Is Your Head on Straight?

     Torticollis is a condition in which one’s head tilts to one side while rotating to the other. This is caused by the tightening of a muscle called the sternocleidomastoid (whoa, say that ten times fast). This looks like a pretty wild word, so let’s break it down. The first part, sterno, refers to the sternum or breastbone. The second part, cleido, refers to the clavicle. The third part, mastoid, is the bony process of the skull that sits just behind the ear. We have two of these muscles, one on each side of the body and they connect to each of these three points: the sternum, the clavicle, and the mastoid, in order to contribute to movement of the head and neck. When both of these muscles contract, they assist in bending the neck forward.

     When only one of them contracts, the neck bends to the side of the shortened muscle, and then rotates towards the opposite side. When one of these muscles spasms and is stuck in a contracted position, we have torticollis. Torticollis can be caused by a number of different factors. In newborns and smaller babies, it can often be caused by position in the womb, or strain on the neck during the birth process, for example, during a forceps assisted birth. When excess pressure is placed on the upper spine during this process, it can result in primary structural shift. Due to the intimate relationship of the upper spine to the spinal cord, via direct attachment of the upper spine to the protective layer, or dura mater, of the spinal cord, primary structural shift can impede normal function and normal brain signals to the rest of 

the body. Think about cutting a telephone wire - the people on either end of the line are both talking, neither can hear what the other is saying. When a primary structural shift occurs, the body may attempt to alleviate the tension caused in this area by creating secondary compensations throughout the rest of the spine or muscular system. These secondary compensations can then lead to excessive contracture of muscles like the SCM, among others.

     Another condition that may occur as a result of torticollis is plagiocephaly, more commonly known as flat head syndrome. If we think back, the SCM attaches to the mastoid bone of the skull. During normal tightening of the SCM, this causes the head to be pulled into flexion or rotation. Because a baby’s skull bones are not yet completely fused (fusion does not happen until around two years of age in order to allow the brain to grow), excessive pulling on the mastoid bone in torticollis can also cause one side of the skull to have a flattened appearance.

     In our office, we have one main goal: correct the primary structural shift in order to increase stability and decrease tension that this shift places on the spinal cord, allowing the nervous system, and thus, the body, function at their highest potential.