All-Care Physical Therapy Center, LLC

Torticollis: What Is It and How Do You Treat It?

By Allison Elbeblawy PTA

What is torticollis?

Torticollis, also known as wry neck, means “twisted neck.” It is most often caused by the tightening of the muscle that connects the breastbone and the collarbone to the skull. This muscle is called the sternocleidomastoid or SCM, which is the common abbreviation. The SCM assists in rotation and side bending of the neck. Who does it affect and why?

Torticollis most commonly affects infants. When a baby is born with the condition, it is called congenital muscular torticollis. It can also occur after birth and sometimes later on in life, which is called acquired muscular torticollis. Congenital torticollis most likely happens in utero and can be caused by the way your baby is positioned in the womb, with his/ her head tilted to one side. It can also be due to injury of the muscle during delivery. Although it can look painful, it usually is not. Acquired muscular torticollis in an infant can be caused by positioning. If the baby tends to sleep with his/her head towards one side or is positioned to one side during feeding, the SCM can tighten. It can also be caused by an injury to the head or neck, which can cause the muscle to spasm.

In much less common cases, the condition can be caused by abnormalities of the cervical vertebrae (bones in the neck). The bones in the neck can either be abnormally formed, fused together, or both. This condition is called Klippel-Feil syndrome. This condition can also affect a child’s hearing and kidney function. The recommended stretching exercises performed to treat congenital and acquired muscular torticollis are ineffective and can be dangerous for a child with Klippel-Feil syndrome. It is important to have a thorough examination by your baby’s pediatrician to determine the cause of your child’s symptoms.

What does it look like?

Torticollis is usually spotted in the first couple months of the child’s life. It can be very prominent and can look like your child’s head is tilted to one side and has limited neck movement. Another common sign can be a small bump on the side of the neck. In more severe cases, it can be accompanied by positional plagiocephaly (flat head), which happens when the child consistently sleeps and rests his/her head to one side, flattening that side of the skull. The condition’s severity can also be very mild and may be difficult to detect when looking at your baby. There is no need to worry if you don’t notice because your pediatrician most definitely will. Your pediatrician will provide a physical examination and possibly order X-rays to determine which type of torticollis your child may have. Depending on the type and severity, your doctor may order other diagnostic testing.

Treating torticollis with physical therapy

Physical therapy is often prescribed by the doctor and is a successful intervention of the condition. A physical therapist will perform an initial evaluation of the child, which can include measurements and palpation. Then the therapist will develop a specific treatment plan for your child. After the plan of care is developed, it is recommended that your child be seen by the physical therapist or physical therapist assistant as prescribed by the doctor. Treatment can include stretching exercises, various positioning to promote head control, and soft tissue massage to the affected muscle. Treatment should always incorporate various forms of play, whether it be visually using toys or through playful sounds or song that will stimulate the baby and encourage him/her to turn toward the desired side. This can also assist in keeping your baby calm and relaxed to achieve a successful treatment.

A home program including the stretching and positioning will be given by the therapist for the parent to continue with at home. Positioning throughout the day during play time, feeding time, and while sleeping and resting are also very important for the child’s recovery. “Tummy time” is also very important as it allows for the strengthening and stability of the neck muscles. If muscular torticollis is detected early within the first couple of months of life, and consistent treatment through physical therapy and the instructed home stretching program is followed, then results and improvements will begin to be seen. At All-Care Physical Therapy Center, we can provide one-onone treatment that will assist in the recovery of this condition.

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Allison Elbeblawy PTA Physical Therapy Assistant

Allison Elbeblawy is a Physical Therapist Assistant (PTA) in All Care Physical Therapy. She holds an Associate’s Degree in Applied Science from the Physical Therapist Assistant Program at Union County College.

Allison works closely with supervising Physical Therapists to implement treatment programs in order to decrease pain, increase strength, and improve ADL function to improve the patient’s quality of life. She has a focus in outpatient orthopedic care where she utilizes various manual therapy techniques and therapeutic exercise interventions. Allison has worked with patient’s of all ages ranging from 6 weeks to 96 years, but has found a passion for working with babies and children with Special Needs.

