Their Back Story Starts Before They Can Tell It
Adults can tell you where it hurts.
They can point. They can describe it. They can say when it started and what makes it worse.
A six-week-old cannot do any of that.
So your child tells you another way.
Feeds well on one side and fights the other.
Turns their head to the right without effort and never quite makes it left.
A flat spot begins to appear where none was before.
Your child is not being difficult.
Your child is being clear.
You just have to know how to read it.
You will notice it before you have a word for it
Almost no parent walks in and says "I think my child has congenital muscular torticollis."
What they say is: my baby only looks one way.
Or: my baby screams when I try to nurse on the left.
Or: my baby's head is getting flat right there, and I keep repositioning, and it isn't working.
The observation always comes before the vocabulary. That is exactly how it should be. You are with your child all day. You see the pattern long before anyone gives it a name.
So here is the name.
Congenital Muscular Torticollis
What congenital muscular torticollis actually is
One of the two long muscles running down the sides of the neck, the sternocleidomastoid, is shorter or stiffer on one side than the other.
The result is a head that tilts toward the tight side and turns away from it.
It is the third most common congenital musculoskeletal condition in newborns (Sargent et al., Pediatric Physical Therapy, systematic review). Depending on which study you read, it shows up somewhere between three in a thousand and sixteen in a hundred infants.
It is common.
It is not your fault.
And it responds well to care.
Why it matters more than it looks like it does
A tight neck sounds like a small thing.
Consider what a baby does with their neck.
They turn their head to find a breast. They lift it during tummy time, which builds the strength they will need to roll, and rolling is what teaches them to sit. They rest it against a mattress for twelve hours a day, which is why a persistent head preference becomes a flattened skull.
Everything downstream is connected to the thing upstream.
Feeding. Sleep. Tummy time. Rolling. Sitting. Milestones.
The neck is not the destination.
It is the door.
The window is real
This is the part I want parents to hear most clearly.
The evidence is extensive that intervention works when it begins in early infancy. And when it begins later, resolution rates fall and treatment takes longer (Sargent et al., Pediatric Physical Therapy, systematic review).
That is not a scare tactic. It is a schedule.
You have time. You do not have unlimited time.
If you noticed something at two weeks, act at two weeks. If you noticed something at seven months, act now, and expect the road to be longer.
Do not wait to see if it resolves. Watchful waiting is what turns a six-week problem into a six-month one.
Physical therapy is the first line. I will say that out loud.
The American Physical Therapy Association publishes an evidence-based clinical practice guideline for congenital muscular torticollis. It was updated most recently in 2024. It is the strongest body of evidence that exists on this condition, and it is a physical therapy document (Sargent, Coulter, Cannoy & Kaplan, Pediatric Physical Therapy, 2024).
Infants with CMT should be referred to physical therapists as soon as postural asymmetry is identified.
I am not a physical therapist.
So when a baby comes to me with torticollis, one of the first things I will ask is whether you have seen your pediatrician, and whether you have been referred to PT.
If you have not, I will send you.
A chiropractor who positions themself as an alternative to physical therapy for this condition is not reading the literature. They are reading their own marketing.
Then what am I doing?
Working alongside.
I assess cervical range of motion, both active and passive. I look at how the pelvis and spine are organizing underneath a neck that has been pulling to one side for weeks. I look at what the rest of your child's body is compensating with, because bodies always compensate, and a six-week-old is no exception.
An INSiGHT scan gives me an objective measurement rather than an impression. Non-invasive. Radiation-free. Ninety seconds.
Then gentle care, on the joints, at a pressure most parents find hard to believe until they see it.
It is roughly what you would use to test whether a tomato is ripe.
Nothing about adjusting an infant should resemble what you have seen on the internet.
Rule out first. Always.
Serious adverse events in infants receiving manual therapy are rare. A 2015 review in the Journal of Manipulative and Physiological Therapeutics searched the literature back to the beginning and found fifteen serious adverse events across thirty-one articles. No deaths were associated with chiropractic care (Todd, Carroll, Robinson & Mitchell, 2015).
But here is the finding from that paper that actually changed how I practice.
In the majority of reported cases, an underlying preexisting condition was present. The authors concluded that a thorough history and examination to exclude anatomical or neurologic anomalies before beginning manual therapy is essential.
