What is Infant Torticollis?

Torticollis, also known as wry neck, is a twisting of the neck that causes the head to rotate in one direction and tilt in the opposite direction. Baby will have difficulty holding the head and neck straight for extended periods of time. The muscle that is most commonly associated with torticollis is the SCM (sternocleidomastoid), but often, other muscles in the neck and shoulder region are also involved. It can be mild, moderate, or severe, and is the most documented cause of plagiocephaly (flat head syndrome).

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What Causes Infant Torticollis?

The most common cause of torticollis is in uterine crowding and this can happen for several reasons: first born, large baby, multiples, and difficult deliveries. With limited room to move, it is very easy for those little necks to get tight.

There are other things that worsen torticollis, including:

  • Increased use of containers
  • Decreased tummy time
  • One sided handling - always holding/feeding baby on same side

How Do I Know If My Baby Has Torticollis?

Because torticollis typically starts in utero, a trained eye can pick up on neck tightness soon after birth. Similar to plagiocephaly, pediatricians often notice the neck tightness at the 1-2 month well visit. Our goal is to bring awareness to this common condition and empower parents to identify it as soon as possible. If you know what to look for, you can get help sooner rather than later.

The earliest indication of a tight neck is baby only wants to look in one direction and may seem uncomfortable when trying to turn the head in the opposite direction. Another indicator is one ear is closer to the shoulder than the other ear. This is what we call a “head tilt.” It’s cute, but if your baby is always in this position, there may be an issue that needs to be addressed!

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What Can I Do To Help My Baby's Tight Neck?

  • Identify turn preference early
  • Increase supervised tummy time
  • Encourage baby to look in the non preferred direction
  • Change position in crib
  • Switch feeding positions
  • Limit container usage (bouncy seats, boppy loungers, swings, DockATot, carseat)
  • Pediatric physical therapy/home exercise program

Does My Baby Need Physical Therapy?

If your baby continues to have a strong turn preference and/or a flat head, despite your attempts to change it, therapy is indicated sooner rather than later. A wait and see approach does not work in this situation. Skilled therapy for torticollis is critical to success. This DOES NOT include stretches you found off a quick google search! Torticollis can have long term effects on spinal alignment, attainment of motor skills, feeding issues, and facial symmetry. It should not be taken lightly.

What is Physical Therapy for Infant Torticollis?

Therapy for torticollis consists of various stretching/strengthening exercises and manipulation techniques by a licensed physical or occupational therapist.

These are incorporated into play activities and SHOULD NOT be uncomfortable for your baby. The therapist should also give you torticollis treatment activities to do at home. This is your home exercise program and is a critical step to your baby’s success. Your hard work will pay off in the end!

One word of encouragement: torticollis is difficult to treat and takes a while to resolve. This is because growth spurts cause the neck to retighten and it seems like you’re starting from scratch. This is normal but can be very frustrating. Keep up with your neck stretches and hang in there!

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Want results faster? We do too! We are able to provide skilled therapy for babies and their families in Texas (either in person or virtually). If you’re outside of Texas, we have you covered. We have trained parent educators that can get you started and help you navigate the next steps in your torticollis journey.