Allison strives to give each patient she works with the best quality of care while upholding a positive attitude and compassion.

The Kitchen Queens Of Cape May

As we embark on the summer season at the Jersey shore vacationers are flooding the shore towns for a week, or longer, to embrace a well needed vacation.

Dot Burton and Lucille Thompson pictured above. Capemay.com. Summer fun includes delicious food, time

spent making memories with family and friends. I have vacationed at the Jersey shore since I was a child from Atlantic City to Cape May. Exit 0 has held a special place in my heart since a dear

Dot Burton and Lucille Thompson pictured above. friend introduced me to https://www.capemay.com/blog/wp-content/uploads/2012/05. it over 26 years ago. When

it came time to start planning family vacations of my own, my husband and I landed in Cape May with our then, four year old twins. We rented on Kearney Street in a beautiful historical house for a number of years. Our family walked from Kearney into town every night to walk the mall, get ice cream or just to soak in a summer night on the town. Our route from Kearney Street to the Washington commons included walking past the Chalfonte Hotel. It is a big beautiful historical structure that is nestled in a residential area a few blocks from the beach. The Chalfonte has an incredible history not only about it’s exterior but its interior that has made it into its success since the early 1900s.

Helen Dickerson was the start of what would be five generations of the “Dickersons” to dedicate a life to working at the Chalfonte. Helen was 8 years old when she first arrived at the Chalfonte with her mother, Clementine Young and the then owners. The original owners would travel from Virginia to Cape May every year to open the hotel and they would bring their staff along with them. Helen started off picking flowers with the owner’s wife for table centerpieces. She also became the owner’s baby sitter making a mere $3.00 per week. Ms. Helen worked her way up through the ranks as a waitress. Then, one fine day Helen was asked to fill the shoes of interim chef for the restaurant. This was no easy task, but Ms. Helen was up to the challenge and began preparing two seatings per day for over 180 guests per sitting. Helen not only held on to that role for over 77 years she brought her daughters, Dot and Lucille to work at the hotel. At the young ages of 7 and 9. Dot and Lucille started their employment at the hotel rinsing out the sand of the guests bathing suits and hanging them on door knobs so they would be ready for the next day at the beach. To add a bit of history to the time era, the Dickerson women were well respected as “staff” of the hotel, however they endured prejudice as women of color along the way. It has been reported that “blacks were not permitted to stay as guests” in the hotel but could be employed. It was not until the ownership changed hands to two incredible women in the 1980s that permitted all guests regardless of race. Lucille and Dot have reported in interviews that in the 1950s the beaches were also segregated. The beach on Grant street was the only beach designated as the “colored” beach which is where they were permitted to swim in the ocean. Ironically, Grant street has become the beach I frequent and my family favorite. Dot and Lucille worked their way from the front of the house to the back of the house and right into the kitchen eventually learning how to prepare the famous recipes for breakfast and dinner. Helen Dickerson was renown for her “southern specialties” and was known to have described her style as “soul food with its Sunday clothes on.” Those specialties are still known to be a part of the menu at the Chalfonte and include mouth watering Southern style fried chicken and crab croquettes. The traditional menu provided a week of daily specials that ended the week with seafood options. The recipes received so much publicity that Ms. Helen was invited to a 1984 appearance on the Phil Donahue show. In case you are a younger reader, to be a guest on the Phil Donahue show was equivalent to being interviewed by Oprah Winfrey. Ms. Helen was also were featured on the Food Network “Tyler’s Ultimate.” If that is not enough there is a cookbook entitled, “I Just Quit Stirring When the Tasting is Good” with all of the family’s generations of secrets printed on page after page. The incredible mouth watering Dickerson prepared meals have been singlehandedly made Helen Dickerson pictured above. Mother of Lucille Thompson and Dot Burton Seattletimes.com. in two black cast iron skillets that are over 100 years old. To give you an idea of its size, each skillet can hold up to 40 pieces of “quartered” chicken.” Just imaging frying 80 pieces of chicken in the summer heat with no air conditioning over hot cooking oil makes me start to sweat. Helen worked in the hotel into her 80s and along the way she taught her daughters Dot and Lucille how to prepare each meal from scratch, meaning all fresh and prepared daily and everything from the vegetable to the meats to the mayonnaise! Keep in mind there were no microwaves, no food processors, no electric can openers. Through the years Dot and Lucille added their own recipes to enhance the menu. They each prepared different meals which afforded them the ability to co-exist in the kitchen. Dot and Lucille earned recognition from the hotel guests and staff as “The Ladies and/or the queens of the Chalfonte” through their hard work, charm and amazing down home southern style. However, these titles did not come with ease. The Ladies would arrive by 6am and not leave until after 6pm every day during the open season of the hotel which was from Memorial Day to Columbus day. They had one pleasure which was to watch the soap opera, General Hospital on a television placed in the kitchen by Ms. Helen, which was only one of the two televisions that were in the hotel. They raised their families in the kitchen of this grand hotel and Dot’s daughter Tina Burton has also become a regular serving up the culinary traditions. Other family members raised at the Chalfonte have continued on in the food industry as well. It has been reported that Dot passed away in February of 2015 at the age of 87. In a 2016 interview by Jacqueline L. Urgo with Lucille Thompson, then 87, Ms. Lucille was already looking ahead to the summer of 2017. Lucille had a beautiful smile and was glowing with decades of pride that her family has contributed to not just the Chalfonte but the town of Cape May.

