Torticollis (Tilted Neck)

Parent Q&A

  • Pediatric PT for Torticollis

    (3 replies)

    Hello parent friends! Our 12 week old has a right side head lying bias - Dr indicated due to tight RH neck muscle (torticollis) and recommended PT. Have a referral at CH/ Oakland but can't get appt for 6 weeks - looking for alternatives Can anyone suggest a ped physical therapy provider that you had a good experience with?  Much thanks Freddy

    RE: Pediatric PT for Torticollis ()

    Have you considered cranio sacral treatment? Nancy Burke is wonderful and works with babies. It is a very gentle treatment, but effective.  I had it in pregnancy for back pain and brought my baby in with tightness in jaw that was interfering with latching and we saw improvement quickly.

    It can be used in combination with PT, chiropractic, etc.. and is not invasive.

    I noticed she moved to El Sobrante but she is worth the drive.

    RE: Pediatric PT for Torticollis ()

    I would also recommend cranio-sacral treatment. Our daughter had a slight torticolis and we worked with Trisha Parrish located in North Berkeley for a few sessions with 100% success. Trisha is highly skilled and has a lovely, gentle way with babies and moms (dads too!). Over those tender months she helped our baby overcome multiple ear infections without needing antibiotics as well as the torticolis, and we had similar positive experiences when we brought our second child in for same issues. Trisha can be reached via Elixir Salon on Hopkins: 510-527-1700.

    RE: Pediatric PT for Torticollis ()

    Dr Meg Jett is an Osteopath who's also a pediatrician (DOs have full license to practice medicine like MDs).  She did her rez at Kaiser and worked under one of the most experienced pediatric osteopaths, Margaret Sorrell. I would to go to her. Osteopaths who specialize in cranial osteopathy have far more formal training than most cranial-sacral therapists.  We took our son to her to deal with a similar issue, and to help his ears drain to avoid infection and antibiotics. I would recommend her.

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Two year old with torticollis - physical therapist?

Aug 2009

Can anyone recommend a pediatric physical therapist in the East Bay or SF? I have a 2 year old son who was born with torticollis and have noticed that his back muscles are not developing symetrically. I am looking for someone who is hands on and can offer some sort of treatment versus an evaluation/suggestions. Recommendations for other practitioners such as chiropractic and craniosacral are welcome. Thanks in advance! David

Elaine Westlake of Kids Development Studio* Janet Green-Babb of Developmental Progressions* Cindi Berry of CPMC's Child Development Center* are all excellent. Elaine's studio would probably be most accessible from the East Bay as it's just off 280. Good luck! j.

I know and could recommend Kaiser PTs but it sounds like you are not Kaiser so I'd recommend starting with Children's Hospital Oakland, where they also have lots of great PTs who see lots of kids with torticollis. good luck

Dr. Paul Walton is a great chiropractor in Orinda. He is also one of the teachers at the chiropractic college in Hayward. I don't know if he works with kids or not, but I'm sure he would be able to point you in the right direction if he feels that it's necessary.

Jason Rabineau is also wonderful. He is a chiropractor as well as a rolfer and really understands how the body is put together and how to bring it back into alignment. He has an office in S. Berkeley as well as S.F.

On an other note, my daughter had torticollis as well and a physical therapist (in CO.) gave me some daily stretches for her. They did help, however I think that including some deeper tissue/skeletal work as well would have been a good idea. Best!

Babies with torticollis

Sept 2008

I have 6 month old twin boys and one of them was diagnosed with torticollis 2 months ago. He has been seeing a physical therapist, we've been doing stretching exercises and now he is wearing a collar (which he hates). Overall I don't feel that he is getting much better, even with the collar. For those who have gone through this, how long has it taken for the torticollis to resolve? Any advice on how to entertain a baby who has to wear a neck collar?? I'm feeling pretty lost here... J

My son had torticollis (diagnosed minutes after birth). He did not have to wear a collar, but we were doing PT with him for about two years. Part of the PT involved not only neck stretching, but trunk strengthening (which is a little hard when they are not at least crawling). I also highly recommend chiropractic care. Make sure the chiropractor specializes in children. My son ''graduated'' from PT at 2.5 years. I notice no tilting. It seems as if it will never go away, and then one day you see it is gone.....

