Torticollis, Why is it a big deal?

You just noticed your baby only looks one direction. You've googled it and WebMD says your baby has Torticollis. You asked the pediatrician at your appointment and he said lets just wait and see. The doctor gave you some stretches but its freaking you out to move your baby's head that way so you decide to skip it.

Guess what? Torticollis (or a tight neck muscle) is very common and very fixable! It can occur for many reasons including intrauterine restriction and plagiocephaly or flat head. The latter is like the chicken and the egg. We often don't know if the flat area is caused by the tight muscle or the tight muscle is caused by decreased movement of the neck due to the flat head. We do know that proper positioning and gentle stretching started as early as possible can reverse both conditions.

But why is torticollis a problem? I have a stiff neck and I just work through it and it often feels better without intervention.

As a newborn gaining some head control is a baby's first job. If your baby has tightness in one side of the neck he won't be able to lift it and build neck strength. That tightness causes your baby to prefer to look to one side and this can make nursing difficult. Weak neck muscles will make tummy time unpleasant and hard.

If the tightness is allowed to continue into the 2-4 month age range it can prevent your baby from trying to roll over. Have you ever tried to rollover without turning your head? You can't do it. Decreased turning of the head also prevents your baby from looking around his environment which keeps your baby from learning about the world around them. And laying in one position without moving the head is what causes the flat spot to develop.

Longer term tightness in the neck makes weightbearing on your arms and sitting up difficult. It also prevents your baby from rotating around their center of gravity - this is called transitional movement and is what your baby does to change positions. One of the biggest goals of the first year is to get your child to walk. If they can't change positions from sitting to hands and knees or from laying down to sitting up or from sitting to standing, they won't begin to be mobile.

If your pediatrician has asked you to wait and see you may want to discuss with them why they feel early intervention isn't the best course of action. The earlier you learn how to properly position and stretch your baby using simple daily activities the quicker torticollis will be in your rearview mirror. If the thought of working with your baby's neck makes you cringe that's reason enough to ask for a PT consult so you can be taught good techniques that won't make you feel like you are hurting your child.