Torticollis (Wryneck) in Infants

What is Congenital Muscular Torticollis?

Congenital Muscular Torticollis (CMT) is a postural condition where the muscle found along your baby’s neck (the sternocleidomastoid) is shortened.

This change in muscle length typically occurs on one side, resulting in a head tilt and rotation to one side. It usually presents at birth or in the first few weeks following.

What Causes Congenital Muscular Torticollis in Infants?

The exact cause of CMT is unknown. Some theories suggest it may be related to your baby’s position in the womb, or it may be related to other more serious conditions. Early detection of torticollis is key. The sooner it is identified, the faster treatment can begin to help the tightness from persisting or worsening.

Symptoms of Congenital Muscular Torticollis

The following are the most common symptoms of CMT; however, it is important to note that each baby may experience torticollis differently.

Symptoms include:

• Your baby’s head is tilted or turned to one side

• Your baby has limited movement of their head and neck

• You note stiffness and tightness in the neck

• You may notice a lump in your baby’s neck muscle

• Your baby may have difficulty feeding on one side

• Your baby may have flattening on the back of the head (positional plagiocephaly)

How is CMT diagnosed?

A thorough physical exam of your baby’s neck is important in identifying torticollis.

A pediatric physical therapist experienced in treating infants with torticollis can perform a full health history related to your baby’s birth and development, along with a comprehensive physical assessment.

They will discuss an appropriate treatment plan and provide strategies to help address your baby’s needs. They may recommend further diagnostic imaging, such as x-ray or ultrasound, to rule out other medical conditions.

What Are the Possible Complications of Torticollis?

If your baby has torticollis, they may also experience flattening to one side of the head and asymmetry in the face.

Your baby’s skull is very soft and malleable during infancy. When they are unable to freely move their head and neck due to torticollis, the pressure from resting in one position for prolonged periods of time can result in flattening to that part of the head.

How Can a Physical Therapist Help?

A pediatric physical therapist will work to improve your baby’s neck mobility and posture as much as possible.

If there are concerns regarding head shape and flattening, your physical

therapist will assess and provide recommendations for this as well. Initial treatment focuses on stretching and repositioning of your baby’s neck.

As your baby’s range of motion improves, strengthening exercises are incorporated to develop symmetrical movement in the neck.

These exercises and strategies will be demonstrated and taught to parents as

part of a comprehensive home exercise program tailored to your baby’s need.