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Leo Meyer was just a few months old when his parents, Evan and Courtney Meyer, began noticing him struggling to turn his head to the left.

"He rarely turned that direction (left) on his own and was extremely resistant when we tried to manually make him look that way," said the Crookston mom. "He would completely stop tracking objects with his eyes when we tried to get him to turn. It was around this time he also stopped nursing on one side during feedings and would cough, cry and struggle to latch which was very unusual for him."

RiverView Health Family Medicine provider Dr. Erik Kanten, Leo's primary care provider, referred him to RiverView’s Rehab Services Department for an evaluation. Physical Therapist Christine Loff quickly began treating Leo for torticollis and teaching Courtney how to work with him at home to aid in recovery.

Pain in the Neck

Torticollis is a stiff neck that makes it hard or painful to turn your head due to muscle tightness. There are two types of torticollis. Leo was diagnosed with congenital muscular torticollis, a condition in which an infant holds their head tilted to one side and has difficulty turning the head to the opposite side.

In congenital torticollis, the muscle that extends down the side of the neck—the sternocleidomastoid muscle—is tight and shortened. Early intervention is critical to help lengthen the muscle and restore proper alignment.

For Leo, like most babies, stretching exercises and simple changes in how the infant is held or positioned will gradually lengthen the muscle and correct the problem.

"Christine gave us various stretches to work on at home as well as techniques to help direct his neck the opposite direction of the torticollis," Courtney reported. "She was so incredibly kind and reassuring."

According to Loff, torticollis may contribute to other impairments if not treated promptly, including feeding delays, vision issues, back issues, or flat head syndrome.

"After a few weeks of working with him at home we had a follow up appointment with Christine," Courtney said. "Although Leo's torticollis had improved immensely with the stretches she gave us, she wanted Leo to have a cranial helmet consultation. The back of his head on the right side was showing signs of flatness because of his lack of mobility."

"Due to the change in head position, often times infants will develop flat head syndrome," Loff reported. "Infants and families may need to be referred to a doctor who can prescribe a helmet for flat head syndrome. The helmet will mold the infant's skull into shape and provide cushioning to prevent further flattening. Helmet therapy for flat head syndrome is most effective between 3-7 months of age, therefore early intervention is critical."

Leo spent a little over ten weeks in a helmet and shows no signs of torticollis or flat head syndrome today.

"Christine went above and beyond to make sure I felt confident in the stretches she gave me and helped relieve some anxieties I was having about improving his torticollis diagnosis," Courtney shared. "Her gentle demeanor and straightforward delivery of information was exactly what I needed to make sure Leo was back on the right track with his milestones."

Not Just for Kids

Torticollis is not just an infant diagnosis. Many adults suffer from acquired torticollis, caused by irritation to the cervical ligaments from a viral infection, injury, or vigorous movement. Additional causes may include:

• Sleeping in an awkward position
• Neck muscle injury at birth
• Burn injury
• Any injury that causes heavy scarring and skin or muscle shrinkage
• Neck muscle spasm

Loff uses a variety of practices to aid adults with torticollis, one of them dry needling. Dry needling is a safe, effective treatment involving needles the same size as those used in acupuncture. Certified as a Functional Dry Needling Specialist, Loff inserts the needles along a patient's trigger points — the tight bands of tissue within a muscle — to promote the body's healing mechanisms. The practice loosens stiff muscles, eases joint pain, and improves blood flow and oxygen circulation.

Dry needling is an inexpensive service that helps provide pain relief, faster recovery from injury, optimized sports performance, and prevents issues from becoming chronic.

If you or your child suffers from neck issues, talk to your primary care provider or learn more about the services offered through RiverView’s Rehab Services by calling 281.9463.

Pictured above: Christine Loff, DPT, works with Leo Meyer on stretching activities to relieve his torticollis.