Torticollis, or twisted neck positioning, is thought to be caused by in utero constraint. The muscle that tilts the neck, the sternocleidomastoid muscle, becomes shortened, leading towards a persistent positioning of the head turning (rotating) towards one direction while tilting typically in the opposite direction. The ideal age for initiation of physical therapy intervention for this condition is before 3 months of age. Caregivers and/or the pediatrician will often note that a baby tends to look preferentially in one direction. They may also note some flattening of the back of the head.

The primary goal of physical therapy intervention is to restore full neck movement as early as possible to help reverse or stop the progression of skull deformity, cranial facial asymmetry and to prevent bony and postural changes that may cause asymmetric motor development. The pediatric physical therapists at Duke are highly skilled in treating children with torticollis. They work with the family to develop a plan of care that encompasses positional changes and therapeutic exercises that are incorporated for use throughout the child’s day to promote optimal outcomes.


PT Treatment

  • Gross motor skills
  • NICU

OT Treatment

  • NICU
  • Visual motor skills