Specialista in Ortopedia Pediatrica
Congenital muscular torticollis
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Sternocleidomastoid (SCM) stretching
Fundamental maneuver to lengthen the shortened muscle
With baby supine. Stabilize shoulder on affected side with one hand. With other hand, GENTLY tilt head toward OPPOSITE shoulder (ear to shoulder) then rotate chin toward shortened muscle side. Very gentle movements — baby should not cry from pain. Hold 10-15 seconds. Ideal during diaper change or after bath when tissues are softer.
10 reps with 10-15 second holds, at each diaper change
2.Positioning and visual stimulation
Encourages baby to actively turn head toward correct side
Position toys, lights and visual stimuli on the side the baby has difficulty turning toward (opposite to shortened muscle). During feeding, alternate sides. In crib, periodically change baby's orientation relative to room light/stimuli. Goal is for baby to ACTIVELY turn head in correction direction.
Constantly throughout the day
3.Guided tummy time
Strengthens neck muscles and promotes symmetry
Place baby on tummy (tummy time) on stable surface. Stimulate baby to lift head using toys or voice. Position stimuli on the side baby needs to turn toward. Tummy time strengthens neck extensor muscles and promotes symmetric motor development. Start with short sessions (1-2 minutes) and gradually increase.
3-5 sessions daily, starting from 1-2 minutes and increasing
4.Carrying in corrective position
Use carrying moments for passive correction
When holding baby, position so they must turn head in correction direction to look at you. Carry with head tilted toward side opposite shortened muscle. When holding upright (on shoulder), gently tilt head in correction direction. Every carrying moment becomes a therapeutic opportunity.
At every carrying and holding opportunity
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Children and adolescents with this condition, as directed by the specialist. Exercises are general and should be adapted to individual cases.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Sternocleidomastoid (SCM) stretching
Fundamental maneuver to lengthen the shortened muscle
With baby supine. Stabilize shoulder on affected side with one hand. With other hand, GENTLY tilt head toward OPPOSITE shoulder (ear to shoulder) then rotate chin toward shortened muscle side. Very gentle movements — baby should not cry from pain. Hold 10-15 seconds. Ideal during diaper change or after bath when tissues are softer.
10 reps with 10-15 second holds, at each diaper change - 2
Positioning and visual stimulation
Encourages baby to actively turn head toward correct side
Position toys, lights and visual stimuli on the side the baby has difficulty turning toward (opposite to shortened muscle). During feeding, alternate sides. In crib, periodically change baby's orientation relative to room light/stimuli. Goal is for baby to ACTIVELY turn head in correction direction.
Constantly throughout the day - 3
Guided tummy time
Strengthens neck muscles and promotes symmetry
Place baby on tummy (tummy time) on stable surface. Stimulate baby to lift head using toys or voice. Position stimuli on the side baby needs to turn toward. Tummy time strengthens neck extensor muscles and promotes symmetric motor development. Start with short sessions (1-2 minutes) and gradually increase.
3-5 sessions daily, starting from 1-2 minutes and increasing - 4
Carrying in corrective position
Use carrying moments for passive correction
When holding baby, position so they must turn head in correction direction to look at you. Carry with head tilted toward side opposite shortened muscle. When holding upright (on shoulder), gently tilt head in correction direction. Every carrying moment becomes a therapeutic opportunity.
At every carrying and holding opportunity
Frequently Asked Questions
Does congenital torticollis correct on its own?
With consistent mobilizations and correct positioning, the vast majority of muscular torticollis resolves within 6-12 months. The key is starting early and being consistent. In rare resistant cases, specialized physiotherapy may be needed.