Conservative Management of Congenital Muscular Torticollis Involving Use of the Tubular Orthotic for Torticollis (TOT)


The main clinical features of congenital tightness of the sternocleidomastoid muscle (SCM) are restricted range of motion (ROM) of the neck and head tilt. Conservative treatment consists of stretching, positioning and active exercises. At British Columbia's Children's Hospital we frequently find a persisting lateral head tilt following achievement of full passive range of motion. This appears to be due to weakness of the contralateral SCM. To address this concern our treatment program stresses strengthening of that muscle and use of a tubular orthotic in addition to the standard treatment. This unobtrusive and unrestrictive "collar" provides a stimulus to encourage the child to actively use the contralateral SCM to lift the head into the midline position.

Data will be presented on over 100 children completing treatment between 1989 and the present. Data will include age at referral, length of time to achieve full ROM, numbers with persisting head tilt and length of time to correction of head tilt with use of the TOT. Our treatment regime at British Columbia's Children's Hospital has been very successful in eliminating head tilt in children with congenital muscular torticollis.

British Columbia's Children's Hospital, 4480 Oak Street, Vancouver, B.C., V6H 3V4