Which means the exam is not a formality on the way to the adjustment.
The exam is the care.
Some things that look like torticollis are not torticollis. Ocular torticollis. Klippel-Feil. A clavicle fracture from birth. Neurologic conditions that have nothing to do with a tight muscle.
If your child has fever, poor weight gain, projectile vomiting, blood in the stool, refusal to feed, or is not meeting milestones, that is a pediatrician's office and not mine.
I would rather refer you and be wrong than adjust you and be wrong.
What I will not claim
I do not claim that chiropractic care prevents illness.
I do not claim it treats ADHD, autism spectrum disorders, cerebral palsy, or developmental and speech disorders. The International Chiropractic Pediatric Association, which certified me, instructs its practitioners not to make those claims.
I do not claim that a well child is well because of me.
Your child having good posture, hitting their milestones, and rarely getting sick is wonderful.
It is not proof of anything I did.
Most healthy, loved, well-fed babies hit their milestones. There is no second version of your child who did not receive care, and no honest person can tell you who they would have been without it.
What I can tell you is what I found, what I did, and what changed.
That is the whole of it. It is enough.
Who else is in this room
Your pediatrician.
Your physical therapist.
Your occupational therapist.
Your lactation consultant, if feeding is part of the picture, and it very often is.
Chiropractic care is one part of a child's care. It has never been the whole of it, and any practice that suggests otherwise is selling you something.
The families who do best are the ones whose providers talk to each other.
Every body has a back story
Your child's began before they could tell it.
Before they had words for the tight place, or the flat spot, or the side they could not turn toward.
They have been telling you anyway, in the only language they have.
Our work is to listen carefully, to look honestly, and to send your child somewhere else when somewhere else is where they need to be.
Because every body has a back story.
And the ones who cannot tell theirs yet deserve the most careful readers of all.
Dr. Haylie Vincent, DC Webster Certified, International Chiropractic Pediatric Association
Serving families across McLennan County.
References
Sargent B, Kaplan SL, Coulter C, Baker C. Informing the Update to the Physical Therapy Management of Congenital Muscular Torticollis Evidence-Based Clinical Practice Guideline: A Systematic Review. Pediatric Physical Therapy.https://pmc.ncbi.nlm.nih.gov/articles/PMC8317609/
Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy. 2024. https://pubmed.ncbi.nlm.nih.gov/39356257/
Todd AJ, Carroll MT, Robinson A, Mitchell EKL. Adverse Events Due to Chiropractic and Other Manual Therapies for Infants and Children: A Review of the Literature. Journal of Manipulative and Physiological Therapeutics. 2015. https://www.jmptonline.org/article/S0161-4754(14)00178-X/abstract
FAQ
My baby only turns their head one direction. What does that mean? It may be congenital muscular torticollis, a shortening or stiffness of one of the muscles along the side of the neck. It is the third most common congenital musculoskeletal condition in newborns. Start with your pediatrician.
Is torticollis serious? It is treatable, and treatment works best when it begins early. Left unaddressed it can affect feeding, tummy time, rolling, and head shape. Resolution rates decline and treatment duration increases when intervention starts later in infancy.
Should I see a physical therapist or a chiropractor? Physical therapy is the first-line, evidence-based intervention for congenital muscular torticollis, supported by a clinical practice guideline from the American Physical Therapy Association. Chiropractic care works alongside it. Ask your pediatrician for a referral.
Is chiropractic care safe for infants? Serious adverse events are rare, and no deaths associated with chiropractic care appear in the published literature. In the majority of reported adverse events, an underlying preexisting condition was present, which is why a thorough history and examination before any care is essential.
How much pressure is used on a baby? Roughly what you would use to test whether a tomato is ripe. Infant care does not resemble adult adjusting.
When should I call my pediatrician instead? Fever, poor weight gain, projectile vomiting, blood in the stool, refusal to feed, or missed milestones. Always call your pediatrician first.
Does chiropractic treat ADHD, autism, or ear infections? No. There is no credible evidence supporting those claims, and the ICPA instructs its certified practitioners not to make them.
What is a flat spot, and is it related? Positional plagiocephaly frequently accompanies torticollis, because a baby who cannot turn their head both directions rests it in the same place. Addressing the neck is part of addressing the head shape.