Physical Therapy Approaches for Congenital Muscular Torticollis

Congenital muscular torticollis (CMT) is characterised by unilateral shortening and fibrosis of the sternocleidomastoid muscle, leading to head tilt, restricted cervical range of motion and potential facial asymmetry. Early intervention with conservative measures remains the cornerstone of management, aiming to restore symmetry and function. Standard protocols comprise passive stretching exercises, manual therapy, positioning strategies, strengthening of antagonist musculature and caregiver education. Stretching regimens focus on gentle lateral flexion and contralateral rotation, typically administered multiple times daily. Manual techniques such as myofascial release and soft-tissue mobilisation target fibrotic bands and promote tissue remodelling. Positioning aids and passive placement during feeding or play encourage active correction of posture. Adjunctive modalities, including diagnostic ultrasound and elastography, facilitate objective assessment and guide tailored therapy. Intensive, family-centred programmes within the first six months of life yield the most favourable outcomes, with response often monitored through clinical scales and imaging metrics. Long-term follow-up ensures early detection of residual stiffness or recurrence, with surgical release reserved for refractory cases beyond one year of age.

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Physical Therapy Approaches for Congenital Muscular Torticollis publication trend

The graph below shows the total number of articles in physical therapy approaches for congenital muscular torticollis across all publications each year (not limited to Nature Index journals).

Technical terms

Congenital muscular torticollis: A condition in infants characterised by unilateral shortening and fibrosis of the sternocleidomastoid muscle, leading to head tilt and restricted neck motion.

Sternocleidomastoid muscle: A paired cervical muscle on each side of the neck, responsible for rotation and lateral flexion of the head.

Surface electromyography (sEMG): A non-invasive technique for recording electrical activity of muscles via electrodes placed on the skin.

Acoustic radiation force impulse (ARFI) elastography: An ultrasound-based imaging method that assesses tissue stiffness by measuring the propagation speed of induced shear waves.

Shear-wave velocity (SWV): The speed at which mechanically induced shear waves travel through tissue, used as an index of stiffness.

References

1. Using Flexible and Stretchable Surface Electromyography Electrode Array to Evaluate Congenital Muscular Torticollis in Children. IEEE Transactions on Neural Systems and Rehabilitation Engineering (2023).
2. Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis. Diagnostics (2019).
3. Longitudinal follow-up of muscle echotexture in infants with congenital muscular torticollis. Medicine (2017).