What is torticollis?

Torticollis is a sign of underlying disorder that is characterized by asymmetric posturing of the head and neck. The majority of infants who present with torticollis during the first year of life have congenital muscular torticollis (CMT). CMT is caused by tightness in the neck muscles called the strenocleidomastoid (SCM). A recent study (UCSD Medical Center and UCSF School of Medicine, Oct 2008) reports that as many as one in six newborns have torticollis. CMT can be identified as early as birth or during the first few months of life.

How can I recognize it in my child?

Noticeable signs and symptoms may include:

• Preference to tilt head towards one side 
• Preference to turn head towards one side 
• Lack of full neck range of motion towards non-preferred side
• A detectable mass (smaller than pea-size) in SCM muscle during early infancy
• Asymmetrical facial features (ie ear, eye, jaw line and/or cheek on one side of face is smaller or shifted forward)

Torticollis can lead to the associated conditions:

• Plagiocephaly- flattening of head on one side
• Gross motor delay (ie dislikes "tummy time") - See "Gross motor milestone checklist" for details.
• Asymmetric facial features

The child with torticollis may have the ability to turn his/her head both ways when prompted, however full range of motion will typically be limited on the non-preferred side. The favored head posture can be mild or severe. The extent of the head tilt/turn preference may vary during the day, but is usually most noticeable when the child is sleepy, fussy or hungry. Infants with head turning preference to one side are at high risk of quickly developing head shape deformity.