Torticollis and Plagiocephaly Awareness

Understanding Torticollis and Plagiocephaly: What Parents Need to Know

When a baby consistently tilts their head to one side or develops a flat spot on their head, it can be concerning for parents. Two common conditions often linked together are torticollis and plagiocephaly. While they may sound complex, both are relatively common in infants and importantly, they are very treatable when addressed early. Our amazing physical therapy team treats torticollis with great results.

What Is Torticollis?

Torticollis occurs when a baby’s neck muscles are tight or shortened on one side. This causes the head to tilt in one direction while the chin points in the opposite direction.

Common signs include:

• Head consistently tilted to one side
• Difficulty turning the head both directions
• Preference for looking in one direction
• Tightness or a small lump in the neck muscle (in some cases)

Torticollis can develop due to positioning in the womb, birth factors, or limited movement early in life.

What Is Plagiocephaly?

Plagiocephaly refers to a flattening on one side of the back or side of a baby’s head. It’s often called “flat head syndrome.”

You might notice:

• A flat spot on one side of the head
• Uneven head shape when viewed from above
• Ears that appear misaligned
• Forehead prominence on one side

Plagiocephaly is often related to babies spending a lot of time lying in the same position, especially on their backs or can happen due to in-utero positioning.

How Are They Connected?

Torticollis and plagiocephaly frequently occur together.

When a baby has torticollis, they tend to look in one direction most of the time. This repeated positioning puts pressure on the same part of the skull, which can lead to flattening—plagiocephaly.

In other words, Torticollis affects movement and Plagiocephaly affects head shape but one often contributes to the other.

Why Early Intervention Matters

The good news is that both conditions respond very well to early treatment. Babies’ bodies and skulls are still developing, making this the ideal time to intervene. Our physical therapists can treat torticollis and if treated early enough, plagiocephaly can sometimes be fixed with positioning to avoid needing a helmet. Without treatment, these issues can lead to persistent head shape asymmetry, delayed motor development and ongoing movement limitations. Early interventions with our physical therapists helps prevent long-term concerns and supports healthy development.

Physical therapy treatment is typically conservative and highly effective. Our pediatric physical therapist will provide the following exercises:

• Gentle stretching exercises

• Strengthening activities
• Positioning strategies
  • Alternating the baby’s head position during sleep
  • Encouraging looking both directions
  • Increasing supervised tummy time
• Encouraging symmetrical movement

If needed, our physical therapists have relationships with local orthotists who can measure your child’s head to determine if a cranial orthosis (helmet) is recommended. For moderate to severe plagiocephaly, a cranial orthosis (helmet) may be recommended to help reshape the skull as it grows.

Talk to your pediatrician if you notice:

• A consistent head tilt
• Limited neck movement
• A flat spot developing on the head
• Decreased tolerance to tummy time
• Your baby strongly prefers one side

Early referral to our physical therapy team can make a significant difference.

Torticollis and plagiocephaly can feel overwhelming at first, but they are common and highly manageable conditions. With early recognition, guided therapy, and simple daily strategies, most babies make excellent progress and go on to develop normally.

If you have concerns, trust your instincts and talk to your pediatrician early to get a referral for physical therapy to support the best outcomes.

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