The most difficult part was stretching because he would fight it and then tighten what we were trying to stretch!!

My husband did the best...he would cradle him in his arms with my son on his torticollis side and let my son's body weight stretch him. It was a very relaxing time if he was in the right mood.

Torso strengthening using an exercise ball....probably all stuff your PT is doing. nancy

Hi -- You don't mention if therapy is including things other than the use of the collar and stretching. I am a pediatric PT with 18 years' experience and find that most babies HATE HATE the collar, and it does not always give optimal results.Several other issues need to be addresses and looked at as well. Has your child's physician also checked his hips? Sometimes a ''torticollis'' is actually a hip issue that is resulting in shortening all the way up one side. Does he shorten in the trunk on the side of the lateral flexion of the neck? Simply stretching the neck and wearing collar will not generally solve the torticollis problem if the trunk issues are not dealt with as well. Therapy needs to include active stretching (i.e. your son moving his own body AWAY from the position of the tight muscle with facilitated transitions and activities, AND addressing both aspects of the muscle tightness (the lateral flexion and rotation components).One also needs to be aware of whether the muscle is still restricted as you go along, because babies can work out of the tightness with PT, but often continue with the torticollis posture as this is how they have learned to orient themselves from day 1 -- need lots of constant input at both therapy session and home as to correct head position. If all of those things are not being watched and addressed, I would seek a referral for another PEDIATRIC PT. Best of luck!

Baby with head tilt at one year

October 2006

I would like to solicit som advice about my son's torticollis: I know there has been some advice in the archive, but my son's case seems particular. He is one year old now, and since he is 6 weeks old, his head is tilting to one side, mainly the left. After we took him to OT, his head was straight for like 2 weeks, then tilting again. Sometimes, his head will tilt to the other side, for appr. 2 weeks again. The doctor said he would outgrow it by 6 months, then by a year. His is a year old now, and still his head is tilting to one side, pretty strongly. The pediatrician said it wasn't a typical torticollis, as the neck muscle seems fine. No one seems to know where it comes from.

My son is also delayed in his gross motor skills. It seems like he has poor trunk control. He also developed a flat head from sleeping with his head slightly titled to one side.

I am at a loss. If you have any advice or idea, please let me know. I have already seen a neurologist, a cranio-sacral therapist and a PT Puzzled mom

Have your son's vision checked. Some children tilt their heads in order to create correct vision. I actually just saw a show on TV about a child who sounded very similar to your child and, if I recall correctly, one of his optic nerves (or one of the other facial nerves) was longer than the other which created double vision that was corrected by the child through his head tilt. He required surgery and immediately the head tilt (and other associated gross motor challenges) went away. Good luck! Diane

My niece as an infant had a tendency to tilt her head to one side. Like your son, she was evaluated and it was determined that nothing was wrong with her muscles. Based on a hunch my sister had, the doctors tested her eyesight and, sure enough, it turned out that my niece was extremely nearsighted in one eye, but had normal vision in the other -- she was tilting her head to favor the good eye. She has been wearing glasses since she was 9 months old and, sure enough, that made the head tilt problem go away. I didn't know it was even possible to test infants for nearsightedness, much less to figure out what strength lenses they need, but apparently they don't need to be old enough to read an eye chart -- measurements can be done with lasers instead. If your son's vision hasn't been tested yet, you may want to give that a try Diane Fisher

Our daughter had the head tilt and subsequently started to develop a flat side because she seemed to sleep facing one direction. We were referred to Children's Hospital by our pediatrician for an evaluation. The doctor said that while the tilt is no major problem by itself as they grow it effects how they look at the world, literally. They immediately scheduled her for OT and fitted her for a neck brace that she was to wear all day. Then we learned exercise for her, ways to hold her to help stretch and strengthen the muscles. We were told that the head braces that you see listed on some sites to fix the flat head part actually do nothing for the problem which is the result of the weakness in the neck. She was also developmentally delayed. Initially when we saw improvement we slacked off only to see her tilt again, so we became more diligent and unless she is very tired you don't notice it at all (no one does but us) and she has caught up totally in every way. I cannot say enough good things about the folks at Children's hopital.

