In plain words
The sternocleidomastoid is a large muscle that runs from behind each ear down to the collarbone and breastbone. Both sides together help turn and tilt the head. In babies, the muscle can become tight or shortened on one side, which may make the head prefer one direction. A parent may notice that the baby turns one way, or that one side of the head looks flatter. When this is present from birth, it is called congenital muscular . Many babies improve with positioning and stretching guided by a therapist. The muscle also comes up in the jaw and feeding discussion, because a tight neck is one factor discussed when a baby has trouble feeding.
The deeper version
The sternocleidomastoid is innervated by the spinal accessory nerve. It acts as a bilateral neck flexor and, unilaterally, as a lateral flexor with contralateral rotation. Congenital muscular torticollis is a unilateral shortening or fibrosis of the muscle, with physical therapy usually begun in the first months. Stellwagen and colleagues (2008) described torticollis and related head asymmetry in normal newborns. The differential for an infant head tilt includes ocular torticollis, cervical spine anomalies, neurologic causes, and, more rarely, fibromatosis colli. Treatment is primarily positioning and stretching under physical therapy, with surgical release reserved for persistent cases.
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Sources
- Stellwagen L et al. — Torticollis, facial asymmetry and plagiocephaly in normal newborns. Archives of Disease in Childhood 2008