Torticollis/Plagiocephaly

Torticollis is a condition in which a baby’s neck can become tight and shortened on one side, which results in the baby keeping his/her head tilted to one side and often turned to the opposite side. It can sometimes lead to a condition called plagiocephaly, or a misshapen skull. Plagiocephaly usually results in flattening of the skull on the sides or back of the head and can also cause one ear to shift forward and one side of the forehead to push forward.

At PTLC, our therapists conduct evaluation and treatment of babies with torticollis and plagiocephaly.  Our therapists collaborate with other members of the medical team, such as physical therapists, optometrists, and/or orthopedic physicians, as needed to optimize outcomes.

• Keeps head tilted to one side
• Strongly prefers turning head to one side over the other
• Prefers feeding on only one side or facing one direction
• Difficulty visually tracking a toy to both sides
• Face seems asymmetrical (one side of cheek is fuller than the other, one eye may appear lower)
• Flattening on one side or back of head

Mild torticollis:

Moderate torticollis:

Severe torticollis:

(Images provided courtesy of Cranial Technologies)

Click here to see examples of plagiocephaly.

Both torticollis and plagiocephaly are much more common now, especially since the introduction of the Back to Sleep campaign to reduce SIDS deaths. Babies spend more time on their backs and in containers (like car seats, baby swings, and bouncy seats) than ever before, putting them at more risk for head flattening and keeping the head turned or tilted to one side.  Tummy time is critical to development, and many babies don’t get enough of it.  Click here for more information on tummy time.

Torticollis affects the entire child and is not just a head and neck problem. It can affect:

• Vision
• Sensory awareness of involved side/overall sensory development
• Gross and fine motor skills
• Skull shape
• Facial symmetry

Early recognition and treatment of these conditions is key to good outcomes. Babies who are diagnosed and provided therapy early (as early as possible in the first year of life) generally need therapy for a shorter duration than those who are diagnosed beyond 6 months.  Speak to your doctor and request a therapy referral if you suspect torticollis and/or plagiocephaly.  If plagiocephaly is recognized and treated early, more intense treatments like helmets are usually not necessary.