According to my injury classification system, Torticollis is considered level 2, as per the two structures compromised, alignment and muscle/tendon layers. Wry neck, or torticollis, is a painfully twisted and tilted neck that causes significant pain and restriction of neck movement. It is classified as congenital (present at birth) or acquired. According to the type of neurological system involved (sympathetic or parasympathetic), it can be further classified into spastic or flaccid torticollis.

Spastic torticollis

Spinal misalignments affecting the parasympathetic system tend to cause an increase muscle contraction tilting the head to the same side and resulting in the spastic torticollis. The spinal segments that influence the parasympathetic is from the base of the skull (occiput) down to the C5 segment.


Flaccid torticollis

Spinal misalignments affecting the sympathetic system tend to cause a decrease muscle tone on one side of the neck causing the head to tilt to the opposite side by the opposing normal muscle tonicity ‘’pulling’’ the neck towards this side.  The spinal segments that influence the sympathetic is from the C5 down to L5.



Clinical evaluation of the spinal alignment and specific orthopaedic tests to pinpoint the location of the injured muscle/tendon.

Examination to distinguish between the spastic vs flaccid torticollis


Anterior – posterior (AP) and lateral spinal views are an essential imaging to check the different patterns of spinal misalignments that contributed to this condition


Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities, in addition aids to identify the type of tendinopathy (tendinitis or tendinosis) and the corresponding appropriate treatment care.

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.


Treatment Protocol

Specific Spinal adjustments  followed by a rehabilitation regime to strengthen the entire soft tissue support.

Application of Low-level Laser and PEMF to aid on the cellular level of heling as well as improving the microcirculation for the area.

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Dry needling may be used to improve local blood flow and to reduce the deep muscle tension.

Specific selected essential oil application to enhance healing

Depending on level of misalignment and chronicity a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.

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