Tips for Infants with Torticollis

By: Cassidy McCoy PT, DPT

Torticollis is the third most common congenital anomaly that affects infants. It is defined as a head preference, usually a head tilt with one ear close to the shoulder with head rotation to the opposite direction. This is typically due to a muscular imbalance/tightness through one of the sternocleidomastoids, a muscle that crosses the head and neck, or from positioning in utero.

Torticollis can affect the entire child. It is not just an issue of the head and neck.

Without intervention, an infant with torticollis can lead to multiple sequelae in an infant/child. The head preference can lead to the following, however not limited to:

• Plagiocephaly – flattening of one side of the head
• Lack of visual tracking to the involved side
• Decreased use of the involved sides hand/arm
• Shortening through the entire involved side including head, trunk and hips
• Decreased midline skills
• Decreased sitting balance
• Imbalance of muscular strength between right and left sides

The biggest treatment intervention that can assist in “correcting” the affects of torticollis is positioning.

The following examples will be for an infant/child with a tilt to the right (right ear to right shoulder).

1. Rolling: With a right tilt, your child will more easily roll over their left side to access toys
   1. Place toys or shake a rattle on their right side to encourage them to roll over their right side
2. Sitting: With a right tilt, your child will sit with more of their weight over the left side of their body.
   1. Place toys over to the left side to encourage the shift their weight over the right hip
3. Face-Face Play and Crib positioning: Typically with a right tilt, the infant/child will prefer to look to the left.
   1. Position your body to the right side your child’s face to encourage them to look to the right
   2. Position them in their crib so they need to turn their head of the right in order to see the door/your face
4. Carrying positions:
   1. Tilted carry: Hold your child facing away from you body, with their back against your chest, tilt them to the right. This will encourage your child to lift their head to the left, increasing strength of the left side and actively stretching the tight right side.

5. Tummy Time:
   1. This is an important part of any child’s development, however, for children affected by torticollis, tummy time important for constantly stretching the muscle by lifting and turning their head.
   2. Toy placement in prone with a tilt to the right is the same as in sitting. Place the toys to the left to encourage weight shift over the right side of the body to reach and play with the toys using the left arm.

See my previous blog for more tips and trick on tummy time. If you have concerns about your infant’s development, contact our Intake Coordinator at 630.282.2022 to ask questions or schedule an appointment.