Torticollis and Scoliosis

Given my own scoliosis, I was alarmed when I learned that my newborn son has torticollis, a muscular imbalance that could lead to impaired gross motor skill development—or even scoliosis.

I set out to learn more about this asymmetry with an eye toward how I could improve my son’s wellbeing and help reduce his chances for scoliosis.

What Is Torticollis?

Torticollis, also known as wryneck, is a condition where one side of the neck, the sternocleidomastoid muscle, is tight. This leads to a tilting and turning of the chin in one direction. There are other causes, for example vertebral anomalies or tumors, but muscular tightness is most common.

This congenital condition occurs in between 0.3% and 1.9% of births (pubmed.ncbi.nlm.nih.gov/21568831/), with higher incidences among boys than girls by a 3 to 2 margin.

Causes of Torticollis

Common causes include intrauterine position, which often occurs when there is limited uterine space—like in first pregnancies or when there is decreased amniotic fluid—or as a result of traumatic births, or those including forceps, vacuums, or natural postural stress during the delivery process. 

Consequences

The position of the baby’s head can place asymmetrical pressure on the skull and facial bones, which can affect head shape, motor development, language, and posture, possibly leading to scoliosis.  If the head shape is altered, or there is tightness on one side, it can limit proper breastfeeding positioning and make it difficult for the child to eat.

How Is Torticollis detected?

Torticollis is generally detected in babies starting at around four weeks. As babies begin to have more control over their head, parents can notice its rotation or tilt more.

In my case, my son was having trouble nursing on one side. He was noticeably agitated and tense on my right side, when he was laying on his left side. He also made clicking noises while eating, meaning his latch was breaking and he was sucking in air. As a result, I contacted a lactation consultant, who noticed the asymmetry and wrote a report for the pediatrician to review. After meeting with the physical therapist, we found that my son has a flat spot on the right side of his skull from a right cervical torticollis, something that has shifted his ear and jaw, increasing his eating difficulties.

The physical therapist took measurements of his head and angles of his body and palpated his muscles to make these assessments without radiographic imaging. The evaluation appointment was not invasive and gave me a bit of insight into how and why he is having difficulty eating and moving to his left. However, x-rays or MRIs may be required if there are bone and neurologic concerns.

How Is Torticollis Treated?

Torticollis is treated through strengthening and stretching exercises. Physical therapy is often prescribed, but massage and exercises may also be done at home. My lactation consultant recommended YouTube videos and showed me a couple techniques to try to help his tension until I saw the doctor.

The goal of the exercises and massage is to increase range of motion in the neck and develop symmetry in the head and neck, correcting the functional muscle imbalance and head posture.

Massaging the tense areas gently (the right side of my son’s neck) and encouraging him to look the opposite way were key principles I took from the videos and the first couple sessions of physical therapy. Additionally, I was told to increase his “tummy time.” While on his stomach, my son increases his neck strength, and as he looks up it stretches the muscles of his neck. While in this prone position we use toys and talk to him on his left side to get him to turn and further stretch the right side of his neck.

The earlier that infants are referred to physical therapy, the shorter the treatment time (pubmed.ncbi.nlm.nih.gov/21568831/). Note that surgery or bracing may be required for bone or other neurologic causes or when physical therapy isn’t successful.

Torticollis and Scoliosis 

I could not find studies that show torticollis leads to scoliosis. Still, there is evidence that those with scoliosis had torticollis as babies.

Baby with torticollis, demonstrating head tilt and curved posture

I am not a doctor and have no scientific study to back this up this statement, but based on my personal experience, asymmetry can lead to scoliosis. Even functional imbalances (related to muscle use) can over time change the structure of bones—something seen in my son.

As my son used one side more his skull changed shape. If after a couple months of his torticollis muscle tightness we have seen posture rotation and reformation of his skeletal structure, what might years do? I would rather work to address his asymmetries now to limit the strain on his body over time—something that, in my opinion, can reduce the chance that it develops into scoliosis.  

