Should a chiropractor treating infant torticollis work on the cranium, not only the upper neck?

Question

Accepted Answer

Yes. Torticollis is a spasm of the sternocleidomastoid, and that muscle attaches to the mastoid process, which is cranium. Adjust the upper cervical spine, then check the temporal, sphenoid and frontal: the neck, jaw and eye usually share one subluxation pattern.

Yes. Adjust C1 and stop there, and you are hoping.

A baby comes in with a head that won't turn. We look for C1, we make our adjustments, and we expect the range of motion to come back from the spinal correction alone. That plan forgets where the spasming muscle ends.

The muscle ends on the cranium

Torticollis is a spasm of the sternocleidomastoid. It attaches at the sternum and runs up into the mastoid process. The mastoid is part of the temporal, not the spine.

Follow the chain:

Constant tugging on the mastoid rotates the temporal.

The temporal carries the TMJ, so depending on which way it rotates and gets stuck, the jaw moves toward or away from that side.

As the sphenoid torques and the frontal compensates, the orbit rotates with them, and the eyes stop looking even.

Jaw, eye, torticollis. Three findings, one subluxation pattern.

Which came first does not matter. The torticollis can be upstream of the temporal pattern or downstream of it. Either way, both are there, and both need correcting.

Why the head shape follows

A baby who cannot turn well spends the day with one side of the head down, and the occiput flattens. The restriction can also start on the inside: a dural or sutural restriction that keeps the brain from growing evenly.

That is why range of motion work alone can stall. Once a suture is restricted, the head shape will not change until that suture is corrected.

What to do Monday

Keep adjusting the spine. Lateral flexion at the occipital-atlanto joint is spinal work, and it is still yours.

Then check the cranium in order: occiput, sphenoid, temporal, parietal, frontal, maxilla. After each correction, go back to the beginning and recheck. The primary can show up anywhere.

On every torticollis baby, look at the jaw and the orbits before you touch anything. If all three are off, you are looking at one pattern.

Measure the cranial vault asymmetry index and the cephalic index, and track the change over visits. You are not eyeballing it and hoping.