What is Torticollis?

What is Torticollis?

By Nichole Hagerty, DPT

Bringing home your precious newborn is an exciting yet nerve wrecking experience.  Parents will lay awake staring at their little girl, conscious of all their movements.  Her baby pictures will fill your walls, office spaces, and phones.  You will spend endless amounts of time hoping and praying she is perfect.

But then something seems off.  She only looks to the left.  In all of the pictures, her ear is constantly on her shoulder.  When she is placed on her stomach, she will continue to look left, but never right.  As the sleepless nights continue, you begin to notice her head shape is changing.  She begins to have a small flat spot because she is consistently looking left while keeping her ear tilted toward the left shoulder.

You become concerned.  Others may tell you not to worry, that your baby will grow out of it.  But your gut instinct is telling you something is wrong.  A pediatric physical therapy evaluation will determine if your child is affected by torticollis.

Torticollis, derived from the Latin words tortus for twisted and collum for neck, is the tightening of the sternocleidomastoid (SCM).  The SCM is a muscle that goes from the mastoid process of skull to the sternum and clavicle.  You have a right and left side SCM.  When the muscles work together, they flex the head forward.  However, when one is working alone, you bend your head sideways to the right and rotate your head to the left.  This is what occurs when a child has torticollis.  One of the muscles is tight, possibly due to positioning in the womb, birth trauma, or positioning after birth.

The incidence of Torticollis has been steadily increasing since 1997 with the introduction of the “Back to Sleep” campaign.  Not only is your child sleeping on her back, she is often times spending a lot of time in her car seat, her swing, her bouncer, and all of this wonderful baby holding equipment.  However, she is not spending enough time on her stomach.  She is not learning how her body works.  She has difficulty with being on her stomach and has not developed the neck extensors to lift her head that will allow her to explore her world.  Once these are developed, she needs to learn to play on her tummy without as much support, but still being supervised.  She needs to be able to reach and play with both of her hands equal. She needs to discover her body. The best way to do this is to spend time on her stomach.

Torticollis is typically treated with changes in positioning at home, as well as specific strengthening and stretching exercises.   A physical therapist can teach you simple stretching exercises to perform daily at home with your baby.  As time continues, physical therapy will progress to more strengthening exercises.

The best way to decrease continued pressure on the back of the head is to increase the tummy time.  For more reading on tummy time, read our blog post from Kids Place’s Teri Roberts, DPT.

Torticollis is not preventable, but it is treatable with an early referral to a Pediatric Physical Therapist and committed parents who follow the home exercise program recommended by the therapist.  Ask your pediatrician for a physical therapy evaluation if you are concerned your newborn is suffering from torticollis.



Articles referenced:

• Boere-Boonekamp M, van der Linden-Kuiper L. Postional preference: prevelance in infants and follow-up after two years. Pediatrics. 2001 Feb; 107 (2):339-43
• deChalain T, Park S. Torticollis associated with positional plagiocephally: a growing epidemic, J. Craniofac Sugery. 2005 May; 16(3): 411-8
• Do T. Congenital Muscular Torticollis: Current concepts and review of treatment. Curr Opin Pediatr. 2006 Feb; 18(1):26-9.