What Is Torticollis in Babies? And Does Pediatric Physical Therapy Help?

Quick answer: Torticollis in babies is a condition in which a baby consistently tilts or turns their head because of an imbalance or tightness in the neck muscles. Early evaluation and pediatric physical therapy can help improve neck movement, strength, positioning, and symmetry, especially when treatment begins soon after the condition is identified.

What is torticollis in babies?

Torticollis in babies occurs when your baby’s neck muscles cause their head to tip and rotate to the opposite or same side. The top of their head may be tilted to one side, and their chin may be tilted to the other side. This means the head can tilt left and turn left, tilt left and turn right, tilt right and turn right, or tilt right and turn left.

With torticollis, the main muscle that is tight is the sternocleidomastoid, which is one of the most superficial muscles in your neck.

Quick guide: signs, causes, and treatment for torticollis in babies

In infants, the most common form of torticollis is congenital muscular torticollis, which involves tightening or shortening of the sternocleidomastoid (SCM) muscles in the neck.

Signs of Torticollis in Babies

The baby’s head is consistently tilted to one side.
The chin points toward the opposite shoulder.
The baby has difficulty turning their head in one direction.

What causes torticollis in babies?

Torticollis can develop for several reasons, and the exact cause is not always clear. In babies, it most often involves tightness or shortening of the sternocleidomastoid (SCM), a muscle that helps control head and neck movement. Factors that may contribute include:

Positioning in the womb: Limited space or a baby’s position before birth can place pressure on the neck and contribute to muscle tightness.
Birth-related strain: Less commonly, a difficult or traumatic delivery may strain the SCM, leading to swelling, tightness, or scar tissue.
Positioning after birth: Babies may develop or reinforce a preference for turning or tilting their head in one direction based on how they are held, fed, carried, or positioned. Placing a baby in seated positions before they have enough strength and head control may also contribute to an uneven posture.

Some babies may also be born with an unusually short or underdeveloped SCM. More rarely, torticollis can be associated with other medical conditions, such as infection or inflammation in the neck.

Treatment for Torticollis in Babies

The treatment depends on the baby’s age, severity, underlying conditions, and how quickly the condition was detected. Physical therapy, gentle stretching, and supervised tummy time can help strengthen the neck. Surgery may also be considered if the condition persists despite approved conservative treatment or when there are severe deformities.

Parent question	Quick answer	What to do next
Is torticollis serious?	In most cases, the condition improves well with early recognition and treatment.	Seek advice early rather than waiting for it to resolve on its own.
Can tummy time help?	Supervised tummy time can encourage babies to lift and turn their heads and develop neck strength.	Give frequent, short periods of supervised tummy time while your baby is awake.
What exercises can I do?	Gentle positioning and stretching exercises may help improve neck movement.	Only perform stretches or exercises recommended and demonstrated by your baby’s healthcare professional.
When should I seek medical help?	Seek medical advice if your baby has persistent head tilting, limited neck movement, pain, weakness, or other unusual symptoms.	Contact your pediatrician/doctor for an assessment.

Is torticollis common in infants?

Most babies are born with a little bit of torticollis. Now, does that mean every baby needs pediatric physical therapy? No. But it is more common than you think.

There are cases that range from very minimal to severe. Westside therapists encourage parents to try to discourage feeding into the child’s pattern. Working on trying to hold the baby in the opposite arm or keeping their head neutral will help decrease torticollis tendencies.

What age is torticollis noticed and treated?

With any therapy, the earlier you can get your baby treated, the better. This is especially true with something like torticollis, which can actually have effects on the entire body.

The earliest a Westside therapist has seen a baby to treat torticollis was 7 days old. That was an extreme situation. The other end of the extreme was waiting until 18 months.

The typical age range is:

2 to 4 months old. This is the ideal time to get your baby in if you notice they may have torticollis. It is also typically when your pediatrician would refer you to therapy.
6 to 8 months old. This is still a good time to get a baby in for treatment, but therapists recommend getting in before. Between the ages of 4 and 8 months is where many major motor milestones develop, and it is easier to treat before that occurs.

When a child comes in for physical therapy early, they can also get out early! The longer you wait to get your baby in, the more time they may have to spend in therapy.

What is the average time spent in therapy? It is usually recommended until your baby is walking. That does not mean you are coming every week. As mentioned, torticollis can affect the entire body. We want to make sure your child’s gross motor movements (rolling, crawling, and walking) look symmetrical and appropriate.

If we see the symmetry that we are working toward, we are quicker to decrease the frequency of your visits.

How is torticollis diagnosed?

Torticollis is usually diagnosed one of two ways:

Your pediatrician will be able to notice it early. They will see that the neck seems tight and recommend physical therapy.
You can pick up on important signs yourself, such as:
- Your child isn’t turning one way.
- You see a neck tilt.
- You have a hard time feeding one way.
- You notice that your baby likes to go one way and not the other.

As a first-time parent, it may be tough to pick up on certain signs like that. But you can still try to be aware, and if you notice anything that seems off, talk to your pediatrician.

When should you be concerned?

You’ll likely go in to see your pediatrician for your initial 2-week visit, 1-month visit, and so on. Your doctor will also likely be able to notice any hints of torticollis. If you have concerns around 2 months and don’t see improvements by 4 months, that would be an ideal time to get your child in for physical therapy or talk to your doctor some more.

Red flags and early signs to look out for

An early sign or red flag, as mentioned above, is going to be:

Your child is tipped one way with the ear on their shoulder, and they are rotated.