This feature is dedicated to all of the generous ladies, like the Dickersons who have taken the time to teach their children summer after summer to live life with a full skillet!

Left to right: Lucille, Dot, mother Helen, grandmother Clementine, and Dot’s daughter Tina https://www.capemay.com/blog/wpcontent/uploads/2012/05/YoungPhoto.jpg. Dot Burton pictured above Pressofatlanticcity.com.

References: Burros, M. (1980). They Come to Cape May for Sun, Sand and Helen Dickerson’s Food. The Washington Post. Cronin, S. (2012). Legacy recipes: West Cape May’s Lucille Thompson adds new dish to a roster of great family recipes. https://pressofatlanticcity.com/life/legacy-recipes-westcape-mays-lucille-thompson-adds-a-new-dish-to-a-rosterof/article_Of288827-0657-592f-8c62-9eaf43654255.html. Retrieved on June 1, 2021. Levin, E. (2018). Lucille Thompson, the Last of the Kitchen Queens. https://njmonthly.com/articles/eat-drink/last-kitchenqueens/. Retrieved on June 1, 2021. Tanner, P. (2015). The First Ladies of Cape May at the Chalfonte. https://ediblejerseyediblecommunities.com/eat/ first-ladies-cape-may-chalfonte. Retrieved on June 1, 2021. Urgo, J. (2016). After 80 years at Shore hotel, Miss Lucille already looking forward to 2017. https://www.inquirer.com/ philly/news/new_jersey/20160925_After_80_years_at_Shote_ hotel_worker_already_looking_forward_to_2017.html. Retrieved on June 1, 2021. Lucille Thompson pictured above. Inquirer.com.

Dot Burton and Lucille Thompson pictured above. Ediblejersey.ediblecommunities.com.

Rita King, LCSW is a mental health clinician providing psychotherapy services to adults and children. Rita has worked with individuals with mental illness in the community mental health setting, criminal justice system and private practice setting. Rita is a “De-escalation for Individuals with Special Needs” training facilitator and has trained approximately 1,200 law enforcement professionals to date. Rita is also a CIT trained mental health professional. Rita has a strong passion for women’s history and in her free time she continues to raise awareness of the importance of women’s history through lectures and community speaking engagements.