I must admit that looking back on photos, she always had that cute tilt that I thought was part of the pose and tried to overlook when a doctor friend advised me to have it checked out. The photos with her in the neck brace are a little hard to see sometimes but she always had a smile on her face! setting the world straight :)

Hi, I'm not sure if you've also looking into getting a developmental/functional vision evaluation by a developmental optometrist who is trained in looking at young children's vision. I am a pediatric occupational therapist and have occasionally referred children to rule out vision as a possible cause of the torticollis. (We're moving to Berkeley soon so I'm not sure about WHERE to go but if you do a google search I think you might find some possibilities in the East Bay area.) Hope this helps! Laura

Please rule out an eye problem - lazy eye, a nerve palsy, etc., could be causing your baby's head tilt. William Good, M.D. in San Ramon, Walnut Creek, Larkspur, and SF is the best pediatric opthalmologist around. Good luck Anon

Since so many of the replies mention checking for a vision related problem, I thought I'd mention that we've had a very good experience working with Dr. Deborah Orel-Bixler at the UC Berkeley eye center (642-2020) on this. Our son's case is mild, but Dr Orel-Bixler is very thorough, careful, warm and experienced in eye conditions like this for very young children.

The vision connection can be hard to recognize - I specifically asked at his 2 year checkup at the clinic if his head tilt was a vision problem and the drs at that visit (not Dr Orel-Bixler) didn't see it as such, and it wasn't identified until he was 3. As others have said, they do have ways of testing the vision of even babies, but I think the tests get more refined when the child is older and can answer questions.

A vision problem might not explain what your baby is going through, but for the sake of the archives I wanted to recommend Dr Orel-Bixler since she specializes in this area and the UC pediatric eye center is so great for young kids (singing doctors, lights, toys, movies, something to entertain every age) - Charis

16 month old daughter has torticollis

March 2005

Hi, My 16 month old daughter has torticollis. She was diagnosed when she was 4 months old at which point I started physical therapy as well as helmet therapy for her misshapen head. All along everyone told me everything would resolve once she started walking and that her head would even out. Well, a year later she is still has a significant tilt and her head is still misshapen. We were discharged from physical therapy several months ago however continue to go for osteopathic therapy once a week. I would love to speak with other parents who have children with torticollis/misshapen head. My orthopedic surgeon is talking about potentially operating (the operation is called a release), I would love to know if anyone has had this type of surgery and what the results were.

I did not read the original post, but a friend just strongly encouraged my to reply. I am intending to respond to the person who is considering surgery for a child with a torticollis diagnosis. Based on personal experience, which I've detailed below, I urge you to confirm that the torticollis is not due to ocular problems. Perhaps you've already done this, and perhaps you have clear confirmation that the torticollis is due to a muscle spasm or tightness. But in case you haven't, please know that a head tilt is a diagnostic hallmark of fourth cranial nerve palsy,a disorder in which the eye's movement is restricted and the child tilts the head away from the affected eye in order to prevent double vision or to preserve binocular vision.

For what it's worth (and partly to vent), here's my expeience. My daughter was diagnosed with torticollis at 5 months and endured several months of physical therapy stretching exercises (which I felt were pretty traumatizing to her). This, all while I was suspecting that she may have some vision problems, although our pediatrician tried to allay those concerns. When she was 12 months, I could no longer ignore the fact that she continued the head tilt despite the p.t. noting that her flexibility was fine. I also was becoming increasingly concerned with her intermittent squinting and the comments from friends and family that her eyes appeared someone crossed. I took her to an opthamologist (Dr. William Good), who immediately diagnosed her with 4th cranial nerve palsy, which is commonly misdiagnosed as torticollis. We are now treating the problem with patching and will likely be looking at surgery in a few years. Had we checked out the vision problems sooner, we could have avoided all of the physical therapy and begun the proper treatment sooner, possibly avoiding the need for surgery. I hope this helps. Alisa

Baby with wry neck

Jan 2004

Does anyone have experience with a baby with wry neck? Our 6 month-old has been tilting her head to the right for a few months now. I asked the doctor about it and he said that this was just a very mild case of wry neck and that he wouldn't have even noticed it had I not called his attention to it. He said it probably came after a cold that ''got into her neck.'' The doctor recommended doing stretching exercises daily, which the baby hates! What have others done to deal with this condition? What about baby chiropracters? Is there any chance she'll just grow out of it? How long should it take for the stretching exercises to remediate the condition? Thanks! anonymous

