Physical Therapy
Torticollis is a treatable, common occurrence in babies and infants. It can occur due to positioning in utero or after birth. It is caused by muscle tightening in the neck, specifically the sternocleidomastoid (SCM).
What you might see in your baby with torticollis:
- Head tilt to one side
- Preference to rotate to one side (usually opposite the side of the head tilt)
- Flattening on the back or side of the skull (plagiocephaly)
- Favoring one side for play, breastfeeding, rolling
Risk factors for torticollis:
- Larger birth weight/size
- Larger head size
- Small uterus
- Twin pregnancy
- Breastfeeding to only one size
- Spending too much time on their back especially looking to one side
It is important to catch torticollis as early as possible to begin treatment before muscles tighten too much or head flattening becomes permanent or difficult to correct. Sometimes a cranial helmet is required for cosmetic or functional purposes, such as wearing a bike or sports helmet, for head shape correction. You and your physical therapist can talk about the benefits of a helmet which is only needed if there is moderate to severe flattening. 
When torticollis is diagnosed and treated early, 80% of children recover with no long-term detrimental effects.
Torticollis muscle tightening and a preference for rotation to one side may impact the development of gross motor skills including rolling, reaching, sitting, crawling, and even standing and walking. Tightness in the neck can lead to tightness and restrictions in the neck, trunk, and pelvis leading to asymmetrical posture and movements. Pediatric physical therapists have knowledge that can help address torticollis and prevent developmental delays or lasting impairments.
If you or your pediatrician have concerns with head flattening or torticollis, schedule an evaluation with a pediatric physical therapist. They will assist in creating an individualized therapy plan focusing on stretching, strengthening, positioning, and reaching milestones both in and out of therapy. They will also work with you and develop a customized home strengthening and stretching program!