We continue the series of publications about congenital pathologies in newborns. In this article we will tell you how to distinguish muscle tone from torticollis.

Congenital muscular torticollis (CMC) one of the most common diseases of newborns and ranks 2-3 after congenital hip dislocation and congenital clubfoot. This diagnosis is often made by specialists, but sometimes it is not confirmed. Perhaps the baby has muscle tone. Let's try to figure out how these diagnoses differ and what parents should do in each case.

The main cause of ICH is considered to be congenital underdevelopment of the sternocleidomastoid muscle, its injury during childbirth, as well as birth injury of the cervical spine. The sternocleidomastoid muscle is paired, located on the lateral surface of the neck. When the right muscle contracts, the head tilts to the right and the face turns to the left; when contracting with the left, it’s the other way around. If both muscles contract at the same time, the head tilts back and extends somewhat.

Thus, with ICH, the head is tilted towards the affected muscle and turned in the opposite direction with a simultaneous deviation back. The shoulder girdle and scapula with severe torticollis on the affected side are higher, the back of the head on the healthy side is often oblique. Secondary changes with ICH include facial asymmetry. With moderate and severe degrees of ICH (II-III), the child may experience a delay in psychomotor development. With the growth of children who have undergone an ICH, smoothing of the cervical lordosis, the formation of pathological kyphosis, a lag in the growth of the vertebral bodies due to injury to the growth zones, and the phenomenon of osteochondrosis are noted.

If you have not found the above signs of ICH, but the baby likes to keep his head to one side and sleep on one side, then most likely there is muscle tone. Observe your baby, and you will notice that the child's movements are random and erratic, he is not able to raise his head and keep it in an upright position. Arms and legs are bent at all joints and pressed to the body, fists are clenched. This is explained by the fact that until 3 months of age the tone of the flexor muscles of the arms and legs is increased (the so-called physiological tone). But the tone varies. Distinguish hypertonicity(increased muscle tone) and hypotonia(decreased tone).

We looked at the main signs of diseases. Now let's talk about their treatment.
Treatment of ICH begins early, from 2-3 weeks of age, and necessarily includes positioning treatment, massage and physical therapy.

When treating with position, the child should lie on a semi-rigid mattress, preferably without a pillow. Instead of a pillow, a diaper folded several times is placed under the head. It is very important that light, toys, and communication with an adult be on the side of the affected muscle.

You can place the child in a corrective position using a ring wrapped in fabric and placed under the back of the head, as well as incomplete bags of sand (salt, cereal), which are placed on the bed on both sides of the head or on the side of the torticollis (above the shoulder girdle). The procedure is carried out 2-3 times for 1.5-2 hours a day. Since newborns and infants lie down or sleep most of the time, this remedy is easy and effective to use.

A prerequisite for positional treatment is the correct position of the entire torso: it must be symmetrical and straight in relation to the head. To do this, you can place bags or “rolls” of blankets from the child’s armpits to the knees. At first you should watch the baby. Frequent regurgitation excludes the proposed placement.

The child should be placed on his side more often. If the child sleeps on the side of the torticollis, then a high pillow is placed under the head; if he lies on the healthy side, then the pillow is not used at all. Very important carry a baby correctly in your arms:

1. Taking the baby in your arms in an upright position, press him with your chest towards you, your shoulders and the baby’s shoulders should be at the same level. Turn the baby to the painful side, fixing this position with your cheek.

2. Taking the baby in an upright position with his back to you, use your cheek to turn his head towards the painful side and slightly tilt it towards the healthy side.

3. Carry the child on the “sick” side, facing or with his back to you. At this time, support his head, lifting it to the healthy side.

Muscular torticollis can develop (and often occurs) in children with impaired muscle tone (asymmetry) or with a constant one-sided position in the crib. To avoid this, you need to frequently shift the baby and approach him from different sides.

