4 Easy Exercises for Infantile Torticollis
4 Easy Exercises for Infantile Torticollis
Torticollis is a relatively common physical issue that parents face with their newborns. A head tilt is actually a clinical presentation that may have a variety of causes. The vast majority of head tilts in babies come from musculoskeletal causes and are likely to fall under the category of Congenital Muscular Torticollis (CMT). It is very important to get a thorough assessment by a qualified professional to ensure you have the right diagnosis, as the specific diagnosis will depict the appropriate treatment and early treatment is likely to lead to better results. (If you want to learn more about this, please check out our full page with lots of information on torticollis.)
altaviehealth.com/…/AV-Handout-Torticollis.pdf
The standard of care for congenital muscular torticollis in infants includes stretching/soft tissue therapies and a home exercise program. If you are concerned about your child’s head tilt and anxious to get started at home while you wait for your assessment, here are some easy exercises to get you started.
*Please note, these exercises do not replace the need for an assessment and complete care plan!
1 – Tummy Time
Yes, tummy time! Please don’t roll your eyes. Tummy time is BIG DEAL. Success in tummy time is one of the best predictors of future motor success. We need a strong prone posture to build our next set of physical skills on (and it is also important for head shape and vision development and … we could go on and on). Tummy time is specifically important for infants with torticollis for two reasons: 1) it helps develop neck strength and 2) it support motor development success. Children with a head tilt are more likely to be behind in their motor milestones, so they may need extra practice.
If you like numbers, you want to have at least 3 tummy time sessions a day and reach at least the minimum quotas in the chart below.
| Age | Minimum Cumulative Time Per Day
(There is no max!) |
| 1 month | > 15 minutes (or more!) |
| 2 months | > 30 minutes |
| 3 months | > 60 minutes |
| 4 months & older | Floor time, explore time, all the time. |
Struggling with tummy time? Here are some tips to support your success!
- Start small. Try doing 1-2 minutes of tummy time as often as possible throughout the day.
- Try Supported. Use a feeding pillow or other soft props under your babes armpits.
- On-person prone position. (I couldn’t resist the alliteration.) Most infants will tolerate tummy time on a parent’s chest much more than on the floor.
- Lap time. Hold babe across your lap. This way you can gently rock back and forth for movement or add a little bit of a tilt to keep them content for longer periods.
Tummy time counts as anything prone (laying on belly) and awake. So be creative!
2 – Vary positions when holding, feeding, playing.
Variety is your friend. This will encourage your child to move their head in a variety of positions and through a more full range of motion. Alternate positions and switch things up when feeding, carrying, and playing with your child. Sometimes, we default to specific positions because babe has a preference, like if they will only feed from one breast or they always tilt or turn to look the same direction. (If this is the case, I strongly recommend that you see a practitioner the help you out with any potentially restrictive preferences ASAP.) But sometimes, we default to certain positions or holds because of a parent’s preference. We all have a dominant side and comfortable positions that we like to hang out in. Make sure that you are switching which side you carry on so that babe has the opportunity to look both directions. The same goes when babe is in a carrier; try to alternate the direction that they are facing.
Where I often see this sneaking in is with bottle feeding. We tend to naturally switch sides when feeding from the breast, but when bottle feeding we tend to default to whichever side is more comfortable for the parent. Try alternating the direction you hold babe in when bottle feeding. This will be more of a brain twister for most parents than it is a challenge for their babies!
Siblings can come in really handy when trying to alternate sides. If your baby has a strong but not rigid preference to look one direction, have siblings (or parents) hang out and make faces or sings songs to babe from the other side. No siblings? Perhaps try position the family pet or favourite toys on the less favoured side. 🙂
Sleeping is another opportunity to alternate positions. Try switching the side of the bed that you put baby down in, especially if they are in a basinet beside parent’s bed. If they are sound sleepers, you can try to gentle move their head out of the preferred position, but I would not recommend sleep time as your primary battle ground. I would prioritize baby (and parents) getting a good nights sleep and then focusing your efforts on wake-time interventions.
3 – One-Arm Football Carry
This one is really simple, but is a really great passive stretch. When standing or walking around, carry your baby in one arm with their head res
ting in the crux on your elbow on the side that they tend to tilt toward. This means that if your child’s head is tilted with their right ear close to their right shoulder, then you hold them in your right arm.
This position tends to be very well tolerated as babe feels secure, has pressure on their tummy, and gets a nice view. If your arm is small or your baby is big, you can do this as a two-arm carry in front of you, but the head should still be resting in the elbow on the side of the head tilt.
4 – Lateral Head-Righting
If your baby is 4-months old or older, they may be ready to play with active lateral head-righting. This is one of the first postural reflexes to present in infants. Essentially, it is a reflex that keeps the eyes on the horizon when you tilt the body to either side. You can play with this reflexive head-righting in prone or sitting, but we usually start with prone (on their belly).
You can hold babe securely and tilt them side to side like playing superman. It is also really fun when done on an exercise ball. Hold babe securely in tummy time position on an exercise ball and slowly roll the ball side to side. The more upright the child is, the easier it should be for them to control the head tilt.
Setting up a home environment with lots of “reps” in the right direction and following a home exercise program are incredibly important components of torticollis care. The exercises above can be fun parts of a home exercise program and they are great ways to play with any infant. That being said, I want to re-iterate the importance of confirming that it is definitely congenital muscular torticollis that is causing your child’s head tilt. You need an assessment from a professional to rule out “the bad guys” and make sure you are on the right track. Early interventions have better outcomes for torticollis, so please do not delay!