected mms (SCM).
What techniques should be done on a client with Spasmodic Tort?
Full body relaxation.
Direct work on Neck is CI’d.
Use agonist contraction of the opposite SCM.
What are things to note when treating a client with AAT?
Once spasms have decreased or are less painful, gentle on site work can be done (Light TP) work on the SCM can be done.
Eventually you can stretch the SCM and scalenes.
What are things to note when treating a client with Congenital Tort?
Use heat to affected structures.
What are things to note when treating a client with Spasmodic Tort?
in subsequent treatments use cervical tractions.
