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TORTICOLLIS

804-828-3042
craniofacial@mcvh-vcu.edu

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Torticollis is a condition of limited neck motion in which the child holds the head to one side. The ear is tilted to the shoulder. This may be caused by “the baby’s position in the uterus or afterwards. It can cause a shortening of the neck muscle called the sternocleidomastoid muscle. If it is severe and not treated, the child may have difficulties with vision and walking. Torticollis may also cause a flattening to the back of the head called positional plagiocephaly. 

Home therapy will usually treat torticollis. In some cases,  physical therapy may be helpful. 

Below are some neck exercises  to help improve its range of  motion. They should be done at each diaper change.  The child can be placed flat on the couch, changing table or on your lap.

illustration - "Chin to Shoulder"

Chin to Shoulder

The head should be rotated so the chin is touching the shoulder.  Place one hand on the child’s face and the other shoulder.  Gently and firmly move the chin to the shoulder.  Turn the head to initial resistance and discomfort.  Hold for 10 seconds.  Repeat for three times.  Do this on both sides. 

   

Ear to Shoulder

This stretch will be more difficult. The head should be tilted to the left and right side so that the ear is touching the shoulder. Place one hand over the child’s ear and head while the other hand is on top of the shouder.  Gently and firmly tilt the head to the side and pull down on the shoulder.  Be sure that your baby is not trying to turn the head to the side as in the exercise above.  You should press to the initial resistance and discomfort and hold it for 10 seconds. You should do these exercises three times on each side.

illustration "Ear to Shoulder"

Over time you will need to increase the length of the stretch. This will be based on the baby, but the average is about every 5 days. You will need to do these exercises until the baby has normal range of motion.

If your baby has a flat spot on the back of the head, you should encourage lots of tummy time while the baby is awake.  When the baby is lying on his back you should reposition the baby’s head off the flat side. Please see positional plagiocephaly for treatment suggestions.