Torticollis Exercise

What is torticollis?

Torticollis simply means “twisted neck­­” in latin and describes an asymmetrical neck position. It is a shortening or tightness in the muscle called sternocleidomastiod or SCM. It can cause the chin to turn to the opposite side and the head to tilt to the affected muscle. It is a common condition and can be present at birth or devlop shortly afterwards.

What 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).

In some cases, it can be a result of a tumour in the muscle (don’t worry this is just a phrase, nothing to do with cancer). This can be felt as a lump in the muscle although no-one is certain what causes the lump and can appear when the baby is 2-3 weeks old. Usually we ask that this is ultrasound scanned at your local hospital.

Signs and symptoms

• Preferential head turn- mostly looking one way, your baby may have difficulty holding their head in midline.
• Difficulty turning their head to feed.
• A swelling in the side of your baby’s neck.

Treatment

With treatment, most babies regain full range of movement in their necks. Your baby’s movement will be monitored by your physiotherapist and if there is no improvement they may refer your baby onto the Orthopaedic department for further assessment. Torticollis can occur on either side of your baby’s neck.

• Carrying your baby:

With your child facing away from you in a side lying position, have your child’s left ear resting on your left forearm. Try to get your forearm or hand between the child’s ear and shoulder to help stretch the tight muscles in their neck.  You can use your forearm to lift your baby’s head away from the shoulder to get a side bending stretch.

Carry your baby up against your right shoulder so they look outwards and therefore to the left.

• Positions of play:

Playing on their tummy is important when your child is awake. It helps them to develop head control and strengthen their back and neck muscles. Encourage your baby to look to the left side while playing on their tummy. You can position a rolled-up towel under your baby’s chest to elevate their head slightly. Tummy time should always be supervised.

Side lying play is also important for your baby’s development to encourage hand to hand play for feeding, and to practice hand eye co-ordination.  It will also allow gravity to give your baby a gentle neck stretch.

• Stretches

Side stretch – The best place and time to do this exercise is on the floor or on a changing mat, shortly after a feed so that your baby is content and settled.  Place your baby on their back.  Hold your baby’s left shoulder down with your right hand. Use your left hand cupped over the top of their head.  Slowly bend their right ear to their right shoulder.

Rotation (head turning) – Place your right hand on your baby’s right shoulder.  Place your left hand on the side of your baby’s face.  Slowly turn your baby’s head to look over their left shoulder.

For general advice on head turning preference and flattening of baby’s head please click here.