Objective: To discuss the evaluation, treatment of torticollis. This case also highlights two new orthopedic tests: The Rib Cage Compression Test and Shoulder Squeeze Test. Each of these tests are diagnostic for rib cage injury and sternoclavicular injury respectively.
Clinical Features: A 23-year-old woman presented with right-sided torticollis from birth. She had received the standard care for this condition: stretching the affected “wry” muscles. There was only temporary improvement of her cervical range of motion (ROM). No permanent change was accomplished. She complained of the loss of motion and the head tilt to the right and a persistent head pain on the right behind her right ear since childhood.
Intervention and Outcome: An evaluation revealed rib and clavicle subluxations of the right chest wall and chiropractic adjustments were performed which resulted in immediate full range of motion of her cervical to her left. This first intervention has been maintained for three years. She has pain in the cervical and shoulder regions with certain activities, which she manages with chiropractic care twice a month.
Conclusion: The patient had immediate relief from decreased cervical range of motion and the head tilt with adjusting of her right rib cage and clavicle subluxation pattern. The care provided previously focused on the muscular condition the “wry” muscles that reduced her cervical ROM and gave her a persistent head tilt.
Author keywords: Torticollis, Rib Cage, Scalene Muscle, Sternocleidomastoideus muscle, Sternoclavicular Joint, Birth Trauma
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