Congenital Torticollis


Congenital Torticollis

Torticollis is an abnormal position of the head and neck and is common in infants.
Torticollis may be caused by tightness in the muscle on one side of the neck

What is it:

When a baby has tight muscles on one side of the neck, it is called torticollis. This tight muscle causes the baby to keep his or her head tilted or turned to one side most of the time. A baby can be born with torticollis. However, you might not notice your baby has torticollis until your baby is a few months old.

What causes torticollis?

Sometimes there is a thickening or lump in the affected muscle, called fibromatosis coli. This is called “Congenital Muscular Torticollis.” There may be tightness in other neck or shoulder muscles as well. Torticollis can also be caused by soft tissue or bony abnormalities, vision problems or trauma. This is called “Acquired Torticollis.” Sometimes it may be the result of the baby’s position when sleeping on his or her back. This is called “Positional Torticollis.” It is important to work with your doctor to find out the cause of your baby’s torticollis.


Your baby may become fussy when you try to change the position of his or her head or when he or she is put on tummy because he is not able to lift or turn his head.


• A baby can also have a flat area on the side or back of the head, which is called plagiocephaly.
• This is common with torticollis because the baby prefers laying on one side of the head. The baby may have a flattening or bulging on the back or side of the head.
• You may notice asymmetrical ear position.
• Muscle tightness may also change the shape of your baby’s facial features on one side of the face. For example, his cheek may appear fuller on one side.

How is it treated?

Physical therapy is very important to treat your baby for torticollis. There are 4 main areas that your Physical Therapist will help you work on with your baby. They are:

  • Positioning
  • Stretching
  • Strengthening
  • Motor development

Carrying and positioning your baby

  • When carrying your baby, place your baby on the shoulder that helps your baby to turn the head to the opposite direction than your baby prefers.
  • Put your baby on his back while playing. Slowly move a toy from side to side to help your baby turn his head in both directions.
  • Put your baby lying on either side for play time. You may need to put a rolled towel behind him to keep him from rolling onto his back.
  • You can also place a small folded washcloth under your baby’s head to keep their head and neck in line with their trunk.


Try to limit the time your baby spends in a swing, bouncer, or lying on his back. Spending more time side-lying

and doing tummy time will help increase your baby’s neck strength. It also decreases the pressure on your baby’s head, which lowers the risk for plagiocephaly. Perform these positioning techniques throughout the day during play and activities. They do not need to be performed all the tim

e. Place interesting things on the side your baby turns away from. For example, if your baby usually turns his or her

head to the right, put toys to the left. Since your baby always wants to lay a certain way, your goal is to help your baby want to turn his head the other way. Place your baby in the crib so the wall is on the side your baby usually turns toward. This way, when your baby wants to look around the room or look at you, he has to turn the other way.


Lateral neck flexion: At 3 to 4 months of age, start to carry your baby slightly tilted to her right or left side. This causes the baby to lift her head up to midline to strengthen the neck muscles.





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About the Author: The Therapy Spot
The Therapy Spot of Baltimore is a multi-disciplinary pediatric therapy center, featuring an energetic group of experienced and qualified therapists. We provide speech therapy, physical therapy, and occupational therapy to children in the greater Baltimore region.