Comments on: Strategies for Working with Children with Torticollis

By: Dana Childress, PhD

Dana Childress, PhD — Wed, 10 Nov 2021 16:19:32 +0000

In reply to Candice.

Thanks for your question, Candice. Here’s what Kim suggests:
Hello Candice!
Thank you for reaching out. Most children with torticollis will have recurrence of their torticollis if they: 1. Don’t feel good 2. Are tired 3. Growth spurt and/or 4. New gross motor milestone (i.e. walking, climbing, etc.). While I don’t know your daughter, I would suspect that they recently went through a growth spurt and perhaps started climbing or walking up stairs or achieved some other new gross motor milestone. The Clinical Practice Guideline (CPG) for Physical Therapy Management of Congenital Muscular Torticollis recommends that parents try the exercises and stretches they were taught during previous PT sessions if they notice the torticollis returns. If after two weeks of trying the exercises and stretches, the torticollis is still present, the CPG recommends that you follow up with a pediatric physical therapist.
You’re right, the same passive stretches and activities won’t work now that your daughter is older. When kiddos are older I use more active stretching and range of motion. In other words, placing desired toys or objects in a place where they have to look, that will stretch their neck muscles without touching their necks. The older kiddos just don’t tolerate those passive stretches.
I recommend you follow up with a local pediatric physical therapist who can give you new ideas for stretching and strengthening now that your daughter is older. The PT will also be able to determine if your daughter needs to see an Ophthalmologist to rule out any visional component to the torticollis.
I hope that helps!

By: Candice

Candice — Wed, 10 Nov 2021 15:14:49 +0000

Hello,
My daughter is 3 y/o now, and she was diagnosed with torticollis at 6 weeks. We did therapy until she was 1 y/o, and them she was discharged with home exercises. But since she turned 19 months, I noticed the torticollis was back. I can’t find information about exercise for toddlers with this condition. She is a big girl, and the exercises I used to do with her don’t work anymore.
Do you have tips for toddlers?
Thank you.

By: Kim Lephart, PT, DPT, MBA, PCS

Kim Lephart, PT, DPT, MBA, PCS — Tue, 18 Feb 2020 17:20:22 +0000

Sharon!
These are great questions! The APTA’s Academy of Pediatric Physical Therapy (APPT) has some wonderful resources that will help answer all of your questions. If you go to https://pediatricapta.org website. Click on the “Professionals” tab. Then click on the “Clinical Practice Guidelines”. There are resources on torticollis for parents and caregivers; healthcare providers; and clinicians and educators. There is also a Fact Sheet on Plagiocephaly: Under the “Professionals” tab, click on the “APPT Fact Sheets” Under “Interventions” there is a fact sheet on Plagiocephaly. I hope you find this resource helpful in your quest for evidence-based practice!

By: Sharon Smith, PT

Sharon Smith, PT — Mon, 17 Feb 2020 19:25:21 +0000

I wondering what the usual protocol for treatment on average for diagnosis of torticollis and Plagiocephaly? How many weeks etc., HEP, what is skilled treatment vs things parents can do.

By: Strategies for Working with Children with Torticollis |

Strategies for Working with Children with Torticollis | — Sat, 27 Jul 2013 19:14:25 +0000

[…] in with your pediatrician if there is any concerns about torticollis. This is an excellent article from a pediatric physical […]

By: Dana Childress, M.Ed.

Dana Childress, M.Ed. — Thu, 18 Jul 2013 14:38:27 +0000

In reply to Janet Hammond.

That’s really interesting info, Janet. I’m curious…if the child is treated for Sandifer Syndrome, does the torticollis usually resolve itself or do you also have to treat the head tilt? Thanks for sharing the link and starting this discussion!

By: Janet Hammond

Janet Hammond — Thu, 18 Jul 2013 14:29:54 +0000

Torticollis can be secondary to Sandifer Syndrome (http://www.ncbi.nlm.nih.gov/pubmed/17168985), which is a response to painful reflux.

Screening for reflux and referral ro GI should be part of a torticollis work up.

Another nod to the team-based model.