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Tessa Irwin, PT, DPT
Lead Physical Therapist

What is Torticollis?

Torticollis is the shortening of one or more of the muscles of the neck that tilt or rotate the head; mainly the sternocleidomastoid (SCM) muscle. The SCM muscle tilts the head to one side and rotates it to the opposite side. For example, the highlighted muscle below tilts the head to the left and rotates the head to the right.  

This shortening in infants is thought to typically be from position in the womb but can also be due to other issues such as muscle trauma during the birth process, nerve injury during birth, and, less frequently, bone anomalies. An infant will have poor head control for a few months after they are born, but an infant with torticollis will present with a lack of symmetry in their head formation and trunk control.

What are the signs and symptoms?

Torticollis typically presents with the infant consistently tilting or rotating their head to one side. There is also a chance that the infant will have a flattening of their head due to their positioning. This is called plagiocephaly and will be addressed in the February physical therapy blog topic.  

What can a parent(s) do?

If a parent thinks their child may have torticollis, please consult with a physician. The physician can make a referral to a physical therapist for further education on stretching, strengthening, and positioning. A home program is also incredibly important to adhere to in order to decrease the risk of other issues down the road including scoliosis, plagiocephaly, and possible visual problems.

Why Physical Therapy?

Physical therapy is important to begin as early as possible in order to educate families on a home program. The family plays a huge role in the progress of their infants’ range of motion. The physical therapist will help explain the reason why the infant prefers to look or tilt to one side. Being aware of the “why?” will help families understand their home program. A variety of techniques will be covered with the family in how to position the child in order to improve range of motion, along with different exercises and activities to perform at home.

What is the outlook and treatment for torticollis?

It is extremely important to address possible torticollis as early as possible. Clinically, Special Kids has seen quicker improvements the earlier the child is referred, with less treatment frequency and duration required. The majority of early intervention of torticollis consists of a rigorous home exercise program of stretching, strengthening, and positioning.  

Always consult your child’s physician first if you think your child may have torticollis. References are for informational purposes only and they are not intended to replace physician and/or physical therapy treatment(s).