Torticollis belongs to a broad category of disorders describing abnormal flexion, extension or twisting of the neck muscles. A neck twisted to one side is typical of torticollis. Although the exact cause of torticollis is uncertain, the following are potential scenarios where it may develop:<\/p>\n
When it can be traced to a genetic disorder, the condition is referred to as spasmodic torticollis. Although considered rare, spasmodic torticollis affects close to 90,000 people in the United States. Spasmodic torticollis has three variations of neuromuscular dysfunction:<\/p>\n
Trauma that involves bending or twisting the neck too far can lead to acute torticollis. The acute form can also be the result of keeping the neck muscles in shortened positions for a prolonged period of time. A person who has slept in an awkward position or in a cold draft may awaken to acute torticollis.<\/p>\n
Torticollis causes discomfort and pain, forcing many to hold their head straight or rotated to one side. Unilateral in nature, torticollis is irritated when the affected side of the neck\u2019s muscles are activated or even touched. As a contralateral rotator, the sternocleidomastoid (SCM) muscle is most commonly involved in acute torticollis, as any position rotating the head to its opposite side for long periods may cause this condition.<\/p>\n
A massage therapist should confirm that a physician has properly diagnosed any client with torticollis. In some cases, torticollis is mistaken for muscular dystrophy, epilepsy or Parkinson\u2019s disease.<\/p>\n
To assess the condition, the practitioner will be able to palpate and\/or observe shortening and hypertonicity in the neck muscles. The head and neck are held in a non-neutral position, often with rotation to the opposite side. The SCM on the affected side is likely to be more prominent than on the other side. In the clonic variation of spasmodic torticollis, there will be some shaking of the head.<\/p>\n
The cervical muscles will likely be tightened due to a local muscle spasm. In some chronic cases, the practitioner will be able to palpate fibrotic changes in the affected musculature. Active and passive motions rotating the head in the opposite direction of the contraction are likely painful and limited. There may be pain associated with further rotation to the contracted side depending on the severity of the condition and the percentage of muscle fibers recruited for the activity.<\/p>\n
Symptoms of acute torticollis generally resolve in a couple of weeks. Western medicine\u2019s top offering for this condition is an injection of Botox\u00ae to temporarily paralyze the muscles. For those seeking to avoid this toxic injection, the pain and contraction of torticollis responds well to massage. Considering neck muscles in either a tonic or clonic state are highly sensitive, extreme care must be used with any hands-on modality.<\/p>\n
With a gentle approach, bodywork\u2019s goal for torticollis is release of the contracted neck muscles. Such a release typically entails:<\/p>\n
While most massage modalities enhance circulation, a gentle technique must be chosen for torticollis. The increase in circulating cerebrospinal fluid accomplished through cranial-sacral therapy<\/a><\/span> (CST) is an ideal match for a contracted neck. CST typically uses the equivalent of a dime\u2019s weight of pressure for its maneuvers, making it an extremely gentle option. Even some of the simple cranial holds of CST can allow the contracted tissues of torticollis to unwind at their own pace. Additionally, the application of heat in a warmth-producing topical gel<\/span>, heat lamp or hot pack<\/a><\/span> is a non-invasive and safe way to invigorate local blood circulation.<\/p>\n Osteopathic medicine\u2019s passive and active stretching techniques offer a gentle route to lengthening contracted muscles. Myofascial release<\/span><\/a> techniques are ideal for increasing the range of motion that is restricted with torticollis. Additionally, some of sports massage\u2019s<\/a><\/span> stretching techniques are ideal for lengthening neck contraction. All within the realm of osteopathic medicine, some of the applicable stretches in sports massage include:<\/p>\n A client with torticollis may come for a massage after receiving medical treatment from their physician. Bodyworkers need to be aware that an injection of the Botox\u00ae toxin causes motor loss and has no effect on sensory perception. Massage or early manipulation of the injection site can speed up absorption and spread the toxin. Therapists are advised to avoid the injection site to avoid paralysis of the injected as well as adjacent muscles.<\/p>\n The gentle techniques garnered from cranial-sacral therapy, myofascial release and sports massage stretching can be safely and effectively applied to relieve torticollis. A massage therapist familiar with the described methods and the pathology of torticollis will be successful in delivering pain relief and increased range of motion to a client who awoke with a stiff neck.<\/p>\n Cranial-Sacral Fundamentals<\/span><\/a>\n
Warning<\/h3>\n
Recommended Study:<\/h3>\n
\nMyofascial Release<\/span><\/a>
\nSports Massage<\/span><\/a><\/p>\nMore Information:<\/h3>\n