From the very beginning of ICH treatment massage occupies a leading place, is carried out against the background of a general strengthening complex, appropriate to the age and development of the child. Massage is prescribed by a doctor and must be performed by a qualified specialist. After the first course of massage conducted by an experienced specialist, repeated courses can be carried out by parents who are closely observed and trained by the massage therapist.

A course of exercise therapy consists of 15-20 sessions, which are carried out daily or every other day with a break between courses of 1-1.5 months (at this time parents do the main exercises). Up to one year, the child should receive 3-4 courses of complex therapy and another 2-3 courses before the age of 7. In addition, every day until the age of 2, parents should study with the child 3-4 times a day for 5-15 minutes.

From an early age, children with torticollis are advised to exercise in a swimming pool at a water temperature of 35-36 °C. Special exercises in water:

1. The hands of the methodologist (or parents) under the back of the head of the child lying on his back, with the pads of his thumbs, stroking the sternocleidomastoid muscle (the child’s neck in the water).

2. Smoothly move the child in the same position behind the head, either to the right or to the left.

3. Circular movement of the child lying on the water by the head so that the affected side is on the outer part of the circle.

4. The child in the cap lies on his back, legs down. The methodologist moves his arms sideways and downwards, performing a smooth correction of torticollis, increasing traction on the side of the injury.

5. The child lying on his stomach is supported under the chin and led along the width of the pool. With the other hand, using smooth springy movements, the raised shoulder girdle is held in the water.
For mild forms of ICH, it is recommended to use orthopedic devices. If it is impossible to correct torticollis with massage and exercise therapy, they resort to surgery. There are pre- and postoperative periods; at the outpatient rehabilitation stage, classes last up to 9-12 months. The main task of exercise therapy is to completely restore the function of the operated muscle. For this purpose, various head movements with resistance and weights in various positions are used. Correction of posture continues (especially in the thoracic region).

Massage will help with muscle tone. This is the most effective way to bring muscles to their normal state, i.e. balance the tone of the flexor and extensor muscles of the limbs. However, before carrying out the procedures, a consultation with a neurologist is necessary, since there may be cases when using massage alone is not enough.

When performing a massage, you should be guided by the state of muscle tone. In particular, the extensor and flexor muscles. On the arm, the flexors are located on its inner surface, on the leg - on the back surface. Massage of the flexors should reduce tone. In this case, relaxing massage techniques are used: stroking, light rubbing and gentle kneading, vibration, shaking. Extensor massage is aimed at increasing tone. A strengthening massage is performed: stroking, more vigorous rubbing and kneading, stimulating pinching and percussive techniques.

You can find a set of daily activities with your baby on our website. Classes are recommended to be carried out when the baby reaches 2 months, unless otherwise prescribed by the doctor. Before starting classes, consult an experienced massage therapist about how to massage correctly. After all, training to balance muscle tone has its own characteristics. For example, with hypertonicity of the flexor muscles of the limbs, you can use only those exercises that are associated with extension. All active (i.e. when the child makes movements independently) exercises are based on this principle. As for passive (performed with the help of an adult) movements of the limbs, they cannot take place before 3 months, since in the presence of increased flexor tone, the performance of these movements is associated with sharp resistance from the child and the danger of violence against him.

The main purpose of massage when indicating muscle tone is to balance the tone of the flexor and extensor muscles of the arms and legs. The number of sessions and their duration are assigned individually.

Grow up healthy!

Pain in the neck area accompanies the current generation, even generations (since this pain, like love, is conquered by all ages), with enviable consistency.

Any office worker, professional athlete, retiree or schoolchild sometimes experiences unpleasant sensations - the neck hurts, it hurts to turn the head, the pain is felt from behind, from the side, the neck makes a crunch when turning. The cause of pain in the first place was a sedentary lifestyle, which we all voluntarily or forcibly prefer.

Neck. Functional features of a body part

But one more function of the neck can hardly be called secondary - to withstand enormous loads.

So, the average weight of an adult’s head is approximately 4.5 kilograms - this is the weight that constitutes the main load on the neck and spinal region with ideal posture (flat back and straight head). By the way, the first sign that something is wrong with your posture is that your neck hurts, and it hurts to turn both your head and body.

