Torticollis Treatment for Children

Effective treatment for torticollis incorporates several components working together to restore symmetry, strength, and full range of motion.

A comprehensive Pediatric Physical Therapy plan includes:

• Manual Therapy
• Passive and Active Range of Motion
• Strengthening Exercises
• Positioning and Handling Strategies
• Visual Tracking Exercises
• Righting Reactions and Postural Education
• Environmental adaptations

One of the most important factors for successful treatment is early identification and early Physical Therapy intervention. If you notice signs of torticollis in your baby, speak with your Pediatrician or a Pediatric Physical Therapist. Parents and caregivers are the best advocates for their children.

Pediatric Physical Therapy Torticollis Treatment

Manual Therapy

Treatment often begins with gentle manual therapy to address tightness in the neck muscles. Light massage can be performed by running fingers along the muscle belly and applying gentle thumb pressure to areas of tightness along the sternocleidomastoid muscle.

Goals: reduce muscle tightness, improve flexibility, increase neck range of motion

Passive and Active Range of Motion

Range of motion exercises help address limitations in head rotation and lateral flexion. Gentle guided movement allows the child’s head and neck to move through their available range while maintaining comfort.

Goals: increase mobility of the head and neck, open joint space, reduce movement restrictions

Shoulder Depression

Gentle downward pressure at the shoulders can help reduce elevation and allow improved neck mobility.

Goals: reduce shoulder elevation, improve cervical alignment, decrease muscle tightness

Lower Trunk Rotation (guided rolling)

Guided rolling encourages symmetrical movement patterns. Using the pelvis to guide movement, help your child roll from supine to sidelying to prone on both sides. Gentle rocking can help initiate momentum.

Goals: promote transitional movement skills, encourage symmetrical rolling, activate both sides of the body

Strengthening Exercises

Strengthening focuses on the head, neck, trunk, back, and upper extremities. When performing strengthening activities, it is important to monitor for compensations and address muscle imbalances.

Therapy Ball Exercises

Tummy time on a therapy ball can help improve strength and postural control. Support child at the trunk while gently rocking side to side or front to back. A mirror placed in front of the child can help encourage head alignment and engagement.

Incline Ramp Exercises

Using an incline wedge or soft ramp can help encourage head and neck extension, rotation, and upper body weight bearing.

Positioning and Handling Strategies

Torticollis Treatment Tummy Time

Prone (Tummy Time)

Tummy time is one of the most important positions for building strength and encouraging symmetrical movement. Gradually increase the duration as your child builds tolerance. Mirrors, toys, or engaging faces can help motivate your child to look in different directions.

Goals: strengthen the head, neck, and upper body, encourage pushing through the arms, promote fluid head rotation

Sidelying

Sidelying can encourage your child to turn away from the restricted side while allowing both arms to participate in play. A pillow or positioning support can help maintain alignment during play.

Baby Carrier Positioning

Using a carrier with the baby facing inward can promote proper head control and allow opportunities to encourage looking away from the restricted side.

Handling Strategies

Superman Hold

Supporting your child in a horizontal position encourages trunk and neck extension. This can be done in your arms or across your lap.

Visual Tracking Exercises

Encourage child to track toys or faces smoothly from side to side. Tracking activities can be practiced in many developmental positions including: supine, sidelying, prone, quadruped & supported sitting. Visual or auditory toys can help motivate engagement.

Righting Reactions and Postural Education

Therapy Ball Weight Shifting

Weight shifting on therapy ball can be practiced in prone, supine, or supported sitting to challenge postural responses and trunk activation

Dynamic Sitting Surfaces

Using dynamic surfaces such as a wedge or balance disc can help develop trunk stability in sitting and shoulder strength during prone activities.

Environmental Adaptations

Small environmental changes can encourage your child to move toward their limited side throughout the day. Strategies may include:

• Positioning toys on the side opposite the restriction
• Placing interesting objects across the room to encourage turning
• Adjusting crib or changing table orientation
• Alternating feeding positions to gently stretch the restricted side
• Using mirrors during sidelying play
• Encouraging rolling before lifting your child from the floor or crib

For more information check out our Torticollis Treatment Equipment post!