What is Torticollis ? 

Torticollis is the term used to describe the tightening of a muscle in baby’s neck. It is the shortening of one of the neck muscles, the sternocleidomastoid (SCM), which results in the baby’s head tilting slightly to the side and rotating in the opposite direction. 

What are some causes of torticollis?

  • Position of baby in utero (higher risk with twins or pregnancies with growth restrictions)
  • A long/difficult labour and delivery which can cause muscle spasms in baby’s neck
  • A preference of looking one direction over the other, eventually leading to the muscle shortening
  • Having a flat spot on the head may cause the baby to always rest in this position and over time, tightens the muscle

These are some conditions that appear like torticollis and are important to rule out: 

  • Vision difficulties
  • Hearing difficulties 
  • Reflux or GERD 
  • Viral infections 
  • Improper alignment of the spine 

How will torticollis impact my child?

Imagine your baby trying to develop their gross-motor milestones while their head is always tilted and looking one way. They will have difficulty with the following:

  • Learning to roll both directions
  • Learning how to sit independently
  • Discovering where the center of their body is (discovering midline)

Furthermore, torticollis can often lead to plagiocephaly – a flat spot on baby’s head, because of a preference to always rest in one position. See our plagiocephaly post here: Help! My baby has a flat head!

The neat thing about torticollis and plagiocephaly is it can be corrected quite easily, especially from a young age. EARLY INTERVENTION is key, and easiest to treat. 

What to expect during an assessment with your paediatric physiotherapist:

  • We will see how your baby’s neck moves to determine if there are any restrictions
  • Rule out the more complicated causes of torticollis
  • Provide tips to help to correct this and if warranted, give you stretches and strengthening exercises appropriate for the stage of your baby’s development
  • Depending on baby’s age and severity of the torticollis, we may also track your baby’s head shape to ensure they’re not developing a flat spot

Remember, the EARLIER the BETTER. It’s much easier to work on positioning and stretching exercises with younger babies, and that can allow us to introduce strength exercises at the optimal time. 

If you have any questions, please contact us at! We’re able to provide assessments over video call until we get over the COVID-19 hurdle. You do not need a referral for physiotherapy.

Written by: Karly Dagys, Physiotherapist

My baby has a flat head…

Is this a common issue?

YES, this is a very common issue with babies. Flattening can be caused by the following:

  • Your baby has a preference of looking in one direction, resulting from tight neck muscles
  • Your baby prefers looking in a certain direction but there are no neck restrictions
  • Your baby is a good sleeper and doesn’t move much when sleeping

 3 Types of Flattening

Plagiocephaly is flattening on one side of the head from your baby preferring to look left or right. It is often associated with tight neck muscles (torticollis). Things you may notice:

  • Flattening on the back when washing your baby’s hair
  • One cheek appears larger
  • One side of your baby’s forehead is more prominent than the other
  • One eye is slightly larger than the other

Brachycephaly is flattening directly on the back of your baby’s head and is often seen with babies who sleep for long stretches without turning their head to either side. It causes baby’s head to be wider than average.

Scaphycephaly is the rarest type of head shape issues we see and is when the head is more narrow than average. It is most commonly seen in babies who spent long periods of time in the NICU because their heads are being turned from one side to the other.

How will a flat head impact my child?

  • Depending on the severity of flattening, your child may have difficulty fitting helmets, because these are made for the average shaped head.
  • Plagiocephaly can result in a forward shift of the facial bones, which can be purely aesthetic or in severe cases can lead to jaw issues.

What can we do?

  • A paediatric physiotherapist can measure your baby’s head to determine if there are any concerns and provide you with education to best manage your baby’s head shape.
  • When recommended, we can refer you and your baby to an orthoptist for helmeting. This is dependent on your baby’s age and the severity of flattening.

When is it best to seek help?

  • The earlier the better! This provides more time to track your baby’s head growth and improvements in flattening. The earlier you come in the more likely we can address the flattening conservatively (with positioning, education and stretches if needed).
  • If a helmet referral is required, seeking help earlier is better to optimize the amount of change obtained with the helmet.

 If you have any questions about your baby’s head shape, feel free to contact us!


Written by: Maegan Mak



Our first post was on infant motor milestone assessment and one of the things we also screen for in this assessment is torticollis, the shortening of neck muscles that causes a preference in the direction baby looks.