But let’s return to the strength of materials: axial load is much lighter compared to inclined load. What happens if a person tilts his head just three centimeters forward? The load on the neck increases to 9 kg. If the slope is six centimeters, the equivalent increases to 13.5 kg. And this is because of some few divisions on the line.

Now you can count how many times during the day a person changes the position of his head. Not exactly, of course. On average - about 1000. A weak neck would definitely not be able to withstand this. Therefore, we can rightfully classify the neck as one of the most powerful parts of the body. And most of us are to blame for the fact that it hurts a little.

If the spine is uneven, then the neck hurts

The first and most common cause of frequent neck pain is poor posture. Nowadays, few people adhere to the rule of an ideal back: this is when it is straight, the chin is slightly raised, and the shoulders are leaned back a little (just as the unforgettable Lyudmila Prokofyevna was taught from “Office Romance”). Everyone is basically like her - shriveled, squeezed. And this is a big problem for neck health.

The main problem, even the threat of incorrect posture, is that the head moves to the side or forward (visually this is not noticeable, but the neck reacts very negatively). Such a posture creates all the prerequisites for deformation of the spinal discs and the development of a hernia. And if at the beginning of the “era of incorrect posture” everything seems to be fine, nothing bothers you, then after a year or two the uneven spine will make itself felt. If your neck hurts, it hurts to turn your head - this is a “hello” from a spine offended by inattention.

Massive office plankton problem

Not only have cars filled everything around, but computers have also joined them! Nowadays it is hardly possible to find a non-computerized one. Unless the janitor does not use the “infernal machine”, that’s why he is in good health.

Everyone who stays in front of their PC eight hours a day and five days a week, counting, developing, plotting and forecasting, suffers massively from osteochondrosis.

A familiar ailment: it hurts to turn your head, your neck hurts. Or you feel unbearable discomfort inside your neck, you want to throw your head back on the back of the chair for a few minutes. This, by the way, is a sin to deny yourself: the neck, exhausted by constant tension, asks for mercy and rest.

Throwing back and circular rotations of the head are the most accessible exercises that can be performed without leaving the workplace, and which the neck really needs.

Disease beyond age

Although there is no specific name for this disease, everyone characterizes it almost the same way: the neck hurts, it hurts to turn the head, but it cannot be classified as frivolous and self-limiting.

It has no specific age preferences, it is typical for both primary school students, students and working youth, as well as for grandmothers who spend their leisure time interestingly on benches at the entrances.

Nature and reasons

Pain in the neck area can be either sharp (lumbago) or nagging in nature. Both types are extremely unpleasant. A lumbago occurs in any part of the neck, usually on one side. If your neck hurts and it hurts to turn to the right, then this is what it is - a “long-lasting” viscous pain. If one-sided pain lasts more than a week, this is a signal from the body about some serious illness.

Neck pain can be caused by:

• injury;
• osteochondrosis;
• osteoarthritis;
• severe strain of the neck muscles;
• being in an uncomfortable position for a long time;
• hypothermia;
• staying in a draft;
• tumor or hernia of the spine;
• some diseases (rheumatism, heart attack, syphilis).

First steps for pain

Nobody likes going to the doctor, and at the first slight or very noticeable pain, we all prefer to endure, treat ourselves, or hope for chance. Well, your neck is jammed, it hurts to turn your head - is this a reason to rush to the clinic?

If a person is sure that pain in the neck does not pose anything dangerous - he just turned unsuccessfully or stretched out, then he can try to get rid of the unpleasant sensations on his own.

The first thing you need to do if your neck hurts, it hurts to turn your head, warm up the muscles with a massage. Maybe one of them is pinched, and massage movements can “pull” it out and put it back in place.

If you know for sure that the cause of the pain is a draft, then a massage is not enough. Warming rubs or compresses are needed. At the same time, you can take aspirin.

