Pediatric Series, #1 – Torticollis

What is torticollis and does your child have it? We will discuss what the word means, what to look for, how is it caused, and how to get help for your little one.

What is Torticollis?

Torticollis in Children

Torticollis is a neck deformity where the head constantly tilts or rotates to one side, or a combination of both. This coincides with a stiff neck where there is muscle tightness on the side of the tilt and a decrease in range of motion in the opposite direction of the tilt and rotation. In infancy, if the torticollis remains untreated, “plagiocephaly” or skull and facial deformities may develop.

The Causes of Torticollis

There are multiple causes which further classify pediatric torticollis into “congenital torticollis” and “acquired torticollis”.


Congenital torticollis means your baby was born with the torticollis due to either shortened and tight muscles on one side of the neck from positioning in the womb, known as “muscular torticollis”, or Klippel-Feil syndrome (much less common). Klippel-Feil syndrome is a genetic phenomenon where two or more vertebrae in the neck are fused during fetal development.


Acquired torticollis occurs after birth and may result from several situations. One such situation being imbalanced positioning during the first few months of life when your baby does not have the strength to correct her head positioning against gravity.


If your baby is unknowingly and consistently being placed in a position where her head is leaning to only one side, that side with eventually tighten and she will have developed “muscular torticollis”.


A second situation may be lymph node swelling from a cold or an ear infection, in which case your child may hold her head in a position of comfort in response to inflammation and pain. In this case, the torticollis should resolve itself after your child gets over the illness.


Another situation may be head or neck trauma. Again, your child may position the head away from midline for comfort. In this last case, be sure to determine the method of injury and ask your child’s doctor about any concerns to rule out more serious injury.

If my child has it, what do I do?

If your baby presents with congenital torticollis, typically the pediatrician will catch this early on, during your baby’s wellness first few visits. Your baby’s doctor will be able to determine whether the torticollis is due to shortened neck muscles, or another cause. If your child has muscular torticollis, the pediatrician may show you some stretches and recommend physical therapy.


Here at Rebound Hawaii, we treat muscular torticollis through stretching, positioning, and strengthening. We also educate parents and equip them with a therapeutic program to carry over treatment at home to optimize success.


It is important to address torticollis early to reduce the appearance of plagiocephaly and prevent compensations related to vision, posture, muscle imbalance, and gait pattern. If you have any questions, do not hesitate to contact us!