Torticollis is an abnormal posturing of the head and neck that may affect your baby’s development. Usually, torticollis results from positioning or crowding in utero that causes a baby’s neck muscles to be short and tight on one side and elongated on the other. More rarely, torticollis results from visual impairments that cause babies to always look one direction, trauma, or muscle masses. You may notice torticollis as soon as your baby is born, or it may develop 2 or more months after birth.
ability, and reflexes.
Signs of Torticollis
Parents whose babies tilt their heads toward one side, sleep with their heads always in the same position, or regularly look a certain direction should ask their pediatricians about torticollis.
Parents should also ask about torticollis if they notice their baby has an asymmetrical or flattened head shape. These abnormal head shapes are called plagiocephaly, and up to 90% of babies with torticollis also have plagiocephaly. Plagiocephaly and torticollis go hand-in-hand because an infant's soft skull may become flattened in areas subject to prolonged pressure, which is usually due to a baby's preferred sleeping position. Simultaneous specialized treatment of both conditions is required for the quickest and best results.
Torticollis and Physical Therapy
Pediatric physical therapists are experts at treating torticollis and plagiocephaly. In fact: "Infants participating in physical therapy demonstrate increased symmetry on average 2 months sooner compared to infants receiving stretching from parents only (Ohman et al, 2010)."
Pediatric physical therapists assess your baby’s posture, body strength and flexibility, spinal alignment, head and facial features, gross motor development, visual tracking
Treatment helps babies with torticollis maintain a midline head position at each stage of development to encourage symmetrical movements and bilateral achievement of motor milestones, like being able to look or roll to both sides.
Infants participating in PT demonstrate increased symmetry on average 2 months sooner compared to infants receiving stretching from parents only (Ohman et al, 2010).
Physical therapy treatment is always tailored to your baby’s needs. It may include:
- Teaching you how to position your baby for sleeping, eating, feeding, and holding for optimal neck position
- Helping you increase your baby’s tummy time and decrease the time your baby spends in swings or car seats, to better strengthen neck muscles Stretching your baby’s neck and trunk
- Helping your baby with age-appropriate activities
- Referring for a cranial orthotic, if necessary, to treat plagiocephaly
Early Physical Therapy is Best!
"Strong evidence supports early intervention for the best outcomes in both torticollis and plagiocephaly" (Demirbilek, 1999). "Younger babies who are diagnosed and treated early have the best results in the least amount of time" (Kaplan et al, 2013).
|AGE OF REFERRAL
||LENGTHS OF SYMPTOMS/TREATMENT
<3 MONTHS ||1.5-3 MONTHS
Early intervention is also effective in decreasing the chance your baby will experience a cascade of injuries associated with untreated torticollis and plagiocephaly. Due to poor neck and head position, babies with torticollis may face persistent gross developmental delays, facial asymmetry, injury to the nerves in the neck that control the arms, and jaw dysfunction. (Kaplan et al, 2013). Babies who always look to the right, for example, may learn to roll only to the right, may not learn to reach with their left hands, and may have less tolerance for tummy time, sitting, crawling, or any position that requires them to maintain a certain head position. Untreated plagiocephaly may cause facial abnormalities, asymmetric ear position, and a bulging forehead.
How to get Help
The pediatric physical therapists at Back in Motion love helping babies with torticollis and supporting their families. Whether you have a physical therapy prescription from your pediatrician or you simply suspect your baby has torticollis, schedule an appointment with one of our experts. We will evaluate your baby, begin treatment, and refer you to other care providers if needed. Call us at (703) 372-5716 to schedule an evaluation.
Physical therapy treatment is individualized for each child and may include any of the following:
If your child was born prematurely, see a Back in Motion pediatric physical therapist to help with optimal gross motor development. Call (703) 372-5716.
- Parent education - holding and carrying positions, sleep positions, play positions
- Tactile (touch) and kinesthetic (movement) stimulation
- Facilitation of age-appropriate developmental activities such as rolling, sitting, crawling, walking, jumping, hopping, and skipping
- Balance training
- Genu Valgum, often called knock knees and commonly associated with in-toeing. Should resolve by 7 years old.
- Gait training
- Functional strengthening activities through play