The inflammatory process should be relieved with cold compresses: keep ice wrapped in a towel for several minutes. After the compress, the neck must be wiped and warmed - at least by taking a hot shower.

If your neck hurts, it hurts to turn and touch - injury is possible. In this case, a visit to the doctor cannot be avoided.

And if the pain radiates to the arm, up to numbness of the limb, is felt in the ears or in the bone of the base of the skull, then this is a serious reason to consult a neurologist - such symptoms are a harbinger of very dangerous diseases.

How to get rid of pain forever? Is it possible?

If the pain has just begun to manifest itself, then it may very well be that nothing has been lost yet. You need to carefully analyze its character, find out the reason and start getting rid of it.

The fact that your neck hurts, that it hurts to turn your head, may indicate an incorrect lifestyle.

Therefore, the new rules for everyone who wants to forget about pain are as follows:

• sit less at the computer and in front of the TV, walk more in the fresh air;
• when working sedentarily, you need to take a ten-minute break every hour - just walk around the office, stand by the window, drink coffee, in the end;
• perform a set of simple exercises daily;
• visit a massage therapist regularly;
• Even if you have been ill, it would be useful to periodically do acupuncture.

Exercise to restore posture

So, posture. The most important factor in preventing neck pain. If you can keep your back straight, then your neck will be fine. Unfortunately, for most people, straightening their back is an almost impossible task. That is why the neck hurts, it hurts to turn it even slightly - its pain is hidden in the back.

The proposed exercise gives an excellent effect, but it is difficult because it can be forgotten in the hustle and bustle of the working day, it can be endlessly put off until tomorrow. But if your neck hurts, it hurts to turn, you need to take action. This exercise belongs to the category of preventive exercises, but it also helps with the first sensations of pain.

1. The starting position is to stand straight.
2. Shoulders should be raised as high as possible.
3. Raise your shoulders to the sides until they stop.
4. Lower your shoulders.

This position is necessary for the disappearance of pain in the neck. The main secret to the success of the exercise is constantly reminding yourself of its necessity and monitoring the correct position of your back. It is uncomfortable and difficult only in the first few days, and then correct posture becomes a habit.

Simple rescue gymnastics

To relieve or prevent neck pain, you need to train it daily through simple exercises that can be performed without leaving your desk.

Exercise 1. Leaving your shoulders motionless, you need to tilt your head first to one, then to the second shoulder.

Exercise 2. Place your hands on your forehead and, leaning forward slightly, create resistance to tilting your head with your palms. The same applies when bending backwards and to the sides.

Exercise 3. Holding a load (no more than 2 kg) in your hands, shrug your shoulders several times.

Main complaints

After being in a draft, with an uncomfortable position during sleep, with a sudden change in head position, everyone has almost the same complaints about neck pain:

• After a long and uncomfortable sitting on a low chair (the head was constantly raised up), a feeling of dull pain appeared in the lower occipital part - the place where the neck “joins” the head.
• I smoked near the open window, now it hurts to turn my head and my neck hurts.
• I slept all night on an uncomfortable pillow and woke up with a feeling of numbness in my neck.
• The neck always hurts when you turn your head sharply and lift up.
• The pain came unexpectedly - my neck hurts, it hurts to turn and touch.

Sculptural gymnastics for muscles, joints and internal organs. Anatoly Sitel

Tilt your head to the side. Pain relief

The head is tilted to the side due to the work of the sternocleidomastoid and scalene muscles. The angle of normal tilt of the head to the side is 45°.

Exercise 5.5. Diagnostic test

Sit or stand in front of a mirror with your neck straight and your arms close to your body.

When performing the diagnostic test, make sure that the head is tilted to the side and not turned.

The normal head tilt is 45°.

Exercise 5.5. Diagnostic test: A– norm; b– limitation

If there are restrictions on mobility on the right or left, then it is necessary to perform the following exercises for the tonic muscles - the lateral flexors of the neck, tense on one or both sides.

