Pediatric muscular torticollis is characterized by tilting and leaning of the head to the affected side, with rotation of the face towards the unaffected side. Clinically, torticollis generally refers to muscular torticollis caused by contraction of the sternocleidomastoid muscle on one side, except for a few cases of bone-related torticollis caused by spinal deformities, compensatory torticollis due to visual impairment, and neurogenic torticollis caused by neck muscle paralysis. Let's take a look at the massage techniques for pediatric muscular torticollis.
Massage Techniques for Pediatric Muscular Torticollis
Treatment principles: Promote blood circulation, relax muscles, and reduce swelling.
Common massage techniques include:
1. The child lies on their back, and the masseur uses three-finger kneading on the affected side sternocleidomastoid muscle.
2. Apply pressure to the affected side sternocleidomastoid muscle (bridge bow point).
3. Use three-finger kneading on the affected side sternocleidomastoid muscle (bridge bow point).
4. Combine passive movements of the child's neck, with a focus on bending towards the unaffected side and rotating towards the affected side.
Acupressure Massage for Pediatric Muscular Torticollis
Apply pressure to the Hegu, Lieque, Fengchi, Quchi, Jianjing, and Xingxue points on the unaffected side; add massage and kneading techniques on the affected side, including San Guan, Dazhui, Zhiyang, and Jin Suan points.
Explanation of Massage Techniques for Pediatric Muscular Torticollis
1. Three-finger kneading on the affected side sternocleidomastoid muscle can improve blood circulation and help absorb hematoma; applying pressure can break up blood stasis and dissipate nodules; combined with passive movements, it can help relieve spasms, stretch tendons, and improve neck mobility and function.
2. The Yangming meridian is rich in qi and blood. Hegu is the original point of the Yangming meridian, with the functions of regulating qi and blood and promoting meridian circulation; Quchi is the confluent point of the Yangming meridian, and the qi and blood of the meridian flow from here, thus stimulating the circulation of qi in the Yangming meridian; Lieque is a branch point of the Taiyin Lung meridian, and one of the eight confluent points, connected to the Ren meridian, with the functions of promoting the flow of qi in the Taiyin meridian and connecting the qi of the Yangming meridian, allowing qi and blood to reach the top of the head, making it one of the four important points; Jianjing is the confluence point of the Shaoyang meridian and Yangwei, with the functions of regulating the key points and maintaining the balance of the yang meridians; San Guan is located along the Yangming meridian, with the functions of regulating and supplementing qi and blood, relaxing tendons, and promoting meridian circulation; Dazhui is the Shu point of the Du meridian, and also the confluent point of the three yang meridians, a key point for dredging meridians and promoting circulation; Zhiyang is the point where the yang qi of the Du meridian converges from bottom to top, and is level with Pishu, with the functions of benefiting the Yuan and Rong vessels, promoting the circulation of chest yang, treating flaccidity and paralysis, relieving spasms, and controlling convulsions; Jin Suan is also a Shu point on the Du meridian, located where the qi of the liver and gallbladder converges on the back, with the functions of strengthening tendons and bones, relaxing tendons, promoting meridian circulation, and nourishing the liver and gallbladder.
Causes and Pathogenesis of Pediatric Muscular Torticollis
The pathological feature of muscular torticollis is fibrous contraction of the sternocleidomastoid muscle on the affected side. Initially, there may be fibroblast proliferation and muscle fiber degeneration, which eventually gets replaced by connective tissue. The exact cause of muscular torticollis is not completely known, but the following are commonly believed:
1. It is mostly considered to be associated with injury. During childbirth, the sternocleidomastoid muscle on one side may be injured and bleed due to compression by the birth canal or forceps, leading to muscle fibrosis and contraction.
2. It is considered that during childbirth, abnormal positioning of the fetus's head obstructs blood supply to the sternocleidomastoid muscle on one side, resulting in ischemic changes in the muscle.
3. It is believed to be caused by the fetus leaning towards one side in the uterus, unrelated to the process of childbirth. Additionally, there are theories about abnormal embryonic development.
Clinical Manifestations of Pediatric Muscular Torticollis
After birth, a spindle-shaped swelling can be observed on one side of the neck (which may disappear on its own after six months), and then the sternocleidomastoid muscle on the affected side gradually contracts and tightens, appearing as a prominent cord-like structure. The child's head tilts towards the affected side and the face rotates towards the unaffected side. In some cases, there may only be bony changes resembling warts around the attachment point of the sternocleidomastoid muscle on the affected side, with limited neck movement and difficulty in rotating towards the affected side and bending towards the unaffected side.
Precautions for Pediatric Muscular Torticollis Massage
1. Early detection and treatment are crucial for achieving effectiveness. The younger the child, the better the outcome.
2. During treatment, the massage technique should be gentle and within the child's tolerance range to ensure long-term adherence to the massage.
Daily Care for Pediatric Muscular Torticollis
1. Correct the position of the head. When feeding, carrying, and using pillows for sleep, the parents should adopt a position opposite to the torticollis to correct it.
2. Self-massage. Parents can use their index, middle, and ring fingers to knead the affected area of the child's neck, focusing on the swollen and nodular areas.
3. Pregnant mothers should pay attention to prenatal examinations and correct malposition; during pregnancy, pay attention to sitting posture and avoid bending over and pressing on the abdomen to prevent adverse effects on the fetus and the occurrence of torticollis.
4. It is not advisable to hold the child upright too early to prevent positional torticollis.
