06/05/2025
⬛Torticollis is a stiff neck that makes it hard or painful to turn your head. In older kids and adults, it can happen after sleeping in a funny position. Babies can be born with a stiff neck, but the condition is a little different and not painful
💠causes torticollis?
There are various causes of torticollis; this leaflet explains the muscular torticollis for which you have been referred to physiotherapy. In some cases, it is not clear why a baby has torticollis but some contributory factors could be:
Positional- this more common in breech babies or babies who were overdue.
Forceps delivery or trauma.
Repetitive patterns (i.e. attention drawn to one side continuously e.g. looking to one side continuously).
🔶Symptoms
The head tilts to one side, and the chin points to the opposite shoulder. In 75% of babies with torticollis, the muscle on the right side of the neck is affected.
Limited range of motion in the neck makes it difficult for the baby to turn their head side to side and move it up and down.
During the baby's first few weeks, a soft lump may be felt in the affected neck muscle. This lump is not painful and gradually goes away before the baby reaches 6 months of age.
One side of the face and head may flatten because the child always sleeps on one side.
⭕Physical therapy intervention⭕
🔵Forward Head Pulls
While standing next to a counter, place your right hand on the back of your head. Hold the edge of the counter with your left hand.Slowly turn your head about 45 degrees to the right and then look down. You should feel a stretch in your neck and shoulders. If you can, use your right arm to gently press down on your head to deepen the stretch. Hold for up to 40 seconds.
🔵Opposing Rotations
Stand straight and lace your fingers together behind your head. Extend your elbows outward.
Slowly turn your head in the direction opposite your torticollis. Keep your shoulders and arms still. When you feel a stretch in your neck, hold your position for thirty seconds, then release back to a neutral position. Repeat this three to five times a day.
Once you feel comfortable doing this exercise on its own, you can add resistance to it. Lie on your side with your head on a pillow, with your torticollis causing you to look up. Gently turn your head towards the pillow and push your face into it, then hold this position for thirty seconds
🔵Sideways Head Pulls
Stand next to a counter so that your torticollis causes you to lean your head towards it. Hold the counter with your nearest hand.Place your other hand on top of your head.Lean your head away from the counter, aiming your other ear towards your shoulder. You should feel a gentle stretch. Use the hand on your head to deepen the stretch. Hold this position for up to forty seconds.
🔵Visual Tracking
When lying on their back, help your baby to
look at and follow faces or toys. Slowly move the toy to the right side in order to encourage head turning. Repeat this activity while your baby is lying on their tummy or sitting with
support.
🔵Side bending
Hold your child’s LEFT shoulder down with your RIGHT hand. Place your LEFT hand on top of the LEFT side of your child’s head and slowly bend their head towards their RIGHT shoulder.
Hold for a count of 5Repeat x 3
🔵Rotation
Place your LEFT forearm against your child’s RIGHT shoulder, and cup your child’s head with the same hand. Use your RIGHT hand to hold your child’s chin. Slowly rotate your
child’s face to their LEFT.Alternatively, roll your child onto the LEFT side. Keep their interest with a toy or eye contact. Gently roll your child's body onto their back whilst keeping their head rotated to the LEFT.Hold for a count of 5Repeat x 3Alternatively, roll your child onto the LEFT side. Keep their interest with a toy or eye contact. Gently roll your child's body onto their back whilst keeping their head rotated to
the LEFT.Hold for a count of 5Repeat x 3
🔵SIDS
Sudden Infant Death Syndrome (SIDS) is the sudden unexpected death of a baby from
no cause. The current recommendations for preventing SIDS are:
🔹Dos:
- Place your baby on their back to sleep from birth
- Sleep your baby with their face and head uncovered at all times
- Dress your baby in clothing appropriate for the weather
- Encourage tummy time when you baby is awake and being supervised by an
adult
🔹Don’ts:
- Never sleep your baby on their tummy or side in
any environment, even when resting on an adult’s
chest
- Never leave your baby surrounded by loose
bedding, toys or clothing
- Don’t sleep your baby on a tri-pillow (boomerang
pillow), bean bag or hammock
- Don’t expose your baby to cigarette smoke
🔵Neck Rotation During Tummy Time
When your baby is enjoying tummy time, you can work on neck rotation exercises to help with torticollis. Place their favorite toys and colorful baby-safe objects to the side of your baby, and encourage active looking towards the toys. You can also assist your baby in rotating their head by gently turning their head during tummy time.
🔵Lateral Head Tilt
When the sternocleidomastoid muscle becomes tight, the head and neck get pulled towards the tight side. To stretch this, sit with your knees bent and hold your infant on your thighs. To stretch the right side of the neck, hold your baby's right shoulder down while slowly and gently bending their head away from the shoulder. Hold for 20-30 seconds and repeat four times. Do this multiple times during the day.
🔵Cheek-to-Cheek Hold
To gently rotate your baby's neck away from the tight side, hold your baby upright against your chest and neck. Press your cheek against your child's cheek, and slowly press your cheeks together, allowing your child's head to rotate away from yours. Hold this position for 5-10 seconds, and release. Repeat five times. A mirror may be used to keep baby engaged and turning their head to one side.
🔵Side-Lying Head Lift
To have your baby actively engage their lateral neck muscles, you can try the side-lying head lift exercise. Place your baby on one side, and be sure they are supported by a rolled-up towel or blanket behind their body. Then, use engaging and age-appropriate toys to keep your baby's attention, and move the toy up away from the floor.
Your baby may naturally try to follow the toy with their eyes and head, lifting their head up sideways and engaging their lateral neck muscles. Perform this for a few minutes, and then give them a rest. (Your child may become fussy if you exercise too much with them
⛔⛔Prevention⛔⛔
Change your baby's body position often when they are awake.
Limit the time spent positioned in car carriers, swings, and strollers.
Provide ur child with supervised tummy time to strengthen neck, shoulder and back muscles.
Monitor your child for signs of neck tightness on one side, and check-in with your pediatrician if you suspect any problem with your baby.