Treating Infants with Torticollis

It is painful to the infant and can cause fussiness and discomfort.

There is nothing to do to prevent torticollis from occurring, however, there are techniques to help treat and improve head turning to release the stiffness in the neck muscles.

The neck muscles on the affected side feel tense and when palpitated, feels to be hard or a “knot” in the neck.

Torticollis can be diagnosed by a doctor during a physical exam of their ability to head turn. If you are concerned with your child’s ability to turn their head, consult a doctor to see if they have torticollis. If your infant does have torticollis, your doctor will refer you to get therapy and will monitor your baby’s progress every few weeks will condition has improved.

How can you tell if your child has torticollis?

• Tilting their head to one side
• Turning head to the preferred and comfortable side
• Tracking with their eyes but do not turn their head to the direction intended
• Prefers feeding to one side, cannot fit comfortably in opposite side
• Easily frustrated when unable to turn to look at you

Right vs left torticollis

There is no difference between having a pulled neck muscle on the right side vs left side. An infant that has torticollis on the left side or right side could be due to the way they were positioned in the womb or after birth. There is no known reason as to why an infant may have torticollis, however, it can be improved with treatment and gentle stretches.

What can you do to treat torticollis?

If your infant does have torticollis, you can help treat your child at home as well as get the recommended therapy to improve their condition. Occupational or Physical Therapist can treat torticollis and teach you how to perform these techniques to develop their neck muscles and get rid of the stiffness in the neck.

• Stretch the neck side to side while placing the infant in a supine (on their back). You can also move their head gently forwards/ backward in the midline to allow muscles to relax (passive range of motion)
• Place the infant in prone (on their tummy) and allow them to lift their head. Turn their head to the affected side (side they are avoiding) and allow them to tolerate a few minutes on that position. Make sure to ease the baby into that position without any forceful pushes to avoid further injury and pain to the baby. This will help stretch and strengthen the neck muscles for improved neck range of motion. Tummy time will also help avoid your baby from getting a flat head.
• When baby sleeps, roll a small washcloth and place at the neck of the affected side to gently stretch neck while baby sleeps
• When the baby is awake, place the infant on the affected side inside laying towards the wall. This will encourage them to turn their head to look for movement and people
• Using a rattle, allow the baby to track the toy and allow them to gently move their own head to the desired direction or both directions (active range of motion)
• Rub their neck muscles when possible to help loosen the muscles
• When feeding, position them on the affected side (the side they do not like) to encourage a stretch the neck

Types of Stretches

• Actively engaging infant on opposite side with toys to encourage stretching.
• Gentle range of motion in a circular pattern of the neck.
• Positioning the infant on its side to face the wall and allowing them to turn their head towards sounds.
• Placing them on their tummies and allowing them to lift their head up in the midline. As they lift their head, stimulating them with toys to look towards both sides to encourage the infant to perform their own active range of motion.

Preventing Torticollis

There is no way to prevent torticollis as it can happen unexpectedly, however there are exercises that you can perform to encourage the range of motion to prevent stiffness. Positioning the infant when placing them to sleep or when holding plays a role in decreasing stiffness in their neck.

Conclusion

Torticollis does get better with positioning, strengthening and stretching exercises. It does take time to improve, however there is hope. Perform these activities daily 5 to 7 times a day and get the recommended therapy to allow your baby to develop in a healthy manner. If therapy and these techniques do not improve, your baby may need muscle release surgery if not improved with therapy.