Torticollis

What to do if your baby has torticollis

What is torticollis?

Torticollis, sometimes called ‘wryneck’, is a condition where the sternocleidomastoid muscle (SCM) is shortened or tightened on one side causing the head to be tilted toward the tight side and turned toward the other side. Sometimes there is a lump felt in the muscle within the first month. Usually, it will disappear by four months of age.

infant playingThe SCM muscle has two parts, one part coming from the clavicle (collar bone) and the other from the sternum (breast bone). These muscles go up the side of the neck and join together to form one thick muscle ending behind the ear. (When you turn your head, you can feel the muscle sticking out).

What causes torticollis?

The cause of torticollis in not fully known. It may be caused by the baby’s position in the womb. It may be caused by plagiocephaly when a baby has a flattened head shape or has a preference to keep their head turned to one side.

What do I do if my baby has torticollis?

Talk to your doctor about your concerns. They will usually recommend you see a physiotherapist who has been trained to treat torticollis. If you need treatment, you can contact our intake team to make a referral for physiotherapy

How is torticollis treated?

There are three main treatments that physiotherapists use: positioning recommendations, strengthening exercises and stretching exercises.

Positioning recommendations

  • Position your baby in their crib so that they have to turn their head to the tight side to look at you when you approach.
  • Place toys on the side of your baby’s tight muscle or right above your baby’s head. Mobiles are excellent for helping your baby look up with their heads in the middle and mirrors and colorful musical toys placed on the sides of the crib can help encourage head turning.
  • Avoid having your baby sleep in car seats or sitter chairs as this will encourage your baby’s head to tilt to one side.
  • Your physiotherapist can show you how to place a rolled blanket along your baby’s back to keep their head in the middle when they are in a car seat, or when laying on the floor.

Using baby equipment

Limit time in baby equipment such as Jolly Jumpers or Exersaucers. Wait until your baby is able to sit on their own before using them.

When your baby is awake, spend some supervised playtime in a side lying position: have your baby lay on their left or right side, with a roll behind their back providing additional support.

When awake and supervised place your baby on their tummy to play. By 3 months of age your baby should be spending about one hour a day (in total) on their tummy to play.

Tummy time is important for your baby to develop head control and it helps your baby to strengthen their body to learn to crawl, sit and eventually walk.

Tummy Time

Strengthening neck muscles and improving head control

Age one to three months

Encourage your baby to keep their head in the middle instead of turning to one side.

Play games such as pat-a cake, encouraging your baby to bring their hands together.

To help strengthen your baby’s neck you can gently lift them up by supporting the shoulders and head, until they are in a sitting position. Lower them down again while keeping their head in the middle.

When your baby is laying on their back, sing or talk to them. Young babies especially like faces. Encourage your baby to turn their head to look at you and follow your movements.

Place an unbreakable mirror in your baby’s crib on the side of the tight muscle. Using mobiles, rattles (or other noise-making toys) and colorful toys, encourage your baby to hold their head to the middle, and turn it to the right and left sides.

Provide supervised tummy time while your baby is awake. Have your baby lay on their tummy on the floor, or across your lap. Place toys in front of them to encourage them to lift their head.

After three months

With your baby sitting on your lap, gently tilt them slightly to one side and wait for your baby to realign their head to an upright position. Repeat this in all directions (i.e. right, left, forwards, and backwards).

Stretching neck muscles

demonstrating stretching the neckDepending on which muscle is tight your physiotherapist will show you how to stretch your baby’s neck muscles. The stretches are done gently and should be done as often as you change your baby’s diaper. Your physiotherapist will watch that your baby’s neck movements are improving. They will also monitor your baby’s development.

This information has been developed and provided
by TVCC with the
support of the Middlesex-London Health Unit

pdfDownload this brochure (pdf) 

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