Wow, you are a great parent for noticing this and being concerned. However, I worry that your pediatrician isn't taking this seriously enough. First, are you absolutely sure that your daughter does not still have an infection of the ear or sinus? Some kinds of infections can throw off the ''balance center'' in the inner ear and cause the head tilting that you are noticing. She should definitely be examined to rule out any type of infection first. If that turns up nothing, she may actually have torticollis (although its strange that it would appear so late after birth, usually it is caused by an injury) in which case she should be referred to a pediatric Physical Therapist or Occupational Therapist to intervene now before it gets worse. Untreated torticollis is a serious condition and can lead to facial deformities and uneven eyes and features besides the odd neck tilting which becomes a permanent deformity in itself. The key to treating it is not only to do the right kind of stretching, but also more importantly the right positioning in car seats, bed, swings, etc. A pediatric PT or OT can show you games to play to work with your daughter to make the stretching easier. Trust your parent instincts and get a second opinion from another pediatrician. a PT and a mom

A first alternative to seeing a baby chiropractor is to see a specialist in craniosacral therapy. Susan Feldman, at Back in Action Chiropractic at 2500 MLK Way in Berkeley, is an expert craniosacral therapist and often sees babies. I had her check my 6 week old son for anything to watch out for in terms of stiffness or soreness, especially since my older niece could only breastfeed from one side because she refused to move her neck to one side (my son checked out with no issues and enjoyed the whole thing). I've had it done myself for neck pain and headaches and found it extremely beneficial yet extremely gentle. I believe Ms. Feldman may even be advising/consulting or doing something or other with Children's Hospital of Oakland (but my memory is not so good now that I'm a mom, so I'm not s! ure how accurate I am on the latter). Again, it's so gentle that, as long as an expert who has experience with babies checks her out, there should be no problem with simply having your infant looked at. CST enthusiast

We needed body work for our daughter when she was born, and were thrilled to find Nancy burke in Richmond. Nancy Burke Bodyworker and Craniosacral Massage Work: 236.1007 237 25th Street Richmond, CA 94804 MacDonald Exit Left on 25th She uses very gentle massage technique called CranioSacral therapy. It didn't look like much to me until I made an appontment for myself (becasuse my vertabrae kept rotating after my daugheter's birth, and I didn't get any help from weekly chiropractor appts. Finally after 7 months I saw Nancy and it only took two treatments. Never had another problem) Anyway, she works with a lot of babies and is a natural with them. You might look up craniosacral massage for more information about it; I would basically say it is a gentle technique for releasing tension in the connnective tissue, with the idea that by releasing those tissues then the muscles can relax. Our baby was twisted up and as a result had a very stiff neck and couldn't open her mouth wide enough to nurse properly. She was helped in just a few treatments, the nursing worked itself out, and she's still happily nursing! at 18 mos. CranioSacral sounds much more gentle to me thase xercises that you and your baby hate! I urge you to call Nancy and at least chat with her about the issue; if she cant help you, she knows a lot of other people that do bodywork with infants. Good luck!

10-month-old has mild torticollis

March 2002

My daughter, now 10 months old, has mild torticollis or a tilted neck, probably from how she was positioned in utero. I discovered it at about 6 weeks, although it took the doctor a few more months to take it seriously. I've taken her to an osteopathic doctor and physical therapist, and although she's much better, I'm not sure how much they helped or if it was just her growing and getting stronger. I'm worried about long-term effects because I myself have chonic pain from scoliosis and an assymetrical body. I want to try other body work treatments for her to address her asymetry at this point, before she might deal with the effects it has on her developing body as she learns to walk, etc. Any one have experience with this or can recommend a really good infant body worker? Thanks.

