Short and Long Term Effects of Untreated Torticollis

Torticollis is the shortening/tightness of the muscles on one side of the neck, typically the Sternocleidomastoid muscle. It is a common diagnosis in infants and has many short term and long term effects if it is not treated.

Short Term Effects:

• A tight neck muscle may be uncomfortable for your baby so they will not be able to turn their head to look and interact with their full environment, which may lead to a delay in their development.
• If your baby is always looking in one direction, especially when on their back or laying in equipment, it places a lot of pressure on the back and side of their head. Your baby may develop a flatness on their head, which is known as plagiocephaly.  Plagiocephaly has many long term effects as well.
• Your baby’s Asymmetric Tonic Neck Reflex (ATNR) will not be integrated. The ATNR can be seen when a baby turns their head to one side and the arm/leg on that side extend and the opposite arm/leg flex. Infants have many reflexes present in the first several months of life that help them initially navigate their environment; however, as they grow older these reflexes become integrated. Integrated means that they will not automatically demonstrate this pattern when they move a certain way. An integrated ATNR means that they can turn their head to both sides without automatic arm and leg movement. The ATNR helps an infant roll, but if it is not integrated, crawling and walking may be delayed.
• Other musculoskeletal issues – Since your baby may not be able to turn their neck to see what is on the other side of their body, they may compensate by moving their spine or hip/pelvis in unnatural ways. This may lead to abnormalities in their spine alignment and hip dysplasia.

Long Term Effects:

• Delays in crawling and/or walking.
• Weak core strength may impact their ability to sit upright on the floor or in a chair. It may also affect their balance and may lead to more developmental delays in their gross and fine motor skills.
• A head tilt may be present and noticeable during all developmental activities such as sitting, standing, walking and as they grow older, it may also affect their schoolwork.
• Plagiocephaly, the flatness on the back/side of their head, alters the bony shape of their head which can lead to asymmetries in facial features that can be seen in their ears and eye positioning. Additionally, it may cause other developmental delays in gross motor, fine motor, language and cognitive skills

-Kelly Raines, PT, DPT