Torticollis: What is it and how can you prevent it in your infant?

What is torticollis?

Torticollis is a shortening of muscles, specifically the sternocleidomastoid (SCM) muscle, on one side of an infant’s neck. Torticollis is very common in infants and can be treated or prevented. Torticollis can also accompany plagiocepahly or a flat spot on the head. The tight muscles of the neck can promote lying on one side of the head which can change head shape. Plagiocephaly can occur in infants due to the soft spots on their skull and their skull bones not being fused yet.

What are the signs of torticollis?

The most common sign of torticollis is a rotation of the neck to one side and a head tilt. The tightness of the neck muscles will result in a strong preference for the infant to position their head to one side. It will be difficult for the child to look in the opposite direction. They will struggle to rotate their head to one side and will not be able to maintain their head position in that direction.

What is the cause of Torticollis?

Torticollis can happen for a variety of reasons. Some infants are born with torticollis due to their positioning in utero. This happens often in larger babies and multiples. Torticollis can also develop in the months after birth and can be prevented.

Tips

  • Switch which arms are holding or feeding your baby (when bottle fed)
    • Although one way may be more comfortable for you, it is important to switch which side you are holding your baby on. Switching the side you are holding them on can decrease the risk for tightness in their neck and encourage them to look and turn their head in both directions.
  • Alternate which way you lay your baby in their crib daily
    • This encourages your baby to look to the opposite side when looking out of the crib for you or other motivating objects to look at.
  • Limit your baby’s time in containers such as swings, bouncers or car seats
    • Although practical for day to day with an infant, containers can encourage a baby to have one sided preference. Minimize the time a baby is sleeping in a car seat and awake in bouncers or swings.
  • Increase the time your baby is on their tummy
    • Tummy time is extremely important for developing neck and core strength in infants.  When in tummy time encourage your infant to look to both directions by talking to them or encouraging them to track to both sides. If your infant does not enjoy tummy time, do short bursts of tummy time frequently throughout the day. Work up to having your baby on their stomach for 2 hours total daily.

Treatment for Torticollis

Torticollis is commonly treated by a pediatric physical therapist. This would begin with an evaluation by the therapist to identify the child’s needs. When caught early, (2-4 months of age) Torticollis can be treated in a short time period. Treatment of torticollis includes: stretching, soft tissue massage, neck strengthening exercises, positioning techniques, ROM exercises and tummy time modifications. If you have concerns for torticollis in your infant, contact LLA Therapy for an evaluation by a physical therapist.

-Alexa Bachmann, Physical Therapist

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