Exercise 5.6. Postisometric relaxation of the muscles - the lateral flexors of the neck on the right (option I)

While inhaling (9–11 seconds, eyes looking left and up), begin to press your right hand to the left, overcoming the resistance of your left arm and head and gradually increasing muscle tension.

During exhalation (6–8 seconds, eyes looking down and to the right), relaxation occurs; With your right hand, move your head 1–3° to the left.

While holding this position, repeat the inhalation (9–11 seconds), and during the next exhalation, with your right hand, move your head another 1–3° to the left.

Inhale again, maintaining the achieved position, and on the next exhalation, move your head another 1–3° to the left with your right hand.

Exercise 5.6. Postisometric relaxation of the muscles - the lateral flexors of the neck on the right (option I): A- initial position; b

Exercise 5.7. Postisometric relaxation of the muscles - the lateral flexors of the neck on the left (option I)

Stand or sit on a chair. Place the thumbs of both hands behind the ears on the mastoid processes, and place the rest on the temporal bones. Try to keep your head strictly vertical.

Exercise 5.7. Postisometric relaxation of the muscles - the lateral flexors of the neck on the left (option I): A- initial position; b– position after three repetitions

While inhaling (9–11 seconds, eyes looking left and up), begin to press your left hand to the right, overcoming the resistance of your right arm and head and gradually increasing muscle tension.

During exhalation (6–8 seconds, eyes looking down and to the left), relaxation occurs; With your left hand, move your head 1–3° to the right.

While holding this position, repeat the inhalation (9-11 seconds), and during the next exhalation with your left hand, move your head another 1-3° to the right.

Inhale again, maintaining the achieved position, and on the next exhalation, move your head another 1–3° to the right with your left hand.

The final tilt angle should be 3–9°.

Repeat the exercise 1 to 3 times daily until the lateral tilt angle reaches 45°.

Exercise 5.8. Postisometric relaxation of the muscles - the lateral flexors of the neck on the right (option II)

Stand up or sit down. With your left hand, clasp your head above the parietal region so that the hand fixes the temporal bone on the opposite side.

While inhaling (9-11 seconds, eyes looking up and to the left), press with your left hand to the left, overcoming the resistance of your head and gradually increasing muscle tension.

At the moment of exhalation (6–8 seconds, eyes look down and to the right), relax, with your left hand, move your head 1–3° to the left.

While holding this position, repeat the inhalation (9-11 seconds), at this time, with your left hand, press your head to the left again, overcoming its resistance.

As you exhale (6–8 seconds), move your head to the left another 1–3°. Repeat the inhalation phase, then, as you exhale, use your left hand to move your head to the left another 1–3°.

The final tilt angle should be 3–9°.

Repeat the exercise 1 to 3 times daily until the lateral tilt angle reaches 45°.

Exercise 5.8. Postisometric relaxation of the muscles - the lateral flexors of the neck on the right (option II): A- initial position; b– position after three repetitions

Exercise 5.9. Postisometric relaxation of the muscles - the lateral flexors of the neck on the left (option II)

Stand up or sit down. With your right hand, clasp your head above the parietal region so that the hand fixes the temporal bone on the opposite side.

While inhaling (9–11 seconds, eyes looking up and to the left), press your hand to the right, overcoming the resistance of your head and gradually increasing muscle tension.

Exercise 5.9. Postisometric relaxation of the muscles - the lateral flexors of the neck on the left (option II): A- initial position; b– position after three repetitions

While exhaling (6–8 seconds, eyes looking down and to the right), relax, and with your right hand, move your head 1–3° to the right.

While holding this position, repeat the inhalation (9-11 seconds), at this time again press the head to the right with your right hand, overcoming its resistance.

As you exhale (6–8 seconds), move your head to the right another 1–3°. Repeat the inhalation phase, then, as you exhale, use your right hand to move your head to the right another 1–3°.

The final tilt angle should be 3–9°.

Repeat the exercise 1 to 3 times daily until the lateral tilt angle reaches 45°.