With the heat and humidity this late summer has brought us and the cool fall, people have been cranking up their air conditioners to stay cool. Then when you wake up, you have a stiff neck. What happened?? You have severe pain and can't move your head (making it impossible to do a shoulder check when driving). It can be very frustrating!
This condition is more common than you think, and has various causes. Torticollis is an abnormal position of the head and neck to the rest of the spine. The head side bend to the affected side while the head is turned away is the most common presentation, and sometimes the shoulders may be raised, as the sternocleidomastoid muscle is usually the most affected. There are a few different types of toritcollis, which results in different treatment approaches.
Acute Acquired Torticollis:
This is when one side of the neck either shortens or goes into spasm, which results in an altered head position. This can be triggered by holding the head in the position for a long time(while taking a phone call), sleeping with a cool breeze on your neck (causing the muscles to spasm), or just falling asleep in an abnormal position. The spasms may be triggered by trigger points being irritated and shortening the muscles, a subluxation of C1 on C2 joint irritation in the neck, an infection or a disk related pathology.
Massage for Acute Acquired Torticollis is centered around relaxing the muscle spasm. Massage is applied to compensating muscles on the opposite side. When the body starts to relax, gentle massage and indirect relaxation techniques can be applied to the affected side. Self care is also critical. Exercises to build strength in weak muscles and correcting the posture that may have triggered the spasm can be given to avoid a future flare up. A referral to a chiropractor or physiotherapist will be given if there is a subluxation.
Congenital Torticollis:
If one sternocleidomastoid muscle is damaged during delivery (trauma in the birth process, injury from forceps or cesarean section) can cause the head to be improperly positioned. If this is not corrected it can lead to chronic postural imbalances and discomfort. Some causes of Congenital Torticollis are unknown. It is usually treated with stretching or corrective surgery.
Massage for Congenital Torticollis is similar to that of Acute Acquired Torticollis, but with less pressure as the tissues in infants are usually more sensitive. The parents can be shown how to properly apply gentle stretching and passive range of motion to help the muscles to relax. Referrals to other health practitioners should also be given.
Spasmodic Torticollis:
Involuntary muscle spasms of the cervical muscles can also cause torticollis. The cause of Spasmodic Torticollis is generally unknown, but may be linked to disturbances in the central nervous system, malformations in the cervical spine, postural dysfunction or trauma to the head and neck.
Direct massage on the neck is contraindicated for Spasmodic Torticollis as techniques may make the spasm worse. Treatment is focused on general relaxation to help calm the spasm.
If you think you or someone you know may be experiencing a form of torticollis, please speak to a health practitioner. They are qualified to give your proper recommendations to help reduce your symptoms before they manifest into something worse.
As always, don't be shy if you have any questions or concerns!
References:
Rattray, F., & Ludwig, L. (2005). Clinical Massage Therapy: Understanding, Assessing And Treating Over 70 Conditions (11th ed.). Elora, ON: Talus Incorporated p. 477-487.
Title Image:
Treating Torticollis with Registered Massage Therapist Training. (n.d.). Retrieved August 18, 2017, from http://www.ovcmt.com/index.php/blog/treating-torticollis-with-registered-massage-therapist-training
Sternocledomastoid Image
Sternocleidomastoid muscle. (2017, August 09). Retrieved August 18, 2017, from https://en.wikipedia.org/wiki/Sternocleidomastoid_muscle
Thank you for taking the time to stop by, and I hope you have a great day!
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