This congenital condition occurs in between 0.3% and 1.9% of births (pubmed.ncbi.nlm.nih.gov/21568831/), with higher incidences among boys than girls by a 3 to 2 margin.

Causes of Torticollis

Common causes include intrauterine position, which often occurs when there is limited uterine space—like in first pregnancies or when there is decreased amniotic fluid—or as a result of traumatic births, or those including forceps, vacuums, or natural postural stress during the delivery process. 

Consequences

The position of the baby’s head can place asymmetrical pressure on the skull and facial bones, which can affect head shape, motor development, language, and posture, possibly leading to scoliosis.  If the head shape is altered, or there is tightness on one side, it can limit proper breastfeeding positioning and make it difficult for the child to eat.

How Is Torticollis detected?

Torticollis is generally detected in babies starting at around four weeks. As babies begin to have more control over their head, parents can notice its rotation or tilt more.

In my case, my son was having trouble nursing on one side. He was noticeably agitated and tense on my right side, when he was laying on his left side. He also made clicking noises while eating, meaning his latch was breaking and he was sucking in air. As a result, I contacted a lactation consultant, who noticed the asymmetry and wrote a report for the pediatrician to review. After meeting with the physical therapist, we found that my son has a flat spot on the right side of his skull from a right cervical torticollis, something that has shifted his ear and jaw, increasing his eating difficulties.

The physical therapist took measurements of his head and angles of his body and palpated his muscles to make these assessments without radiographic imaging. The evaluation appointment was not invasive and gave me a bit of insight into how and why he is having difficulty eating and moving to his left. However, x-rays or MRIs may be required if there are bone and neurologic concerns.

How Is Torticollis Treated?

Torticollis is treated through strengthening and stretching exercises. Physical therapy is often prescribed, but massage and exercises may also be done at home. My lactation consultant recommended YouTube videos and showed me a couple techniques to try to help his tension until I saw the doctor.

The goal of the exercises and massage is to increase range of motion in the neck and develop symmetry in the head and neck, correcting the functional muscle imbalance and head posture.

Massaging the tense areas gently (the right side of my son’s neck) and encouraging him to look the opposite way were key principles I took from the videos and the first couple sessions of physical therapy. Additionally, I was told to increase his “tummy time.” While on his stomach, my son increases his neck strength, and as he looks up it stretches the muscles of his neck. While in this prone position we use toys and talk to him on his left side to get him to turn and further stretch the right side of his neck.

The earlier that infants are referred to physical therapy, the shorter the treatment time (pubmed.ncbi.nlm.nih.gov/21568831/). Note that surgery or bracing may be required for bone or other neurologic causes or when physical therapy isn’t successful.

Torticollis and Scoliosis 

I could not find studies that show torticollis leads to scoliosis. Still, there is evidence that those with scoliosis had torticollis as babies.

I am not a doctor and have no scientific study to back this up this statement, but based on my personal experience, asymmetry can lead to scoliosis. Even functional imbalances (related to muscle use) can over time change the structure of bones—something seen in my son.

As my son used one side more his skull changed shape. If after a couple months of his torticollis muscle tightness we have seen posture rotation and reformation of his skeletal structure, what might years do? I would rather work to address his asymmetries now to limit the strain on his body over time—something that, in my opinion, can reduce the chance that it develops into scoliosis.  

UPDATE
About 18 months after treatment, I wrote a new post about where we are at. There seems to be more to this story…

Other posts in the Yoga for Scoliosis, Pregnancy, and Postpartum Series:
First Trimester Prenatal Yoga for Scoliosis
Yoga Poses for Scoliosis and Pregnancy
Review: Yoga for Pregnancy: Safe and Gentle Stretches by Sandra Jordan
Prenatal Yoga Tips
Top 5 Prenatal Yoga Poses
Can You Get an Epidural if You Have Scoliosis
Torticollis, Scoliosis, and Sensory Disorders
Torticollis and Lip/Tongue Tie Resources for Babies
Review: 5 Days to Mindful Mothering by Susie Fishleder