As parents, we watch for every smile, giggle, and movement our babies make. But sometimes, those little head tilts or preferences for one side can be signs of a common but treatable condition called torticollis. When diagnosed and addressed early, infant torticollis can be effectively managed with physical therapy, leading to healthier development and happier babies.
In this article, we’ll explain what torticollis is, what causes it, the signs to look for, and why physical therapy is often the most effective treatment. Whether you’re a new parent, caregiver, or pediatric healthcare provider, understanding torticollis can make a big difference in an infant’s development.
What is Infant Torticollis?
Torticollis, sometimes referred to as “wry neck,” is a condition where a baby holds their head tilted to one side, often with the chin turned to the opposite side. It occurs when the sternocleidomastoid (SCM) muscle in the neck becomes tight or shortened.
There are two primary types of torticollis:
- Congenital Muscular Torticollis (CMT): The most common type, present at birth or noticed within the first few weeks. It may result from the baby’s position in the womb or trauma during delivery.
- Acquired Torticollis: This develops later and can be due to a variety of factors including illness, trauma, or underlying neurological or orthopedic conditions.
What Causes Torticollis in Babies?
The exact cause of congenital torticollis isn’t always known, but several contributing factors include:
- Positioning in the womb: Limited space or awkward positioning can cause muscle tightness.
- Birth trauma: Long or difficult deliveries, especially with forceps or vacuum assistance, may strain neck muscles.
- Tightness in the SCM muscle: This leads to restricted neck movement.
- Plagiocephaly: A flat spot on one side of the head, often associated with torticollis.
- Back sleeping position: While important for reducing SIDS risk, consistent sleeping on the back without sufficient tummy time can contribute.
Signs and Symptoms of Torticollis in Infants
Parents are often the first to notice something is off. Some common signs include:
- Baby always tilts head to one side
- Baby prefers to look in one direction
- Difficulty turning head to both sides
- Flattening of one side of the head (plagiocephaly)
- Facial asymmetry
- Trouble breastfeeding on one side
- Delays in motor milestones like rolling, crawling, or sitting
Early recognition is key. If you suspect your baby may have torticollis, bring it up with your pediatrician as soon as possible.
Why Physical Therapy is the Gold Standard Treatment
Physical therapy is the most effective and non-invasive approach to managing infant torticollis. Starting therapy early gives babies the best chance for full recovery and normal development.
Here’s how physical therapy helps:
- Stretching and Lengthening the Tight Muscle
A PT uses gentle, guided stretches to lengthen the tight SCM muscle, improving neck range of motion.
- Strengthening the Opposite Side
Therapists guide babies through movements and play-based activities to strengthen weak or underused muscles.
- Promoting Symmetrical Movement
PTs incorporate activities that encourage the baby to turn and move their head in both directions.
- Improving Head Shape
If plagiocephaly is present, positioning techniques and supervised tummy time help round out the head.
- Parent Education
Therapists teach caregivers how to integrate exercises into daily routines, like diaper changes, feeding, and play.
The Importance of Early Intervention
Time matters. The earlier torticollis is addressed, the faster and more complete the results.
- 0-3 Months: Ideal window for early detection and treatment
- 3-6 Months: Treatment still effective but may take longer
- 6+ Months: Delayed intervention may require more intensive therapy
Untreated torticollis can lead to persistent head shape issues, delays in motor development, and compensatory habits that are harder to break later.
What a Physical Therapy Session Looks Like
Therapy sessions for torticollis are gentle, play-based, and tailored to your baby’s needs. Here’s what you can expect:
- Assessment of head position, range of motion, and motor development
- Hands-on stretching and muscle release
- Guided activities to promote balanced movement
- Use of toys, mirrors, and songs to make therapy fun and engaging
- Home exercise guidance and positioning tips
Most sessions last around 30-45 minutes and occur 1-2 times per week depending on severity.
What Parents Can Do at Home
PTs will give you customized strategies to continue progress between sessions. Common tips include:
- Tummy time: Supervised time on the belly strengthens neck and trunk muscles.
- Switch sides: Change feeding positions, crib orientation, and play direction to encourage turning both ways.
- Engage with toys: Use sound or visual cues on the non-preferred side.
- Carry smart: Hold baby with their non-preferred side outward to encourage turning.
Consistency is key. Daily practice at home reinforces the gains made during therapy.
How Long Does Treatment Take?
Every baby is different, but many improve significantly within a few weeks to months of consistent therapy. Factors that affect recovery include:
- Age of diagnosis
- Severity of muscle tightness
- Presence of plagiocephaly
- Family commitment to home exercises
With early and consistent PT, most babies achieve full resolution without lasting issues.
When to See a Specialist
If your pediatrician notices or you observe any of the following, ask for a referral to a pediatric physical therapist:
- Baby always turns or tilts head to one side
- Limited neck motion
- Flat spot on head
- Difficulty breastfeeding on one side
- Delays in rolling, crawling, or sitting
Why Choose Hohman Rehab and Sports Therapy for Infant Torticollis?
At Hohman Rehab, we understand how concerning it is to notice something off with your baby’s development. Our pediatric-trained physical therapists provide compassionate, effective, and family-centered care to help your baby thrive.
We use:
- Gentle, age-appropriate therapy techniques
- Customized home programs
- One-on-one sessions
- Parent support and education every step of the way
Our Locations
We offer care at three convenient Central Florida locations:
Clermont Office
236 Mohawk Road, Clermont, FL 34715
Phone: 855-404-6908
Fax: 352-404-6909
Ocoee Office
11095 W. Colonial Drive, Ocoee, FL 34761
Phone: 855-404-6908
Fax: 352-404-6909
Apopka Office
125 S. Park Ave., Apopka, FL 32703
Phone: 407-410-3200
Don’t Wait—Early PT Helps Babies Grow Stronger
Torticollis can feel overwhelming at first, but with the right support, it’s a very manageable condition. Physical therapy plays a key role in helping babies overcome neck tightness, improve head shape, and meet developmental milestones with confidence.
If you think your baby may have torticollis, talk to your pediatrician and contact our team at Hohman Rehab. We’re here to support you and your little one every step of the way.
Together, we can help your baby grow, move, and thrive.
Written By:
Dr. Katie Hohman
Physical Therapist, Certified Lymphedema Therapist, Founder