When looking at them, you can only clearly see one side of their face and see a large opening on one side of their neck.
It might be hard to clean the side of the neck that is tight, as it is restricted and you can’t get in.
Feeding can be difficult if the baby won’t turn one way.
Facial asymmetry.

Plagiocephaly is commonly seen in conjunction with torticollis. This is the flattening of the head on an angle, and it is also treatable. Because the neck is tipped and rotated one way, a lot of pressure goes on one part of the skull, causing that part of the head to become flat.

Brachycephaly is also a very common diagnosis with torticollis. This is the flatness of the back of the skull, and it can be caused by a baby being on their back for too long.

How can tummy time and position changes help torticollis?

Tummy time is highly recommended by Westside physical therapists. Our therapists recommend that for every waking hour, a baby should spend at least 10 minutes on their stomach.

If you’re on your back for 12 hours, you should be on your stomach for 12 hours. You want equal symmetry between your flexors on your stomach and your extensors on your back.

Always being on your back can lead to flatness of the head, delayed motor milestones, and potentially toe walking, as body symmetry is not reached. Torticollis can affect the entire body.

Supervised tummy time is recommended from early on. Westside therapists say that getting a baby on their stomach early is good! It helps with neck strength.

Between the ages of 0 and 2 months is an opportune time for babies to gain thoracic spine strength that will impact the rest of their life. That’s not to say it cannot be worked on later, but this is a great time for babies to get that strength. It gives strength to other muscles and helps them crawl, as well.

If you have to go to the bathroom or make food, put your baby on their stomach and let them explore! You can be near them and keep an eye on them while they move around on their tummy.

Babies also self-soothe on their stomach, and it is calming for them. When they are on their back, certain reflexes (such as the startle reflex) can be triggered.

How is torticollis treated with pediatric physical therapy at Westside?

The first thing you will notice is that you are NOT alone in having a child with torticollis. This is something we treat commonly. You will certainly have a strong community of therapists around you, as well as other parents.

Physical therapy at Westside is more medically based than play-based. Therapists have their hands on the child for the full 55-minute session. This consists of lots of stretching for the baby. As they get older and have more strength, we will work on postural alignment and strength.

Will there be tears? Yes. But it’s because they are working, not because they are in pain. And we can of course take breaks for you and your baby.

Throughout the session, your baby is playing with toys, our therapists are interacting with them, and we are explaining to you what we’re doing.

If we can get your baby symmetrical and then crawling symmetrically, we can eventually lessen the number of times we see you!

As long as there is no regression, we can reduce the amount of time spent in therapy.

We will also help you along the way with home exercises. We’ll never overwhelm you with a list of exercises. We’ll give you one or two each week and grow from there as we can.

Nervous about starting therapy?

It’s OK to be! But you have everyone at Westside in your corner as well as other parents.

Our therapists like to tell parents that this can be such a short period of your life and your baby’s life. Let’s get things fixed and have them ready for the rest of their life!

If you’d like to learn more about starting physical therapy, call (815) 620-4736 to get started. Or fill out the form below.

Get Started

Frequently Asked Questions

How do I know if my baby has torticollis?

Your baby may have torticollis if they consistently tilt their head to one side, prefer looking in one direction, have difficulty turning their head both ways, or seem to have an uneven head or face. Feeding on one side may also be more difficult. If you notice these signs, talk with your pediatrician or a pediatric physical therapist for an evaluation.

What happens if torticollis isn’t addressed?

If torticollis isn’t addressed, a baby may continue to develop an uneven neck movement pattern and may be at greater risk of positional head-shape asymmetry, such as plagiocephaly. Persistent asymmetry can also affect how a baby develops movement skills. Early identification and intervention can help improve outcomes and reduce the effects of prolonged positioning.

How do you treat torticollis in babies?

Treatment depends on the baby’s age, symptoms, severity, and underlying cause. Pediatric physical therapy may include gentle neck stretching, strengthening, positioning strategies, caregiver education, and activities that encourage the baby to look and move in both directions. Your therapist can also provide a home program tailored to your baby rather than asking you to perform exercises without guidance.

Can torticollis cause a flat spot on my baby’s head?

Torticollis can contribute to positional plagiocephaly, or flattening of one area of the baby’s skull, because the baby may consistently rest or look in the same direction. Position changes, supervised tummy time while awake, and appropriate treatment of the neck imbalance can help reduce ongoing pressure on one area of the head.

Can baby torticollis go away on its own?

Some mild positional preferences may improve as a baby becomes stronger and more mobile, but persistent head tilting or restricted neck movement should not simply be ignored. Early assessment can determine whether treatment is needed and help prevent the pattern from becoming more established. Congenital muscular torticollis generally responds well to conservative management when identified and treated early.

How long does physical therapy for torticollis take?

Treatment length varies from baby to baby. It depends on factors such as when torticollis was identified, how restricted the neck movement is, the baby’s strength and motor development, and how consistently the recommended home activities are performed. Some babies need only a short period of therapy, while others require longer follow-up to ensure their movement remains symmetrical.

How often will my baby need physical therapy?

No single schedule works for every family. A pediatric physical therapist will determine the appropriate frequency based on your baby’s assessment, progress, and home needs. As neck movement, strength, and motor symmetry improve, visits may become less frequent. The goal is to help your baby develop symmetrical movement while giving parents practical strategies they can use at home.