Torticollis Massage

Torticollis or wry neck, is a spasm of unilateral neck muscles (especially the SCM [sternocleidomastoid muscle]) causing abnormal positioning of the head and neck.

Acute acquired torticollis is a painful, unilateral shortening or spasm of neck muscles resulting in an abnormal head position

( Wry Neck ) Torticollis Massage Therapy Treatment Goals

– Decrease spasm, pain, abnormal position

Special / Orthopedic Tests for Torticollis

  • AF and PR ROM on the neck , thorax, shoulder
  • AR strength testing once the spasm has reduced
  • Cervical Compression Test and Cervical Distraction Tests to differentiate cervical nerve root compression that may underlie an acute acquired torticollis
  • Spurlings Test after the spasm has reduced to test for facet joint irritation

Massage Therapy Treatment for Acute Acquired Torticollis

Supine or sidelying on the affected side:

  • Diaphragmatic breathing
  • Treatment begins on the side that is not in spasm
  • Slow, gentle effleurage and kneading to anterior, lateral, and posterior areas on the unaffected side
  • Move to affected side to begin to reduce spasm
  • GTO release and Origin and Insertion to all the attachments of the spasming muscle (SCM) of the affected side.
  • Agonist contraction of SCM – if done gently, can cause SCM to relax. Isometric contraction of SCM by lateral flexion one way, rotation the other
  • If spasm is reduced, attempt to move head SLIGHTLY to more neutral position
  • Complete this pattern 3-5 times (unaffected side, affected side, attempt to neutralize head position)
  • Once spasm is reduced, treat scalenes, upper trapezius, levator scapula on the affected side
  • Onsite work to SCM includes gentle direct techniques such as vibrations, stroking, finger kneading, light muscle stripping, Trigger point work to SCM, pain free Passive ROM
  • GTO release to suboccipitals, long axis traction, joint play
  • Soothing stroking and petrissage to muscles of mastication, forehead, scalp
  • Treat postural dysfunction if necessary
  • Once spasm is gone, stretches may be done

Signs and Symptoms of Torticollis ( Wry Neck )

-Typical torticollis position: head and neck is side-bent TOWARD the affected side, face is rotated AWAY from the affected side, and the shoulder of the affected side is RAISED

Considerations and Contraindications for Torticollis Massage Therapy

  • avoid full stretches to SCM if Vertebral artery test is positive or if client is dizzy with stretch
  • avoid carotid artery when treating SCM
  • acute acquired: do not passively stretch spasming muscle
  • congenital torticollis – use reduced pressure on children
  • spasmodic torticollis- NO painful technique, joint pay, local direct massage

Self Care for Torticollis

  • Diaphragmatic Breathing
  • Self-stretches to the SCM, scalene, trapezius
  • Chiropractor may help with subluxations

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