Infant Torticollis (& Plagiocephaly)

Physiotherapy is often all that is necessary to correct infant torticollis and plagiocephaly.

Quick Facts – What is it?

• Latin ‘Torticollis’ translation: Tortus= twisted and collum= neck.
• Tightness of a side neck muscle (sternocleidomastoid – SCM).
• Plagiocephaly, (aka flat head syndrome) = flat spot on back or one side of infant’s head.
• When the infant’s head has found a resting side preference, the head will thus tip to one side.
• It could be acquired (positioning preference after birth) or the baby can be born with it.

Possible Causes – Are there predisposing factors?

• It occurs when the sternocleidomastoid (SCM) muscle, on one side of the neck, is shorter or weaker than it should be.
• Position of the baby in the uterus.
• Infant staying in one head turned position for too long (torticollis).
• Infant lying on their back for too long (plagiocephaly). 
• Could be congenital (born with) muscular torticollis.

Complexity of Symptoms – Risk factors

• Affects the child’s ability of bending or turning the neck towards a shoulder.
• Head rotation may be hindered.
• Presence of a soft lump in neck muscle.
• Possible difficulty breastfeeding on one side.
• Infant may develop plagiocephaly (flattened side/area of baby’s head) from remaining in one position for extended periods of time.

Diagnosis

• Usually diagnosed by post-partum physician.  They will test the extent of the baby’s head mobility.
• If you notice your child unable to turn their head easily or have a flatter area of their heid, it may be a sign.

Treatment

• Treatment is essential to minimize difficulties as infant/child grows:
  • Limited control of their head
  • Poor balance
  • Problem feeding
  • Crooked crawling
•  Physiotherapy is often all that is needed to correct the tight muscle, and correct plagiocephaly.
  • Education, exercises, stretches, play-time tips, tummy time, etc.
•  CHEO has a program and resources available to help with self-management, as well as alternative treatment options when Physiotherapy is not enough.
  • Check out CHEO’s information and home exercise sheets!