What is torticollis?

Grace Goodfellow, DPT

Many individuals often wonder, “what is torticollis?”, and if it is a condition that could affect their child. Simply put, torticollis is a condition that causes a muscle imbalance in the next that could cause your child to favor one side of the head over another, which could lead to plagiocephaly further down the road.

What is torticollis?

Torticollis is a condition of the neck muscles which is either congenital (present at birth) or acquired (happening later in infancy). The most common type of torticollis is Congenital Muscular Torticollis (CMT). Torticollis presents itself as tightening of the sternocleidomastoid muscle on either the right or left side of the neck which normally helps laterally flex and rotate the neck. Typically you will first see the head always tilted toward one side and as the muscle becomes more tight you might notice your child only looks one direction. If the right sternocleidomastoid muscle is tight you will see the head tilted toward their right and prefer to rotate their head toward the left. It is opposite if the left sternocleidomastoid muscle (SCM) is tight, you will see the head tilted toward left and prefer to rotate their head toward the right. The good news is that CMT is very treatable the earlier it is caught. 

Torticollis Symptoms:

• Limited range of motion of the neck specifically in rotation or lateral flexion or both

• Preference to look one direction or have feed preferences on only one side

• Potential development of palpable muscle tightness within the tight sternocleidomastoid muscle 

• Potential developmental of asymmetries of face and possible flattening on one side of head 

• Difficulty tolerating tummy time 

Torticollis Causes:

Often the cause of torticollis is multi-factor, It could be caused by:

• Position in utero

• Neck muscle injury or trauma at birth

• Positioning as an infant 

• Time in containers (such as: car seats, swings, bouncers)

Less common causes:

• Viral Infection

• Vision difficulties

• Abnormalities of cervical spine

• GERD (Gastroesophageal reflux)

Torticollis Exercises:

• Tummy time, if your child does not tolerate tummy time well try these tricks:

  • Tummy time over boppy pillow so they are propped at an angle

  • Tummy time on your chest or over your lap 

  • Tummy time with a mirror or toy at eye level

  • Tip! Try placing preferred toys to the side they do not often rotate their head!

• Stretching tight SCM 

  • You stretch opposite of preferred position in both side bending and rotation 

  • A physical therapist can instruct you on proper stretching techniques

• Side-lying play 

  • Place child on the same side as tightness to promote opposite strengthening and stretching of tight side

  • This is also a great position to learn playing with hands and objects at midline