Baby’s Head Always Tilted or Turned One Way? Torticollis Signs and What to Try Today
By Ellen Argo, PT, PCS
Board-certified pediatric physical therapist
What We Noticed in a Photo of Twins
We have a photo of identical twins sitting side by side. Same genes, same nursery, same everything. The twin on the right has a strong opinion about which shoulder his head belongs on.
Once you see it, you can’t unsee it and that’s why we’re sharing it.
What Torticollis Is
Torticollis means a baby’s head tilts to one side, turns to one side, or both, making it uncomfortable or difficult to turn the other way. In babies it is most commonly caused by a tight neck muscle (for those who are interested it’s the sternocleidomastoid or SCM for short).
Most parents spot it in family photos first: “Why is their head tilted or turned to the right in every single picture?”
It is very common and pediatric physical therapists treat it all the time.
What Causes It
Sometimes it starts with how the baby was positioned in the womb. Other times, it develops after birth. Either way, it is not something you caused or missed and it is very treatable.
What to Look For
- Head tilts to the same side most of the time
- Always looks in one direction and fusses when trying to turn the other way
- A flat spot on one side or the back of the head (the official name for this is plagiocephaly)
- Prefers feeding on one side only
- Head is in the exact same position in every photo
- The 2 sides of the face look a little different.
A note for parents: One of these signs on its own isn’t a reason to panic. Seeing a few together is worth talking about but isn’t worth a spiral.
What to Try Today
- Put the good stuff on the hard side: Talk and play from the side they dislike looking toward. Direct toys, faces and lights to that side.
- Flip the crib: Switch which end of the crib their head points toward so the entrance of the room (and where you walk in) is on their non-preferred side. (Your baby should always sleep on their back.)
- Tummy time (short & frequent): Awake and supervised only. Short, frequent sessions beat long, miserable ones.
- Targeted play during tummy time: Hold toys or place your face on their less-favored side to give them a fun reason to look that way.
- Reduce container time: Limit time spent in car seats, swings, and bouncers, which hold the head in one position. Reserve car seats for actual travel.
- Smart carries: Carry your baby so the interesting activity in the room happens on their non-preferred side. Every trip across the room counts as practice.
- Careful with the YouTube and TikTok stretches: Stretching a baby’s neck muscles requires proper technique. Neck stretches work best when a pediatric PT demonstrates the exact direction, force and duration.
Why Timing Matters
Earlier is easier. That’s what clinical research shows.
The American Physical Therapy Association’s (APTA) 2024 Clinical Practice Guideline highlights tracking data for infants based on the age they began physical therapy:
| Age PT Started | Full Neck Movement / No Tilt | Average Time in PT |
| Before 1 month | 98.6% | 1.5 months |
| 1 to 3 months | 89.0% | 5.9 months |
| 3 to 6 months | 62.0% | 7.2 months |
Same condition. The main difference was when PT started.
If your baby is already past 1 month, you’re not too late. The sooner you start, the sooner you’re done.
You’re Not the Only Line of Defense
Your pediatrician may want to evaluate your baby first to rule out underlying medical causes. Pediatric PTs specialize in muscle balance and movement development and will look at your baby’s movement carefully. We are all here to support you. A pediatric PT is one more set of trained eyes on your baby’s team.
What Working With Us Looks Like
- 1st Visit: We measure exact neck range of motion, evaluate movement patterns and check overall motor development.
- The Plan: We build it with you. Some babies come weekly. Some need less.
- At-Home Care: You’ll leave with things that fit into diaper changes and feedings, not a stressful 30-minute routine you don’t have time for.
Noticed Any of This?
You’re not overreacting. You’re paying attention. There are 2 ways to get your baby checked by a PT:
- Through your pediatrician. Mention it at your next visit and ask them to fax a PT referral to High Pointe Therapy at 931-920-4346.
- Straight to us. Tennessee allows Direct Access, which means you can see a physical therapist without a referral, including for babies with torticollis. Not every insurance plan covers PT without a referral, so call us first and we’ll check yours. We’ll keep your pediatrician updated either way.
Have questions first? Call us at 931-920-4333 or email office@highpointetherapy.com.
Source: Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline. Pediatric Physical Therapy, 2024. (Outcome data adapted from Petronic I, et al., 2010).