The 411 About Torticollis & Plagiocephaly

June 20, 2017


By Kelly Komperda, DPT

Torticollis is a muscle condition in which the head tilts to one side and the chin turns to the opposite side. It can be very disconcerting to a parent when their baby is diagnosed with this physical challenge, but luckily, most of the time it causes a child no pain. There are two types of torticollis, congenital and acquired. Either diagnosis requires treatment including therapy, and here at Milestones we successfully provide therapeutic treatment for torticollis and plagiocephaly, which is the flattening or asymmetry of the head, that often accompanies it.

Torticollis Treatment & Outcome Goals
There are seven major areas of therapeutic treatment that are recommended for children with torticollis:

1. Massage
2. Passive and Active Range of Motion
3. Strengthening Exercises
4. Positioning and Handling Guidelines
5. Visual Exercises
6. Righting Reactions/Postural Education
7. Environmental Adaptations

Treatment goals for a baby with torticollis include full range of motion in all cervical spine planes, attainment of age appropriate gross motor skills, symmetry right to left with all movements and play, and active midline control in all positions.

These goals are all very attainable with regular therapy, provided by both a professional, and continued at home by caregivers!

Causes & Recommendations for Kids with Torticollis & Plagiocephaly
Decreased Tummy Time in recent years is the likely cause of increased rates of torticollis and plagiocephaly. While it is important for babies to sleep on their backs to reduce the risk of SIDS, they should be getting plenty of supervised time on their stomachs on a variety of surfaces. We currently recommend 5-10 times daily for 10-30 minutes each session, but more is always better.

Increase in the use of devices like car seats, swings, and bouncy seats has also played a role in increased instances of torticollis and plagiocephaly. It is important to limit time spent in devices to as little as possible. We recommend that parents only use a car seat when the baby is in the car and to discontinue using all other devices when baby is awake.

In addition, stretching is very important to the treatment plan and it is critical that parents and caregivers are doing stretches with their child daily for 30 seconds, 4 reps, 4 times a day. We often recommend doing these stretches at diaper changes to fit it into their routine as easily as possible.

Helmets Help
Plagiocephaly is often diagnosed in a child with torticollis and the use of orthotic helmets is important in the correction of this condition. The sooner the child starts wearing a helmet, the better! Helmets do not just fix a cosmetic issue, there are also developmental issues that go along with head shape. Vision, balance, and strength are all impacted when a child’s head is asymmetrical. Positioning may help in mild cases of torticollis and plagiocephaly if the parents are able to keep the child off the flat spot, but we always recommend that a child with these conditions is evaluated by helmet company such as Cranial Technologies for a free consultation anyway.

A diagnosis of torticollis or plagiocephaly is not something a parent wants to hear! But awareness for both conditions and excellent treatment options have grown tremendously over the last several years. Our expert therapists on staff are here to help. Contact us to learn more!



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