Pediatric torticollis, or wry neck, is a condition that causes your child’s head to tilt to one side. It can make it hard for them to turn their head freely. There are two main types of pediatric torticollis:

• Congenital torticollis — This type of torticollis is present at birth and may happen due to:
• Position in the womb — Sometimes, a baby’s position in the womb can cause their neck muscles to tighten. 
• Birth trauma — In some cases, birth injuries can damage the neck muscles. 
• Acquired torticollis — This type of torticollis develops after birth, often as a result of an injury or infection or even sleeping in an awkward position.

Pediatric torticollis is relatively common, usually affecting children between 6 and 12 years old. It also impacts approximately 16% of newborns. Overall, this condition can be managed effectively with treatments such as physical therapy. If you notice your child has a tilted head or seems to have difficulty turning their neck, it’s a good idea to consult a health care provider for advice. 

How to recognize pediatric torticollis

Keep an eye out for these signs to help you recognize pediatric torticollis:

• Head tilt — Your child’s head may consistently tilt to one side. You may notice your child’s head leaning to one side, while their chin points toward the opposite shoulder. 
• Limited head movement — Your child may have trouble turning their head from side to side. 
• Facial asymmetry — One side of your child’s face may look different from the other. This can happen because the muscles on one side of the neck are tighter, which can affect how their face develops. 
• Neck muscle tightness — You may feel a tight or stiff muscle on one side of your child’s neck. 
• Preferred head position — Your child may always favor one side when lying down or looking around. 
• Discomfort or crying — Your baby may seem uncomfortable or fussy, especially when you try to move their head or change their position. If your baby cries when you gently turn their head, this could be a sign of torticollis. 

If you notice any of these signs, it’s important to consult with your pediatrician. Early diagnosis and treatment can help prevent long-term complications. 

How is pediatric torticollis diagnosed?

To diagnose pediatric torticollis, your child’s health care provider will likely perform the following:

• Medical history review — Your child’s pediatrician will ask about your child’s medical history, including any injuries, illnesses or other conditions that may have contributed to their head tilt. They’ll want to know when you first noticed the symptoms. 
• Physical examination — The health care provider will carefully examine your baby’s head and neck, looking for signs of muscle tightness or asymmetry. They may move your baby’s head gently to see how much they can turn it and if they show any discomfort. 
• Imaging tests — In some cases, imaging tests like X-rays or ultrasounds may be used to rule out other underlying conditions. 

It’s important to consult with your child’s pediatrician as soon as you notice any signs of torticollis. Once a diagnosis is made, your child’s doctor will discuss treatment options.

How is pediatric torticollis treated?

Treatment for pediatric torticollis may include:

• Physical therapy — Physical therapy is an effective treatment for most cases of torticollis. A physical therapist will work with you and your baby to gently stretch and strengthen their neck muscles. This can help improve your baby’s range of motion, reduce muscle tension and correct their head position. 
• Tummy time — Tummy time is important to help your baby build strength in their neck and shoulders. Start with short bursts of tummy time while they’re awake and supervised. You can make it fun by using bright toys to keep them engaged. As they lift their heads to reach for a toy, they’ll be developing those essential muscles.
• Orthotic devices — Sometimes, a little extra support can go a long way. If your baby’s health care provider thinks it may help, they may suggest a soft cervical collar or positioning devices. These tools can help your child keep their head aligned as they explore their world. Just remember, these should only be used under a professional’s guidance and not as a long-term solution. 
• Home care — You can play a key role in your child’s recovery. Keep an eye on their progress and join in on the fun of stretching and strengthening exercises at home. Documenting these activities can be super helpful for tracking improvements and sharing updates with your baby’s health care team. Be sure to consistently check in with your baby’s health care team to make sure everything is on track and allow for adjustments if needed. 
• Surgery — In severe cases, surgery may be considered to help correct your baby’s torticollis. Surgery involves lengthening the tight neck muscles to improve range of motion. However, surgery is typically a last resort and is only recommended in rare cases. 

Physical therapy for pediatric torticollis

Physical therapy can be an effective treatment approach for pediatric torticollis. Your child’s physical therapist will create a customized treatment plan designed to meet your child’s needs. This treatment plan may include techniques such as:

• Manual therapy — Manual therapy encompasses a wide variety of hands-on approaches used by your child’s physical therapist to help release tension and improve mobility. These techniques include:
• Soft tissue manipulation — Your child’s physical therapist may use soft tissue manipulation to help relax tight muscles in their neck. This relaxing technique can help ease tension and discomfort, giving your child the freedom to move with more ease. 
• Joint mobilization — During joint mobilization, your child’s physical therapist gently moves the joints in your child’s neck to improve flexibility and reduce stiffness. This means your child will be able to turn their head with more ease, making it more enjoyable for them when they move. 
• Therapeutic exercises — Therapeutic exercises can be like playful adventures that help strengthen and stretch those important neck muscles and encourage your child to explore their bodies in new and exciting ways. Your child’s physical therapist may use therapeutic exercises such as:
• Range-of-motion exercises — Range-of-motion exercises are a key part of treatment. These exercises help keep the neck muscles flexible and promote better movement, which is perfect for those curious little explorers. 
• Strengthening exercises — To build a strong foundation, your child’s physical therapist may incorporate strengthening exercises into the mix. These activities focus on making the neck and shoulder muscles stronger, which can help prevent future issues. Strong muscles mean better posture and a healthier head position. 
• Visual exercises — Visual exercises are also important. Children with torticollis tilt their heads, which can make it tricky for them to look where they need to. Your child’s physical therapist can use fun activities that encourage your child to move their head and eyes together, helping them develop better coordination and awareness of their surroundings. 
• Postural education — This is all about your child’s physical therapist teaching you and your child how to sit, play and sleep with good posture. The physical therapist will show you the best ways to position your child to ensure that they use their neck muscles properly and avoid habits that could make things worse. 

How is pediatric torticollis prevented?

Preventing pediatric torticollis includes keeping your child’s neck healthy and strong. While it’s not always possible to stop torticollis from happening, there are several fun and easy ways to help you reduce your child’s risk, including:

• Give them tummy time.
• Change their positions frequently.
• Support their proper head position.
• Monitor screen time. 
• Encourage active playtime.

Treating pediatric torticollis entails teamwork. With the right mix of physical therapy, home care and a sprinkle of encouragement, most kids can overcome this condition and thrive. Early intervention is crucial, so if you notice any signs of torticollis, reach out to your child’s health care provider. Together, you can set your child on the path to a healthier, more balanced neck. 

Trust Lattimore PT to help your child build a stronger foundation for a healthier neck

At Lattimore Physical Therapy, we understand how concerning pediatric torticollis can be for both you and your child. Our dedicated team is here to support you every step of the way, offering personalized treatment plans that target your child’s specific needs. We believe in empowering families through education and effective physical therapy techniques to promote a happy, healthy neck for your little one. With our expert guidance, your child can regain their freedom of movement, play with better ease and thrive in their daily activities. Trust Lattimore PT to be your partner in helping your child enjoy life to the fullest. 

Contact our team today for more information or to schedule an initial appointment.