If you notice your baby consistently tilting their head one side or preferring to look one direction, there is a chance your child may have torticollis. While this can sound concerning, it is very common and treatable, especially when identified early.
What Is Torticollis?
Torticollis, is a condition where an infant’s head tilts to one side and is typically rotated towards the opposite side. It is most commonly caused by shortening or tightness of the sternocleidomastoid (SCM) muscle in the neck. Torticollis is estimated to affect 16% of infants, making it one of the most commonly treated conditions by pediatric physical therapists.
- You may notice that your baby:
- Tilts their head consistently to one side
- Prefers turning their head to only one direction
- Has difficulty rotating their head equally both ways
- Develops a flat spot on one side of the head (also known as plagiocephaly)
What Causes Torticollis?
There are a variety of different reasons torticollis can develop, including:
- Positioning in the womb, especially in tight spaces or breech positioning
- Birth-related factors, such as prolonged labor or assisted deliveries
- Postnatal positioning, including spending extended time on the back with limited head movement variation
One important item to mention, is that torticollis is not caused by anything a parent did wrong, many infants develop it despite attentive care and safe sleep practices.
Why Is Early Identification Important?
Research is consistently showing that earlier intervention leads to quicker and complete resolution of torticollis.
In fact, recent research guidelines indicate that infants referred to PT prior to 3 months often achieve full resolution in a shorter period of time. Delayed treatment can cause persistent asymmetries, compensatory movement patterns, and prolonged treatment time. Untreated torticollis can contribute to plagiocephaly (head shape asymmetry), facial asymmetry, delayed motor milestones, and asymmetrical posture or movement as the child grows. Early therapy focuses on restoring symmetrical movement and preventing secondary issues.
When Should a Child Be Referred to Physical Therapy?
A referral to pediatric physical therapy is recommended if any of the following are observed:
For Infants (Birth–12 Months)
- Persistent head tilt or rotation preference beyond the first few weeks of life
- Limited neck range of motion in one or both directions
- Difficulty with tummy time due to head or neck positioning
- Flat spots on the head associated with a preferred head position
- Delayed motor milestones (rolling, sitting, crawling)
Clinical practice guidelines from the American Physical Therapy Association (APTA) recommend referral to physical therapy as soon as torticollis is identified, rather than a “wait and see” approach.
What Does Physical Therapy for Torticollis Involve?
Pediatric physical therapy for torticollis is gentle, play-based, and family-centered. Treatment may include:
- Guided stretching and positioning techniques
- Strengthening for symmetrical head and trunk control
- Tummy time progression and motor skill development
- Education for caregivers on positioning and daily routines
- Caregiver education is a critical component—research shows that consistent home carryover significantly improves outcomes.
Takeaways
Torticollis is common, treatable, and often resolves very well with early physical therapy intervention. If you notice persistent head tilting, a strong side preference, or asymmetry in your baby’s movement, a referral to pediatric physical therapy can make a meaningful difference.
Early support doesn’t just address neck motion—it helps promote symmetrical movement, healthy development, and confident exploration as your child grows.
If you have concerns, trust your instincts and ask your pediatrician or a pediatric physical therapist at Inspire Physical Therapy for guidance.
