What is Torticollis?

Torticollis refers to the tightening or shortening of the muscle on one side of your child’s neck known as the Sternocleidomastoid (SCM). This can pull your child into a combined rotation and lateral flexion position. It may be quite difficult for them to move out of this position as associated muscle weakness can occur. This condition can generally be picked up within the first month of life, however may be diagnosed at a later stage. It is optimal to have it assessed by your Paediatric Physiotherapist to determine the type of Torticollis as most will resolve well within a few weeks with a home program performed daily, however, some may require further investigation.

What are the different types?

• Congenital Torticollis; Muscular vs Postural
• Acquired Torticollis

Torticollis can be congenital which means it can be present from birth, or it can be acquired.

Congenital Torticollis may be muscular of nature or postural. Muscular Torticollis is caused by shortening of the neck muscle as mentioned previously and will demonstrate some passive range of motion (PROM) deficits on assessment, a palpable SCM mass and/or craniofacial asymmetry. Postural Torticollis may present similarly to muscular torticollis with a head preference to one side however, they will not present with any muscle shortening or PROM deficits on assessment.

Acquired Torticollis can stem from a conglomerate of aetiologies such as muscle spasm, trauma, subluxation of the upper cervical spine, infection, inflammation or ocular dysfunction. It is important to always be assessed by your Paediatric Physiotherapist in this instance to determine the most appropriate treatment and referral pathway.

Are there signs and symptoms?

You may notice that your child favours looking to one side when lying on their back to play and sleep, they may feed better on one side if they are breast fed or find it difficult to look in both directions evenly when being held. These are signs that your child may have a Torticollis and should be assessed by your Paediatric Physiotherapist. You may also notice some flattening on the back of their head. This is called Plagiocephaly and can be highly associated with Torticollis as their skull bones are quite soft when they are born. Your Physiotherapist can help to classify the severity of this and determine the most appropriate treatment pathway.

If you have any concerns for your child or notice any of the aforementioned information, please see our Paediatric team for an assessment here at Penrith Physiotherapy Sports Centre.

What can a physio do?

Your Paediatric Physiotherapist will perform a routine assessment on your child to determine the type of torticollis presentation, and screen for additional pathologies that may be present such as Plagiocephaly, Developmental Dysplasia of the Hip (DDH) and Talipes. Based on assessment findings, you may be given a home exercise program that encompasses stretching in cervical rotation and/or lateral flexion combined with additional advice on positioning your child throughout the day. You may also be encouraged to increase tummy time throughout the day as this will give your child the opportunity to strengthen the muscles in their neck and develop optimal head control. We recommend 10 minutes for each month of life spread throughout the day. If your child finds tummy time quite challenging, it is important to talk to your Physiotherapist for additional techniques to increase their tolerance.