We work with children as young as infants who have torticollis.

Torticollis is a tightening of a child’s neck muscles that causes the head to tilt to one side and turn to the other side. This can make it difficult for the child to turn his or her head for visual tracking, hold the head in an upright position, or perform the appropriate upper body movements needed for feeding and play. It can also cause flattening of the child’s face and make it difficult to clean the child’s neck and shoulder.

Our physical therapy team works with children as young as newborns as part of the torticollis clinic at Johns Hopkins All Children's. With early detection and treatment, most children with torticollis recover with no long-term effects.

Physical therapy helps to prevent a permanent shortening of the involved muscle, decrease head and neck pain, prevent secondary concerns such as delayed developmental motor skills and plagiocephaly (abnormal head shape), and avoid the need for surgery.

Evaluation and treatment

A physical therapist will perform an evaluation to assess your child’s passive range of motion, active range of motion, muscle tightness, muscle strength and gross motor skills. The physical therapist will also check for other conditions that can occur in children with torticollis, such as plagiocephaly, hip dysplasia (misalignment of the hip joint), and spine problems.

The therapist will discuss the results of your child’s evaluation with you and make recommendations for physical therapy treatment as needed. The therapist also will teach you stretching and positioning exercises that you will do at home daily with your child.

The goals of physical therapy for torticollis are to:

• Improve your child's ability to turn his or her head from the right to left side
• Improve your child's ability to bring chin to chest
• Improve your child's ability to orient his or head to midline against gravity
• Encourage your child to lift his or her head against gravity while lying on stomach
• Achieve normal weight bearing and shifting over upper extremities
• Encourage symmetrical use of upper extremities
• Allow your child to experience proper weight shifting during developmental activities including sitting, rolling, creeping and walking