by Dr. Marci Westman, Physical Therapist

What Exactly is Torticollis?

Photo of infant with torticollis caused by tightness of SCM muscle that could be relieved by a PT at bothell pediatric and hand therapy
Infant with Torticollis
Image credit: afp/2007/1015/p1197.html

The term torticollis means “twisted neck,” derived from the Latin terms “torta” meaning twisted and “collum” meaning neck.

Torticollis is commonly found in infants and is associated with an abnormal position of the head and neck, where the head is tilted to one side, with the chin typically pointing in the opposite direction.

What Causes Torticollis?

The exact cause of torticollis is unknown. However, there are several different types of this condition.

Types of Torticollis

Congenital Muscular Torticollis

Congenital Muscular Torticollis refers to torticollis that is present at birth, and is the most common type in infants.

It is caused by tightness of the sternocleidomastoid (SCM) muscle on the side of the neck. This muscle tilts the head to the involved side, and rotates the head toward the uninvolved side. There may be tightness to additional muscles in the neck and shoulder as well.

Suspected causes of congenital muscular torticollis include abnormal positioning in utero, birth trauma, or direct injury to the muscle.

Acquired Torticollis

Acquired Torticollis occurs later in infancy or childhood and can be caused by vision issues, soft tissue or bony abnormalities, or trauma.

Positional Torticollis

Positional Torticollis can result from the infant spending excessive amounts of time on his/her back, which can impact the shape of the skull, leading to tightness in the SCM muscle.

Some Signs that Your Child May Have Torticollis include:

sketch of child with torticollis that could be helped by a physical therapist at bothell pediatric and hand therapy
Sketch of Child with Torticollis
Image credit: Wikimedia Commons
  • Preference for turning head to one side and avoiding the opposite side
  • One shoulder higher than the other
  • Head tilting toward the side of the tight muscle
  • If breastfed, preference to breastfeed on one side only
  • Shifting to one side in tummy time, and always reaching with the same arm
  • Rolling toward one direction only
  • Trunk curvature toward the affected side
  • Abnormal head shape and facial asymmetries
  • Delay in motor milestones

How can Physical Therapy Help Children with Torticollis?

Torticollis responds very well to physical therapy treatment. The therapy emphasizes proper positioning, active stretching of the tight neck muscles, strengthening of the weak neck muscles, environmental modifications, and promoting symmetry with movements in every position.

In addition to PT sessions, the physical therapist will educate the family on how to perform these interventions at home to support improved functioning and restoration of the child’s proper posture.

If you think your child might have torticollis, speak to your pediatrician and contact us to schedule an evaluation by one of our licensed PTs.

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