Understanding Toricollis.

Torticollis: shortening of one of the neck muscles, usually the sternocleidomastoid (SCM), resulting in the baby’s head tilting slightly to the side and rotating in the opposite direction.

Do you need a doctor’s referral?

We see these referrals from doctors, chiropractors, midwives and parents who have noticed that their baby looks one way more than the other. You do not need a doctor’s referral to book an appointment. If you have extended benefits that cover physiotherapy, you can use these to cover your session.

What does a torticollis assessment involve?

When you come into physiotherapy for this issue we assess how much baby moves their head on their own to each side and also how much we are able to passively move their head. If there are any restrictions we can teach you some stretches and strengthening exercises, as well as positioning techniques that would be best for your child.

We find this a great opportunity for the you to gain education on positioning, gross motor milestones and ask any questions you may have about development of your baby. When we are assessing a baby for torticollis we are always monitoring their gross motor skills and development for their age. If there are any concerns, we can have the you work on these areas as well!

Often times the families were unaware of the skills noted as needing improvement, or they noticed and were unsure of who to ask. This “one on one” time with your family is beneficial to decrease the stress for you and allow any questions to be answered. If we are unable to answer your questions we can refer you to someone who would be more knowledgeable in that area.

When is the best time to get assessed?

The earlier torticollis is identified the easier it is to resolve. Early identification also reduces the likelihood of secondary issues of torticollis such as plagiocephaly. If you are unsure if your baby should be assessed, feel free to call or email us and we can answer any questions!

Understanding Your baby’s development.

We are so glad you asked. It can be confusing for new parents to understand exactly where their child’s development is currently at. Luckily, we can help break it down into understandable milestones and processes, eliminating the guesswork and give you a greater understanding of your child’s health and motor skill development.

What are Motor Milestones?

Infant motor milestones are a specific skill that we expect babies to reach around a certain age range. Often times parents will be aware of the major milestones such as rolling, crawling and walking, but not know the ones in between. I find parents have lots of questions about what they should be expecting to see next, what ways they can help their babies achieve various milestones and what toys are appropriate for their baby’s specific age.

What does a physio assessment look at?

In these sessions, I observe how the baby moves and assess where they are for their age. From here I educate the parents on where their baby is compared to other babies of the same age. If the baby is behind in any gross motor skills I describe what they should be doing and specific tips to help them achieve this. If the baby is on track, we discuss what to expect next and different ideas of how to facilitate devolvement of that particular skill. We practice the movements and exercises together to ensure the parents are comfortable with doing them at home.

Another area covered in the infant motor milestone session is positioning for their baby.

Many of the babies I see will spend majority of the time on their back, a portion on their tummy, a bit of time in a seat of some sort and then being held by family members. There are different ways to hold babies, pick babies up and different ways for them to be on the floor which all assist in their development. This is information that parents are usually happy learning about and implement into their daily routine immediately!

What parents say…

I hear time and time again how being a new parent is overwhelming and it’s difficult to know what information from the internet is correct. Families love coming in to learn about where their baby is at from a physical stand point and learn strategies to help them reach their next milestones. They appreciate the one on one time spent with them and the safe environment to ask questions about their baby. Often times, moms will say, “I wish I knew about this sooner!”

What about baby toys?

On top of the gross motor skills, I often get asked about what sorts of toys are worth purchasing and which toys provide the most benefit for their baby’s development. I find that it’s not so much about the toy but about the different ways they can use the item. As a pediatric physiotherapist, I can identify several different purposes and benefits of an average toy. If families already have certain toys or equipment I will give them different strategies on how to use it to gain a specific developmental milestone. If they are looking to purchase new toys then I give suggestions on ones that are good for development at their baby’s specific age. Parents find this beneficial because they don’t want to spend money on a toy that will be used for a short period of time or one that that doesn’t promote different areas of development. Space is a large issue for many families as well, and they do not want to fill their space with unnecessary toys or equipment.

Stay Tuned!

Infant motor milestone assessments are just one reason why kids or babies come to physiotherapy! Stay tuned for more information on why kids come to physiotherapy. I will be releasing more blog posts on different reasons of why kids come to physiotherapy!




Photo by li tzuni