Torticollis – Neck Tightness and Movement Preferences in Infants

Have you ever noticed that your child only looks to one direction while sleeping? Or maybe you’ve started to see that they only look or roll to one side? They might even sit with their head tilted to one side – where they look like they’re posing for a cute photoshoot? Any of these attributes may relate to what is known as “torticollis” (i.e. neck muscle tightness).


What is Torticollis?

Torticollis is a term used to describe neck tightness. This tightness comes from shortening of the “sternocleidomastoid muscles” on one side – a large muscle on the front of the neck which tips or tilts the head to the same side and rotates the head to the opposite side. This can occur in utero, if infants are fed in only one arm (and hence look to the same side/direction), being carried over one-shoulder at all times, or most commonly due to sleeping with their head turned preferentially to one side. Because of this sleep position they can also develop “plagiocephaly” (i.e. flattening of the skull) concurrently, which is another common condition treated by Paediatric Physiotherapists.


What does Torticollis look like?

If you are querying whether your infant may have torticollis, watch for these common indicators:

  • Your infant mostly looks to one side;
  • Your infant tilts their head to one side in sitting;
  • Your baby tends to sleep in the same position;
  • Your infant has a flat spot on their head (either on one side, or the entire back of the head); and/or;
  • Your infant has difficulty breastfeeding on one side;
  • Your child only rolls to one side or reaches with one hand;
  • Your baby doesn’t tolerate tummy time.

If any of these apply to your infant, you can inform your family doctor (to do a quick screen) or simply self-refer yourself to a Paediatric Physiotherapist.


What can I do at home?

Tummy Time!  Infants have so many opportunities to lie on their backs, and not just while sleeping.  Being in a car seat, swing, stroller or bouncy seat are common pieces of equipement parents use for their babies, but in all cases they have the back of their head against a surface.  Just because babies are encouraged to sleep on their back does not take away the importance of being on their tummy – this activates muscles needed for head control and shoulder stability and is so important for overall development.

Positioning! Try to find other options other than being on their back – lying on your chest or on a play mat or facing out in baby carriers (consult age recommendations on packages).  When they are in lying (on back or belly) or in supported sitting encourage them to look to the side that they typically turn away from. If you notice that you feed or carry your child over one shoulder, try switching sides often to get them looking in a different direction!

A paediatric physiotherapist can help with more targeted strategies and treatment.


Early Intervention is Best! How Physiotherapy can help your infant.

We understand that knowing your child may present with torticollis can be distressing to you as a parent. Butterfly Physiotherapists are trained in infant conditions and can provide you with the support and education you need to answer any questions you may have, allow you to take an active role in recovery, and be confident that your child is in good hands. We look at the child and family as a whole, and combine education and treatment about the specific neck issue with important early intervention to ensure gross motor milestones are not being compromised.

Early intervention is important, so don’t wait!

Give us a shout at Butterfly if you are looking for hands-on physiotherapy to help! (905) 206 – 0300.