Cranial Technologies

Baby with head tilt caused by torticollis

Torticollis and Plagiocephaly - How Do They Relate?

Torticollis, also known as Wry neck, is caused when the Sternocleidomastoid Muscle (SCM) is abnormally tight or damaged. This muscle pulls the skull from where it attaches behind the ear, resulting in an abnormal head posture.

If left untreated, it can affect facial symmetry and lead to a higher risk of developing flat spots on the head. Additionally, it can lead to delayed cognitive development, muscle weakness, and difficulties with balance or interacting with the environment.

In more severe cases, it can also contribute to scoliosis in the spine.

Parents commonly ask

If my baby has torticollis, will they also have plagiocephaly?

Though torticollis and plagiocephaly are associated conditions, having one does not guarantee the occurrence of the other. Rather, torticollis leads to a much higher risk of developing a flat spot(s).

Is torticollis dangerous?

Generally, torticollis is not dangerous and can be alleviated with mild intervention. However, failure to treat can lead to other conditions like plagiocephaly and tight neck muscles.

Torticollis ranging from mild to severe

What does torticollis look like in infants?

Torticollis can usually be observed at birth or shortly after. Infants with this condition can show a variety of signs ranging from mild to severe including:

  • An abnormal head tilt and/or turn preference to one side
  • Preference to sleep on one side of the head
  • A limited range of motion in the neck
  • A small lump can be felt on one side of the neck
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Torticollis and plagiocephaly

Infants diagnosed with congenital muscular torticollis are likely to also develop plagiocephaly. Studies show that it is estimated to coexist in as many as 90% of babies diagnosed with the condition.

Plagiocephaly is typically caused by prolonged pressure to the skull during activities like back sleeping. Since the condition causes the baby to favor one side, there will be increased pressure to this side of the skull.

What are the signs of plagiocephaly?

Plagiocephaly (flat head syndrome) is characterized by a flat spot, or deformity on the back of the skull. The condition ranges from mild to severe and can show in a variety of head shapes or in combination with one another.

Note: A plagiocephaly head shape is more likely with infant torticollis due to the baby favoring a particular side.

Common signs of plagiocephaly include:

  • Back of the head is flat on one side
  • Asymmetry of the facial features
  • Misalignment of the ear canals

Treatment & prevention techniques

Both torticollis and plagiocephaly adopt similar physical therapy techniques for prevention and treatment.

If the case is mild, the baby will often see improvement with proper care and attention put toward these techniques. However, primary care physicians should prescribe a cranial orthotic for infants with moderate to severe cases of plagiocephaly.

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Parents also ask

Does torticollis only affect one side?

Either side of the neck could be affected, but head tilt tends to occur more often on the left side.

Does gender play a role in diagnosis?

No, there is no evidence to suggest that one gender has a greater instance of the condition over the other.