Torticollis is a condition characterized by abnormal positioning of the head and neck and is most commonly seen in infants.
What is Torticollis?
Torticollis can be caused by positioning when sleeping, and can be congenital or acquired from soft tissue abnormalities. Torticollis often leads to a tightening of one side of the neck causing a preference of head turning to one direction and a head tilt in the opposite direction. Other complications that can be associated with torticollis include abnormal rounding of the head and fascial asymmetries.
How is Torticollis Assessed?
Multiple factors are taken into consideration when assessing torticollis such as:
- Neck range of motion in multiple positions including tummy, back, and sitting
- Posture of the neck, back, and hips
- Shape of the head as well as facial features to assess facial asymmetries
Signs and Symptoms
Some signs and symptoms of torticollis include:
- Changes in head shape – flattening of the back or side of the head and a forward shift in facial features on one side of the head.
- Head tilt – holding head tilted closer to one shoulder.
- Rotational preference – demonstrating a preference of looking to one side and resistance to the head being turned to the opposite side.
Treatment options for this condition include:
- Soft tissue mobilization – massage of the muscles on the side that is tight.
- Stretching – holding and carrying your baby in a position that promotes lengthening of the tight side.
- Positioning – being aware of how objects are placed during play time, increasing the amount of tummy time, and being aware of head position when sleeping and being carried.
- Strengthening – strengthening the muscles of the neck, spine and hips.
What steps can be taken to prevent and treat torticollis at home?
- Positioning – position toys and objects of interest on the opposite side your child prefers to rotate their head. Being aware of your child’s head position when sleeping, feeding, and sitting in car seats or carriers.
- Feeding – bottle or breast feeding your child so that they are having to look opposite to the side they prefer.
- Sleeping – when sleeping at night, position your child so that they have to look at you on the opposite side of the direction they prefer to turn their head.
- Carrying – holding your child in a position that promotes stretching of the side that is tight and strengthening of the side that is weak.
- Play Time – encourage head turning to both the right and left by tracking a toy or your face. Promoting multiple positions when playing, including sidelying, tummy, sitting, etc.
- Tummy Time – tummy time helps strengthen muscles in the neck, back, and shoulders needed for development and helps to off load the back of the head.
How Can Physical Therapy Help?
If your child has been diagnosed with Torticollis a Physical therapist can provide you with a screening of range of motion, head position, and posture. Following an evaluation, a Physical Therapist will provide you with appropriate stretching and positioning exercises you can complete at home with your baby to assist with increasing range of motion, allow symmetrical rounding on the head, and help your baby grow up happy, healthy, and smiling.
Coulter, Colleen, and Dulcey Lima. “Tummy Time Tools: Children’s Healthcare of Atlanta.” Children’s Healthcare of Atlanta, 2015, www.choa.org/medical-services/orthopaedics/orthotics-and-prosthetics/tummy-time-tools.
“Torticollis and Your Baby.” Torticollis and Your Baby, Seattle Children’s Hospital, 2018, www.seattlechildrens.org/globalassets/documents/for-patients-and-families/pfe/pe347.pdf.