As a parent, it’s common to notice little quirks in your baby’s movement. Maybe they always look to one side, prefer nursing on one breast, or have a flat spot developing on the back of their head. While these concerns are common, they can sometimes be signs of torticollis, a condition that responds very well to early intervention with pediatric physical therapy.
At Back Bay Speech & Occupational Therapy, our pediatric physical therapists provide compassionate, play-based care in both our Charlestown clinic and in homes throughout the Boston area to help babies build strength, improve movement, and support healthy development.
What Is Torticollis?
Torticollis, often called congenital muscular torticollis, occurs when the muscles on one side of a baby’s neck become tight. This causes the head to tilt toward one shoulder while the chin rotates toward the opposite side.
Many infants with torticollis:
- Prefer looking in one direction.
- Have difficulty turning their head equally both ways.
- Develop a head tilt.
- Seem uncomfortable during tummy time.
- Prefer feeding on one breast or bottle position.
- Roll or move differently on one side.
Torticollis can be present at birth or develop during the first few months of life.
What Is Positional Plagiocephaly (Flat Head Syndrome)?
When babies consistently rest in the same position, pressure on the soft skull can lead to positional plagiocephaly, commonly known as flat head syndrome.
You may notice:
- Flattening on one side of the back of the head.
- One ear positioned slightly farther forward.
- Forehead prominence on one side.
- Facial asymmetry.
- Hair wearing differently on one area of the head.
Because torticollis causes babies to favor one side, the two conditions often occur together.
Why Early Pediatric Physical Therapy Matters
The earlier treatment begins, the easier it typically is to improve neck mobility and reduce head shape changes. During the first year of life, babies grow rapidly, making this an ideal time for intervention.
A pediatric physical therapist can help:
- Improve neck range of motion.
- Stretch tight neck muscles safely.
- Strengthen weaker muscles.
- Improve head and neck control.
- Encourage symmetrical movement patterns.
- Support age-appropriate motor milestones.
- Reduce pressure on flattened areas of the head.
- Educate caregivers on positioning and home exercises.
Early treatment may also decrease the likelihood that a child will need helmet therapy, although some babies may still benefit from a cranial orthosis depending on their age and the severity of head shape changes.
Signs Your Baby May Benefit from Pediatric Physical Therapy
Consider scheduling an evaluation if your baby:
- Always looks to one side.
- Has difficulty turning their head equally in both directions.
- Has a noticeable head tilt.
- Has a flat spot on the back or side of the head.
- Strongly prefers one side during feeding.
- Dislikes tummy time.
- Rolls more easily in one direction.
- Seems to use one arm or leg more than the other.
- Is delayed meeting motor milestones.
Even mild asymmetries are worth discussing with your pediatrician or a pediatric physical therapist.
What Happens During a Pediatric PT Evaluation?
At Back Bay Speech & Occupational Therapy, your child’s evaluation is relaxed, interactive, and centered around play.
Our pediatric physical therapist will:
- Review your baby’s medical and birth history.
- Observe movement during play.
- Assess neck range of motion.
- Evaluate muscle strength and flexibility.
- Examine head shape and positioning.
- Assess gross motor development.
- Watch feeding positions and movement patterns when appropriate.
- Create an individualized treatment plan.
- Teach parents exercises and positioning strategies they can begin immediately at home.
Our goal is to make therapy fit naturally into your family’s daily routines.
Home Strategies That Can Help
While every child receives individualized recommendations, some simple strategies may include:
- Increasing supervised tummy time throughout the day.
- Alternating feeding positions.
- Positioning toys to encourage looking both directions.
- Changing the direction your baby lies in the crib (while always placing them on their back to sleep).
- Using baby carriers to reduce prolonged pressure on the back of the head.
- Incorporating therapist-guided stretches into diaper changes or playtime.
Consistency with these strategies often leads to meaningful progress.
We Bring Pediatric Physical Therapy to Your Family
Back Bay Speech & Occupational Therapy offers pediatric physical therapy in Boston, including:
- Charlestown
- Back Bay
- Beacon Hill
- South End
- South Boston
- Cambridge
- Somerville
- Brookline
- And surrounding neighborhoods
Schedule a Pediatric Physical Therapy Evaluatio
If you’ve noticed a head preference, neck tightness, or concerns about your baby’s head shape, early evaluation can make a significant difference.
Our experienced pediatric physical therapist partners with families to build strength, improve movement, and help babies meet developmental milestones with confidence.
Contact Back Bay Speech & Occupational Therapy today to schedule a pediatric physical therapy evaluation in Boston or learn more about our in-home.
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