6 month old with torticollis

Has anyone had experience with torticollis? Our six month old daughter has been officially diagnosed and should have been referred to physical therapy earlier. Nevertheless, she will have stretching exercises and be fitted for a cervical collar soon. We are, of course, worried and would love to hear from anyone whose child had torticollis as an infant. Any advice, success stories, things to watch out for, alternative therapies, comments to anticipate from others, other recommendations, etc.? It is pretty uncommon, but the folks at Childrens Hospital Physical Therapy seem to know how to treat it, hopefully successfully in our case. We are curious at what point your child was referred on by the pediatrician. It seems they are not as on top of it as they need to be. Thank you in advance. a concerned mother

Hi My son had a tilted neck, presumably from positioning in utero. It wasn't diagnosed by our pediatrician, but I noticed him looking only to one side, and pretty much ignoring the other side of his body. I talked with my excellent physical therapist about it, and she said we weren't doing him any favors by ignoring it...and sent me to another excellent osteopath who works with babies. Her name is Catherine Henderson, and her office is on Solano. She was trained as an osteopath in Britian, where the practice is much gentler, and sees a lot of babies and kids. She is not licensed as an osteopath in the US, so insurance doesn't pay. Anyway, she saw Alex for 2, maybe 3 sessions...and the problem was gone! I highly recommend her, and my husband and I are not generally into alternative medicine, especially for kids. But she showed me what she did, and I could hardly feel it. Alex did cry, which she attributed to emotional release. But I could see the progress easily, so it was definately working. The PT who referred her, by the way, is Edie Murphy of Lakeview Functional Rehab in Oakland, who also has a good reputation in the East Bay. She works with disabled kids and has a disabled kid herself. If I had been to children's and had a brace, I would still have gone ahead with Catherine, and hopefully shortened the treatment time. Good luck. If you have any more questions about this, feel free to write. patl

[Editor Note Nov 2017: Catherine Henderson has notified us that she is no longer practicing in California.]

I was a chiropractic assistant for several years, and have also been a patient for a long while. I have seen many people, both children and adults with torticollis helped. I have an awesome chiropractor who is dedicated to helping people. She has reasonable rates, and a family plan ($200 a month for a family of 3, and you can come as often as you need to). She's well trained with babies, and my daughter just adores her. Now- don't everyone expect this, but my husband was laid off after we'd been patients for a year. We had a hard time meeting our finanical obligations, and she treated us free, for 7 months! She's dedicated to helping people get well.... Her name is Geraldine Mulhall, and she's in the city- but I know she does some work ing the east bay on Wed. her number (415) 831-8719 Rachel

Hi, I do not know of a infant bodyworker but I do know of a great gentle, noninvasive technique. Orthobionomy. There are a few on Solano Ave. I have not tried them personally but I studied the technique myself and it is fantastic. I had to stop when the new ''massage therapist/healer'' career I was trying caused a final flare of fibromyalgia that never went away. I do have a friend who got sesions from me and then went to a woman on Solano due to the results from our sessions when I was learning and she loved her. mscwalker

My daughter had torticollis. I noticed it at about 3 months -- because in all the pictures I took, her head was always flopped to the right. I mentioned it to our pediatrian, who sent me immediately to a physical therapist. The physical therapist told me to say a special thank you to my doctor the next time I saw her. The PT said that many doctors will not send a child with torticollis to PT. Rather, they have a habit of waiting to see if in a few months the natural strengthening of the neck will take care of it. The PT said that in some cases that's okay, but in others, if the child hasn't had any PT until she begins to walk, then it's alot harder to correct, painful for the child, and sometimes requires surgery. (Our pediatrician was 3 years out of medical school and I attribute her willingness to treat my daughter immediately to the fact that she wasn't ''old school''.) We went to PT once a week for about 3 months, then tapered off to about once a month. By the time she was 10 months, she was ''cured'' (although I still look at her regularly to make sure there's no re-lapse, she's 26 months old now). It did not affect her crawling or walking. The PT session itself was 45 minutes of tilting her body in ways to make her head go the opposite direction of the torticollis. The PT made me learn how to do the exercises, and made sure that I did them between PT visits at least twice each day. The difficult thing was that she was diagnosed with right torticollis but after a couple weeks of PT she started to slip into a left torticollis - the treatment then shifted to strengthening both sides of her neck equally. The exercises themselves were not complicated - just shifting her body in certain ways so she was forced to use her neck muscles in different ways. The PTs know all kinds of tricks to make it interesting for the kids too. I'm afraid I can't give any advice about where to go in the East Bay, because we lived in Washington, DC when this happened. Our PT was at Children's Hospital in DC, and so I'm sure that the Children's Hospital here is equally wonderful.