FROM MY PT SCHOOL NOTES · PEDIATRICS · CHAPTER 05
Torticollis and obstetric brachial plexus injury
Two infants may appear asymmetric, but the examination must identify whether the primary issue is cervical posture, shoulder/arm function, another condition or several factors.
Congenital muscular torticollis
A shortened sternocleidomastoid is commonly associated with same-side head tilt and opposite-side rotation. The lecture reviews ROM, head shape, developmental posture and caregiver handling. Assess active as well as passive movement, tolerance and associated asymmetries; not every head tilt is muscular.
What changes the referral decision?
Atypical onset, neurologic changes, unusual eye movements, pain, abnormal tone, limited passive ROM without the expected muscular pattern, and other red flags may indicate medical assessment. The 2024 pediatric PT guideline supports early identification, examination, caregiver education and individualized intervention.
Obstetric brachial plexus involvement
The older OBPI lecture distinguishes upper plexus patterns from more extensive involvement and emphasizes active movement, sensation, joint alignment and function. Coordinate with specialty teams on shoulder protection, recovery trajectory and surgical precautions; the child's hand use and bimanual activity matter more than one isolated MMT result.
Try a clinical decision
An infant tilts the head to the right and rotates toward the left. Does that finding alone prove a right SCM contracture?
No. It fits a common right-sided CMT pattern but needs ROM, active movement, head shape, ocular/neurologic screening and an appropriate referral decision.
Updated clinical context
2024 APTA CMT CPG: Read the current source
Original class sources: 2 Congenital Muscular Torticollis.pdf, 2 Torticollis handout.pdf, Torticollis Article Highlighted Parts.pdf, 3 Obstetric Brachial Plexus Injury.pdf
This is a focused summary from personal PT-school notes, not a substitute for medical evaluation, an instructor course or a current clinical guideline.
