There is a hidden condition behind infants and young children who keep their heads turned in only one direction. Pediatric torticollis is relatively common, and because early intervention leads to a good prognosis, parents’ timely awareness plays a crucial role in their child’s balanced development.

Pediatric torticollis is a disorder in which the head tilts to one side and rotates in the opposite direction due to abnormal tension in the neck muscles, particularly the shortening or fibrosis of the sternocleidomastoid muscle, the main muscle in the neck.

This condition is mainly observed right after birth or during early infancy and is known as a relatively common musculoskeletal abnormality, occurring in about 1-2% of newborns.

Typically, after 3 to 4 months of age, infants develop their neck muscles and can stably support their heads against gravity, are able to maintain horizontal gaze with both eyes, and gain the ability to keep their necks nearly vertical.

However, if there is congenital shortening or fibrosis of the sternocleidomastoid muscle, or if the head tilting persists for other reasons, this is referred to as pediatric torticollis. Without proper correction, facial asymmetry or postural imbalance can develop as the child grows. In rare cases, it may also lead to secondary alignment issues such as scoliosis.

Clinically, pediatric torticollis may be suspected if a firm lump is felt on one side of the neck, if the child only turns their head in a particular direction, consistently keeps their head tilted and looks in the same direction, or shows discomfort or cries when their head is turned the other way.

원본보기 아이콘

원본보기 아이콘

원본보기 아이콘

원본보기 아이콘

The diagnosis is made based on a comprehensive assessment of medical history and clinical symptoms by a rehabilitation medicine specialist. If necessary, ultrasound can be performed to confirm abnormalities in the sternocleidomastoid muscle and to distinguish from masses outside the muscle.

It is important to establish an individualized treatment plan based on the diagnosis of the underlying cause. Initially, physical therapy is used to restore the flexibility of the shortened sternocleidomastoid muscle and improve neck alignment. Rehabilitation therapy tailored to the child’s stage of development helps recover the neck’s range of motion, taking into account overall developmental balance.

In addition, caregiver education is essential to enhance the effectiveness of treatment. Continuous management at home is required through instruction on correct ways to hold the child, proper feeding positions, and daily posture correction methods. When medical treatment and lifestyle adjustments are combined, the effectiveness of therapy can be maximized.

Choi Seungyoung, Head of the Rehabilitation Therapy Center at Daedong Hospital (specialist in rehabilitation medicine), emphasized, "While pediatric torticollis may resolve naturally in some cases, appropriate therapeutic intervention such as physical therapy to alleviate shortening of the sternocleidomastoid muscle is necessary when muscular torticollis is present. It is desirable to have an early, thorough assessment by a rehabilitation medicine specialist, and to maintain ongoing, customized management for the child, including posture correction, stretching, and caregiver education."

Because growth and development occur rapidly during infancy and early childhood, it is crucial for parents to closely observe their child’s posture and movements in daily life, and to seek evaluation by a specialist if any unusual behaviors persist.

What is Torticollis?

Torticollis (斜頸症, torticollis) is a condition in which the head and neck tilt and rotate abnormally to one side due to abnormalities in the muscles, bones, or nerves of the neck. The most common form is congenital muscular torticollis, which occurs when the sternocleidomastoid (a major neck muscle) shortens or becomes fibrotic.

As a result, the head tilts toward the affected side, and the chin turns to the opposite side, creating a characteristic posture. Early detection followed by stretching and physical therapy often leads to improvement, but delayed treatment can cause complications such as skull deformation or facial asymmetry.
Getty Images Bank