By far, the most common thing I treat in the children I see is torticollis. This leads to a lot of conversations with parents about the treatment and expectations moving forward. As with anything, some cases are mild and resolve quickly and others are more severe and take a longer time to completely resolve. Even when we see a total resolution, sometimes the side preference pops back in down the road somewhere. This is absolutely normal and expected.
Torticollis, truly, is related to the sternocleidomastoid (SCM) muscle. When this muscle gets tight on one side, parents notice that their child prefers to look in one direction. This leads parents to bring their child to the chiropractor or physical therapist for some help. The child gets some manual therapy and parents are sent home with new positions to place their child in, a new way to hold their child, changing up the environment to encourage the child to look in the non preferred direction. Usually after 1-2 visits the parents start to notice that the child is starting to look both ways, maybe not evenly yet but better than on the initial assessment. After a few weeks, the child is usually looking both ways almost evenly. At this point, we begin to work on strengthening the muscle on the non preferred side. Parents are again given some new information to work on it at home. Usually 6-8 weeks following initial assessment, the concern about torticollis is gone and the parents tend to forget which was the preferred side to begin with.
Often though, throughout the first year or two of the child’s life, a parent will comment that they see the torticollis pop back up from time to time. Usually this presents after an illness of some sort, following a growth spurt or maybe you notice it when your child is overtired. It only lasts a few days at a time, but there are occasions that parents notice it for more than a week and they get curious about why it is happening again. The short answer is your child’s muscle memory is bringing it back. Typically if you resume the stretches and strengthening exercises given in the past the tilt and side preference tend to resolve again pretty quickly. Sometimes parents aren’t able to continue with these because the child has hit a few extra milestones and is no longer “happy” being in those positions or you can’t keep them still long enough to make those positions useful, a return visit is likely necessary because increasing the difficulty of the exercises is the best way to help resolve the concern.
Again, it seems frustrating as the parent because you think that the concern is gone and it popping back up can take you by surprise. Don’t worry, resume the exercises and it will be resolved again in no time. I often say, babies are just small adults. Think about an injury you have been dealing with on and off for years. Something triggers it, you go back to the exercises you have fallen out of the habit of doing and the pain gets better in a few days. The same is likely true for your child too!
