Torticollis - Treatment and Condition

Question 1

What is Torticollis?

Answer 1

An abnormal positioning of the head and neck relative to the body.

Question 2

What is Acute Acquired Torticollis (AAT)?

Answer 2

Painful unilateral shortening of neck mms resulting in an abnormal head position.

Question 3

What are symptoms of (AAT) Acute Acquired Torticollis?

Answer 3

Client is in the typical Tort position.

Pain is pronounced, worse on movement, client may be apprehensive to move.

Question 4

What are the causes for (AAT)?

Answer 4

Activation of latent TP’s, Subluxation of C1-2, Gacet joint irritation, Infection, Disc related pain.

Question 5

What are the causes for (AAT)?

Answer 5

Activation of latent TP’s, Subluxation of C1-2, Gacet joint irritation, Infection, Disc related pain.

Question 6

What is (CT) Congenital Torticollis?

Answer 6

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.

Question 7

What are the causes for (CT)?

Answer 7

Idiopathic,
Trauma in birth process causing inflammation, then fibrosing of the SCM.
Torsion of the fetus cranial bones.

Question 8

What are the Symptoms of (CT)?

Answer 8

Typical head / neck position.
Contracture, thickening and shortening of SCM and Scalenes and associated fascia.

Unable to move neck normally, not described as painful.

Question 9

What is Spasmodic Torticollis?

Answer 9

Involuntary spasm of cervical mms and an abnormal head position.

Question 10

What are the causes for Spasmodic Torticollis?

Answer 10

CNS lesions.
Postural Dysfunction.
Trauma.
Could be linked to severe stress.

Question 11

What are the Symptoms for Spasmodic torticollis?

Answer 11

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.

Question 12

What Observation can be made when assessing a client with Torticollis?

Answer 12

Postural assessment.

With typical Torts, the cervical scoliosis convex to the unaffected side.

Question 13

When palpating a client with Torticollis, What can be felt?

Answer 13

Acutely spasmodic mm may reveal heat, point tenderness and firmness.
Contracture may be tender and feel cool / hard and fibrous.

Question 14

What is involved when testing ROM of a client with Torticollis?

Answer 14

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.

Question 15

What does PR rom of Torticollis look like?

Answer 15

Movement away from the affected side is restricted.

With (CT), AF movement away from the affected side is very restricted.

Question 16

What special test can be used for Clients with Suspected torticollis?

Answer 16

Cervical Compression and Distraction.

Used to differentiate between Cervical nn root compression that may underlie an (AAT).

Question 17

For AAT, what position should the client be in for treatment?

Answer 17

Supine / Sid-lying on unaffected side.

Question 18

For Congenital Tort what position should the client be in?

Answer 18

Supine.

Question 19

What position should the Client be in for Spasmodic Tort?

Answer 19

Supine / Sid-lying on unaffected side.

Question 20

What are the Treatment goals for a client with AAT?

Answer 20

Decrease pain, spasms and abnormal positioning.

Question 21

What are the Treatment goals for a client with Congenital Tort?

Answer 21

Lengthen contracted structures, reduce abnormal positioning, Restore ROM of the head and neck, Strengthen weak structures.

Question 22

What are the Treatment goals for a client with Spasmodic Tort?

Answer 22

Reduce SNS firing and spasm, normalize head position, restore ROM.

Question 23

What techniques should be done on a client with AAT?

Answer 23

Direct pressure may be too painful, if so use agonist contraction.
GTO / O & I.

Question 24

What techniques should be done on a client with congenital Tort?

Answer 24

Fascial work to the affected SCM, Scalenes, pecs, upper trap and Lev scap.
Gentle stretching of the affected mms (SCM).

Question 25

What techniques should be done on a client with Spasmodic Tort?

Answer 25

Full body relaxation.
Direct work on Neck is CI’d.
Use agonist contraction of the opposite SCM.

Question 26

What are things to note when treating a client with AAT?

Answer 26

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.

Question 27

What are things to note when treating a client with Congenital Tort?

Answer 27

Use heat to affected structures.

Question 28

What are things to note when treating a client with Spasmodic Tort?

Answer 28

in subsequent treatments use cervical tractions.