What Is Torticollis? Why Early Awareness Matters for Parents

As a pediatric physical therapist, one of the most common concerns I work with in babies—especially in the first year—is torticollis. It might sound like a complicated medical term, but the earlier it's spotted, the easier it is to treat—and the better the outcomes for your baby’s overall development.

In this post, I’ll break down:

• What torticollis is

• Why early identification is so important

• What signs to look for at home

• And how pediatric PT can help

Let’s empower you with knowledge, because you are your baby’s first and most important advocate.

What Is Torticollis?

Torticollis (pronounced tor-ti-COLL-is) means “twisted neck.” It occurs when the sternocleidomastoid (SCM) muscle in your baby’s neck is shortened or tight, causing the head to tilt to one side and rotate to the opposite side.

There are two main types:

• Congenital muscular torticollis (CMT) – present at or shortly after birth

• Acquired torticollis – develops later, sometimes due to positioning or injury

It’s quite common—affecting up to 1 in 250 infants—but the good news is: when caught early, torticollis is highly treatable with pediatric physical therapy.

Why Early Identification Is So Important

Early intervention is key because untreated torticollis can lead to:

• Delayed motor milestones (like rolling, sitting, crawling)

• Plagiocephaly (flat spots on the head from consistent head positioning)

• Asymmetrical development in posture and movement

• Jaw, vision, and oral-motor issues later on

But here’s the good news: the earlier we begin physical therapy, the easier it is to restore full range of motion, improve symmetry, and support healthy development.

Most babies show improvement within a few weeks or months of starting therapy—especially if intervention begins before 4 months of age.

What Should Parents Look for at Home?

Here are some early signs of torticollis to watch for, especially in the first few months:

Positional Signs:

• Baby always turns their head to one side (especially when lying down)

• Head consistently tilts to one shoulder

• Prefers nursing or bottle feeding on one side only

• Has trouble turning head equally both directions

Physical Signs:

• A flat spot developing on the back or side of the head (plagiocephaly)

• Asymmetry in the face, eyes, or ears

• Neck tightness or a small lump in the neck muscle (can feel like a “knot”)

• Uneven use of arms or favoring one side during play

Developmental Signs:

• Difficulty with tummy time or turning the head during play

• Delayed rolling, sitting, or other motor milestones

If you notice any of these, talk to your pediatrician or request a referral to a pediatric physical therapist. You don’t need to wait for a formal diagnosis to get support.

Why Does Torticollis Happen?

Torticollis can develop for several reasons:

• In-utero positioning (tight space in the womb, breech positioning)

• Birth trauma (especially during assisted deliveries)

• Preference for looking one way due to environmental positioning (e.g., crib, car seat)

• Lack of tummy time, which limits muscle development and variety in movement

Torticollis isn’t your fault. But early education and proactive care can make a world of difference in helping your baby develop evenly and confidently.

How Can Pediatric Physical Therapy Help?

A pediatric physical therapist will:

• Assess your baby’s head and neck movement, posture, and muscle tone

• Create a custom treatment plan that may include:

  • Gentle stretches

  • Positioning strategies during feeding, play, and sleep

  • Tummy time progression

  • Parent education and home exercises

• Monitor head shape and refer for further evaluation if needed (e.g., cranial orthotics for plagiocephaly)

Most importantly, we teach YOU, the parent or caregiver, what to do at home. Because therapy isn’t just once a week—it’s what happens daily in the moments that matter most.

Final Thoughts from a Pediatric PT

Torticollis may be common, but that doesn’t mean it should be ignored. When we catch it early—and support babies with the right movement, stretches, and positioning—we’re not just fixing a head tilt. We’re supporting full-body development, symmetry, and the foundation for movement skills your child will use for life.

If you ever feel something “just isn’t quite right” with how your baby holds their head or moves, trust your instincts. You don’t need to wait. Early education and gentle guidance go a long way.