Torticollis

Torticollis is a fairly common condition in infants where the neck muscles (often the sternocleidomastoid- “SCM” muscle) become tight, leading many babies to consistently prefer turning or tilting their head to one side. Parents often first notice it during feeding, sleeping, tummy time, or in photos- when baby seems to always look the same direction.

While a mild head preference can sometimes be normal early on, a persistent preference may contribute to movement asymmetries, feeding challenges, delayed motor milestones, retained reflexes and head shape flattening (plagiocephaly).

The great news: early pediatric physical therapy is highly effective and often leads to excellent outcomes.

What Causes Head Preference or Torticollis?

There are several reasons an infant may develop torticollis or a strong side preference, including:

• Positioning in the womb  

• Birth positioning or delivery factors 

• NICU stays requiring prolonged positioning 

• Preference developed from sleeping or feeding positions  

• Neck and trunk muscle tightness  

• Reflux or discomfort that leads babies to avoid one side  

Since babies often spend so much time on their backs early in life, a strong side preference can quickly impact both head shape and movement patterns.

What Are Common Signs?

You may notice one or more of the following:

• Always looking or rolling to one side  

• Difficulty turning the head equally both directions  

• Flattening on one side of the head  

• One shoulder appearing higher  

• Asymmetrical ear positioning 

• Trouble with tummy time  

• Feeding better on one side  

• Preference using one arm/side more than the other  

• Delayed rolling or other motor milestones  

Many families are told to “wait and see,” but earlier treatment is often easier and more effective.

How Does Physical Therapy Help?

Pediatric physical therapy works to improve:

• Neck flexibility and strength  

• Symmetrical movement patterns  

• Tummy time tolerance  

• Positioning strategies  

• Developmental motor skills  

• Head shape and mild facial asymmetry management 

Our approach is play-based, gentle, and individualized to your baby and your family. Parent education is also a big part of treatment, so you feel confident using the strategies at home as part of everyday routines.