Torticollis is most recognized as being tightness or immobility of the sternocleidomastoid muscle with asymmetrical head positioning. However, there are often other related findings…Torticollis is more than just muscle tightness.  

Effects of Torticollis
  • Tightness of upper trapezius & gluteus medius
  • Shoulder elevation
  • Scapular retraction
  • Trunk shortening
  • Decreased head righting to non-involved side
  • “Non-involved” side weakness due to over-lengthening of the neck & trunk muscles.
  • Reflux is typically the underlying cause for torticollis to the left.
  • Skull asymmetries such as plagiocephaly.
Other areas affected by torticollis:
  • Vision issues can be seen with torticollis. Avoidance of a horizontal gaze to the affected side is seen with an ocular compensation of an upward gaze. Symmetry of eye control with normal alignment of the head and trunk is part of treatment.
  • Upper extremity issues associated with torticollis may include fisting of the hand and retraction of the arm with reduced activation on the “torticollis” side. Treatment addressing shoulder-scapular mobility and strength usually resolves these issues.
  • Lower extremity concerns include increased external rotation of the leg and overall reduced hip extensor (gluteal) muscle activation.   Dragging of the limb and excessive circumduction is also seen during ambulation.
  • Oral motor issues are occasionally seen. There may be a decrease in lateral jaw shift toward the torticollis side, bunching of the tongue, reduced lip closure, and asymmetries in sucking on the bottle or breast.


Physical therapy treatment is strongly recommended.  Therapy is multi-faceted and incorporates specific neuro-developmental techniques to normalize head position.  The following areas are addressed:  strengthening of hip, spine, and trunk extensors; which promotes symmetry of arm reach, and both upper and lower extremity weight bearing.

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