ROMMER
Condition

Torticollis

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What Is Torticollis?

Torticollis (wry neck) is a condition characterised by abnormal tilting and rotation of the head due to shortening or excessive contraction of the sternocleidomastoid (SCM) muscle on one side of the neck. In children, the most common form is congenital muscular torticollis (CMT), which is usually detected in the first weeks or months of life. It may be associated with difficult deliveries, vacuum or forceps use, or intrauterine positioning.

Symptoms

  • Head tilt to one side (towards the shortened SCM)
  • Chin rotated towards the opposite shoulder
  • A palpable firm lump (fibrotic mass) in the SCM muscle in newborns
  • Asymmetric facial development (plagiocephaly) if left untreated
  • Restriction in neck range of motion

Treatment at ROMMER

With early diagnosis and appropriate physiotherapy, the vast majority of children with congenital muscular torticollis achieve full recovery without surgery. At ROMMER:

  • Stretching Exercises: Passive and active-assisted cervical stretching exercises are performed to lengthen the shortened SCM and restore neck range of motion. Parents are trained to continue these exercises at home.
  • Strengthening Exercises: Neck muscles on the affected side are gradually strengthened to achieve symmetrical head control.
  • Positioning and Handling: Parents are educated on positioning during feeding, carrying, and play to encourage the baby to use the full range of neck movement.
  • Tummy Time Programme: Supervised prone positioning promotes head righting and neck strengthening.
  • Plagiocephaly Management: If positional head flattening is present, repositioning strategies and — when indicated — helmet therapy are discussed.
  • Botulinum Toxin: In resistant cases with significant muscle tightness, targeted Botox injection to the SCM can facilitate stretching and improve treatment response.

When Is Surgery Considered?

Surgical lengthening (SCM release) is considered only in cases that do not respond to conservative treatment by around 12–18 months of age, or in older children with significant residual limitation. At ROMMER, post-surgical rehabilitation is carefully planned to consolidate the gains from surgery.

Frequently Asked Questions

At what age should torticollis treatment begin?+
As early as possible — ideally in the first 1–3 months of life. Studies show that children who begin physiotherapy before 3 months of age have the highest rates of full recovery. Even children diagnosed later benefit significantly from treatment.
How long does physiotherapy for torticollis take?+
This depends on the severity of the restriction and the age at which treatment begins. Most infants treated before 6 months achieve resolution within 2–6 months of consistent physiotherapy. Older children or those with more severe tightness may require longer treatment.
Do I need to do exercises at home too?+
Yes — home exercises are essential. The stretching programme performed 3–4 times daily at home by parents is the cornerstone of successful torticollis treatment. At ROMMER, parents are carefully trained in the correct technique.
Will my baby's face become symmetrical?+
If torticollis is treated early, most babies develop symmetric facial growth. Untreated or late-treated cases can result in persistent facial asymmetry (plagiocephaly). Early intervention gives the best chance of symmetrical development.

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