A simple guide to torticollis

baby with torticollis

image credit: spinewave.co.nz

You’ve just given birth to a beautiful child. You’re so caught up in joy and awe that you can’t help but take tons of pictures of the little one. But as you scroll through your pictures you may notice a common trend between 1 and 12 months old: your baby is always looking in one direction.

No, your baby isn’t giving the camera his good side. Your baby may have torticollis.

What is torticollis?

Don’t panic. Torticollis is common and a result of muscle tightness and weakness on one side of the neck. Any diagnosis sounds scary, but caught early enough, torticollis is an easy fix. As a physical therapist, I frequently treat patients with this diagnosis. The key is proactive treatment.

Torticollis occurs when the shoulder muscle, sternocleidomastoid, becomes tight. This can happen due to your baby’s position in the womb or from sleeping position. Twins and large babies are more likely to have torticollis from the reduced womb space. Also, babies’ heads are heavy and tend to rotate to one side when they sleep on their backs. The sternocleidomastoid’s action is lateral flexion (tilting) to one side and rotation (turning) to the other side.

So what can you do?

Start with these two stretches

  • Rotate your child’s head in the opposite direction your child usually looks. Do this hold for 15 to 20 seconds with light pressure every time you change your baby’s diaper (which let’s be real, is 10+ times per day). This improves range of motion and reminds the baby that there is another half of the world to see.
  • The other is the football carry. Place the baby facing out toward the world and turned on his side. Position so that the side of the neck the baby typically tilts is facing down. Put one hand on the side of their head and the other between their legs for support. Use your hand on the side of their head to lightly stretch the baby’s neck. This addresses the tilt component to the muscle tightness.

If you can’t visualize these stretches, I recommend an appointment with a physical therapist. You will see the stretches in person and applied to the specific direction of your child’s rotation and lateral flexion, as well as to learn other exercises for neck strengthening.

Lifestyle tips

  • Feed your child to the direction he doesn’t like to look in order to facilitate active rotation.
  • Adjust crib position so that your child has to turn his head to see what’s happening outside.
  • At playtime, put toys on the opposite side of baby’s head.
  • Have family members stand on the side your child looks to least often when they interact with them.
  • Encourage increased tummy time if your baby has a flat spot on the back of their head so he isn’t falling into that pattern of rotation when on his back.
  • Every adjustment helps!

If torticollis is left untreated, it can lead to a child favoring one arm during sitting and reaching activities, having one-sided weakness, and having an altered crawling or walking pattern. Although it’s an easily treated and often mild condition, ignoring it is the worst thing you can do. Allow your child to see the world from the proper angle and prevent future complications; treat torticollis early!

– Amanda Kirk, DPT, is a physical therapist with Beaumont Macomb Pediatric Rehabilitation.

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