Associated Conditions

TorticollisDiagramTorticollis 

Torticollis is a common associated condition with plagiocephaly. As many as 9 out of 10 infants diagnosed with torticollis may also have plagiocephaly.

Torticollis is derived from two Latin terms, tortus, meaning twisted, and collum, meaning neck. Simply stated, it describes an abnormal neck posture. It causes a baby to have a head tilt and/or turn preference. The condition is caused when the Sternocleidomastoid Muscle (SCM) is abnormally tight and it pulls the skull from where it attaches behind the ear (as shown in the image). Torticollis affects both females and males equally. The tilt is more often to the left than the right.

Often, the presence of neck and facial asymmetry is visible the first week after birth. The baby’s head may tilt to one side, giving him or her a limited range of motion. Torticollis, or wry neck, can result from placement in utero or the birth process. It may also appear when babies are constantly in the same position in car seats, swings, etc. and do not turn their head to both sides. With the baby favoring one side, he or she may develop plagiocephaly (flat head syndrome) in addition to torticollis. In the past, some physicians used irregular head shapes to diagnose torticollis.

Torticollis can affect facial symmetry, ear alignment and can lead to difficulties interacting with the environment. It can limit a child’s ability to turn his head to see, hear, and interact freely with his environment and can lead to delayed cognitive development, delayed whole body awareness, muscle weakness, and difficulties with balance. In more severe cases, it can also contribute to a scoliosis in the spine.

Infants who have been diagnosed with congenital muscular torticollis have a high likelihood of also having plagiocephaly. Studies show that plagiocephaly is estimated to coexist in as many as 90 percent of babies with torticollis.

Examples of Mild, Moderate and Severe Cases of Torticollis

Mild

MildTort

Moderate

ModerateTort

Severe

SevereTort

Additional Clinical Evidence

  • There is a 23 percent increased risk of torticollis when plagiocephaly is present at birth.
  • Early treatment for torticollis (earlier than 2 months) can greatly reduce treatment time to as little as 4-6 weeks.
  • Delayed treatment of torticollis (after 3 months) can increase treatment time to more than 6-9 months.
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