Baby with an injured muscle in his neck.What is torticollis?

Torticollis is when a muscle of the neck, called the sternocleidomastoid, is shorter on one side of the neck than the other. The tight muscle causes the head to tilt toward the side of the neck with the shortened muscle and the head to be turned away from that side. The full name for torticollis is congenital muscular torticollis. Torticollis can occur if the sternocleidomastoid muscle is injured during birth. A baby with torticollis will keep his head turned in one direction.

Causes of torticollis

There are different theories as to why torticollis may happen. The muscle can become short if the baby was packed tightly inside the womb during pregnancy. This problem can also occur because the neck muscle was stretched during birth, and the stretched muscle then healed with scar tissue. It would be this scar tissue that causes the muscle to become tight and short. Sometimes, torticollis can develop after your baby is born. This happens if your baby keeps her head turned to one side more than the other. When this happens, the neck muscles can become tight.

Questions about torticollis

Should I be concerned about the lump on my baby’s neck?
No. The lump that you may be feeling is scar tissue. This is a normal result of the healing process. It is not painful to your child. With specific stretching exercises given to you by a physiotherapist, it should go away in a few months.

Why does my child prefer to look in one direction?
A child with torticollis may tend to look in only one direction. The shortened neck muscle causes the head to be tilted towards it and the chin turns away from it. This is why your child prefers to look away from the tight muscle.

If your baby is always on her back or prefers to look in one direction, part of her skull may become flat. This condition is called positional plagiocephaly, which means flattening of the skull. Torticollis and plagicephaly are closely associated with one another.

What should I do if my child only looks in one direction?

Baby laying on their side turning their head.

If your baby prefers to look in one direction, you should encourage her to look to the less-preferred side until she looks equally in both directions. Your baby may have a tight muscle in her neck and she may need specific stretches. You should speak to your doctor or to a physiotherapist for more information.

In the meantime, here are some things you can do:

  • During playtime, use mobiles or brightly coloured toys to encourage your baby to look in the less-preferred direction
  • When you are holding your baby, hold her in a way to encourage her to look in the less-preferred direction
  • If your baby’s crib is against the wall, put her at opposite ends of the crib each night. Babies prefer to look out into the room.
  • If your baby’s crib is not against a wall, move a brightly coloured, crib-safe toy to encourage her to look in a different direction each night.

When to call the doctor

If you feel your baby has limited neck movement, speak to your doctor to learn about other help available. He may refer you to a physiotherapist. After assessing your child’s head and neck, the therapist will design a home program for your baby. You may be given exercises and other recommendations.

Key points:

  • Torticollis is when the muscle on one side of the neck is shorter than on the other side. It causes the head to tilt to one side. The baby tends to look away from the tight muscle.
  • If your baby only looks in one direction, try to encourage her to look to the less-preferred side. A physiotherapist or occupational therapist may need to prescribe specific stretches.
  • Torticollis is sometimes associated with a condition called positional plagiocephaly, which is when the skull becomes flattened when a baby lays on his back or looks in one direction too long.

Adapted with permission from The Hospital for Sick Children.

About Kids Health is a child health information website that provides parents, children and health care providers with free, evidence-based information about everytday health and complex medical conditions.