Torticollis and plagiocephaly are two common conditions seen in infants, often occurring together. While they may seem separate, they are closely related, and early intervention with physical therapy can significantly improve health outcomes. In this blog, we’ll explore what these conditions are, how they affect each other, and how physical therapy plays a key role in treatment.
What is Torticollis?
Torticollis, also known as congenital muscular torticollis (CMT), is a condition where an infant’s neck muscles tighten or shorten, causing the head to tilt to one side and rotate to the opposite side. This condition is usually caused by:
- Tightness in the sternocleidomastoid (SCM) muscle in the neck
- Positioning in the womb (intrauterine constraint)
- Birth trauma, such as forceps or vacuum-assisted delivery
Signs of Torticollis:
- Head consistently tilted to one side
- Limited neck movement
- Preference for looking in one direction
- Difficulty turning the head during feeding or tummy time
What is Plagiocephaly?
Plagiocephaly, also called flat head syndrome, occurs when a baby develops a flat spot on one side of the head due to prolonged pressure. This can be caused by:
- Spending too much time in one position (e.g., lying on the back)
- Torticollis limiting head movement, causing pressure on one side
- Prematurity, as preemies have softer skulls and spend more time lying down in the NICU
Signs of Plagiocephaly:
- A noticeable flat spot on the back or side of the head
- Facial asymmetry (one ear appearing pushed forward, uneven forehead shape)
- Preference for turning the head in one direction
How Are Torticollis and Plagiocephaly Connected?
Torticollis and plagiocephaly often occur together because:
- Limited Head Movement: A baby with torticollis tends to keep their head turned to one side, causing prolonged pressure on that area of the skull.
- Flattening the Skull: The more time spent in one position, the higher the risk of developing plagiocephaly.
- Worsening of Torticollis: If a baby develops a flat spot, it can reinforce the habit of favoring one side, making torticollis worse.
The good news is that both conditions are highly treatable, especially when addressed early.
How Physical Therapy Helps Torticollis and Plagiocephaly
A pediatric physical therapist can assess your baby’s head shape, neck movement, and muscle tightness. From there, they will create a customized treatment plan. Therapy may include:
Gentle Stretching Exercises
- Helps lengthen the tight SCM muscle to improve neck movement.
- Encourages symmetrical head turning and movement.
Positioning Strategies
- Encouraging tummy time to reduce pressure on the back of the head and strengthen neck muscles.
- Teaching parents how to alternate head positioning during sleep and feeding.
Strengthening Activities
- Exercises to improve neck, back, and core strength, helping babies hold their heads up and move symmetrically.
- Use of toys and visual tracking exercises to promote turning to both sides.
Parent Education & Home Program
- Teaching parents daily techniques to support proper neck movement.
Collaboration with Orthotists for Helmet Therapy
- In cases where plagiocephaly is more severe, a cranial helmet may be recommended to help reshape the baby’s skull.
- A physical therapist can work closely with an orthotist to ensure the helmet fits properly and does not restrict natural movement.
- PTs monitor head growth, skin tolerance, and muscle development, ensuring that therapy and helmet use complement each other for optimal outcomes.
- Adjusting baby’s environment to promote active movement.
When to Seek Physical Therapy
Early intervention is key! Contact a pediatric physical therapist if you notice:
- Your baby’s head tilts to one side frequently.
- There is a flat spot on your baby’s head.
- Your baby has difficulty turning their head equally to both sides.
- Tummy time is challenging due to limited head control.
The earlier therapy begins, the better the results. Babies’ skulls and muscles are still very moldable in the first 3-6 months, making treatment easier and more effective.
Torticollis and plagiocephaly are common but treatable conditions that benefit greatly from early physical therapy intervention. Therapy helps babies develop symmetrical movement, improved strength, and proper alignment as they grow.
At Crawl Walk Jump Run Therapy Clinic, we specialize in pediatric physical therapy and are here to help your baby move and grow in the healthiest way possible. If you have concerns about your baby’s head shape or neck movement, contact us today for an evaluation! You can also check out our other blogs about torticollis to see how craniosacral therapy in conjunction with physical therapy can help your baby!
