Plagiocephaly and Torticollis: Osteopathic Evaluation and Treatment

Plagiocephaly and torticollis are common conditions seen in infants and early childhood, often developing as a result of positioning, muscle imbalance, or restricted motion following birth. While many cases improve with early intervention, persistent asymmetry or limited neck mobility can affect posture, development, and comfort over time. At a practice specializing in Osteopathic Neuromusculoskeletal Medicine, we provide gentle, hands-on evaluation and treatment for infants with plagiocephaly and torticollis, aiming to restore balance, mobility, and healthy structural development.

Understanding Plagiocephaly and Torticollis

Plagiocephaly refers to an asymmetrical or flattened shape of the infant’s head. It often develops when a baby consistently rests in the same position, causing mild skull deformation due to the softness of the cranial bones during early growth.

Torticollis, commonly occurring alongside plagiocephaly, involves tightening or shortening of the neck muscles—most often the sternocleidomastoid—leading to head tilt or rotation to one side. This condition can result from birth strain, positioning in utero, or muscle imbalance after delivery.

When plagiocephaly and torticollis occur together, they may interfere with a baby’s ability to turn the head evenly, latch during feeding (Please see Newborn Latching and Feeding), or develop symmetrical motor skills. Addressing both conditions concurrently allows for better functional and developmental outcomes.

Common Causes and Contributing Factors

Several factors can contribute to plagiocephaly and torticollis, including:

• Intrauterine positioning or constraint during pregnancy.

• Difficult, prolonged, or assisted births.

• Limited neck mobility from muscular or fascial tension.

• Consistent resting on one side of the head (“positional preference”).

• Prematurity or decreased tummy-time opportunities.

These conditions are not purely cosmetic—restricted neck or cranial movement can influence the nervous system, feeding, and overall motor coordination if left untreated.

Who Is Affected

Plagiocephaly and torticollis most commonly affect infants in the first months of life, when the skull bones and postural control are still developing. Parents may first notice uneven head shape, a consistent head turn preference, or difficulty breastfeeding on one side. In more advanced cases, delayed rolling, asymmetric reaching, or compensatory movement patterns may appear as the child grows. Early Osteopathic evaluation is key for identifying these restrictions and supporting balanced development.

The Role of Osteopathic Neuromusculoskeletal Medicine

Osteopathic Neuromusculoskeletal Medicine offers a gentle, holistic approach to diagnosing and treating plagiocephaly and torticollis. An Osteopathic Physician (DO) trained in this specialty carefully assesses cranial mobility, neck muscle tone, spinal mechanics, and overall body symmetry. Treatment employs light, precise manual techniques such as cranial osteopathy, myofascial release, balanced ligamentous tension, and functional positional release to restore motion and reduce muscular strain.

By addressing both cranial and cervical restrictions simultaneously, Osteopathic treatment helps support natural head shape development, improve neck range of motion, and reduce discomfort. This integrative, hands-on care can also complement physical therapy and positioning strategies recommended by pediatric specialists, forming part of a coordinated care plan for the infant.

Seeking Care for Early Intervention

Early recognition and treatment of plagiocephaly and torticollis significantly improve outcomes. The earlier these imbalances are addressed, the more adaptable the cranial and cervical structures remain, allowing for natural correction and growth. Many parents notice improved head mobility, smoother feeding, and more symmetrical posture after Osteopathic care.

Our practice specializes in the evaluation and treatment of plagiocephaly and torticollis using a gentle, patient-centered approach to support healthy structural and neurological development. If your baby shows signs of flat head shape, head tilt, or limited neck motion, we encourage you to schedule an appointment with Dr. Levi. Through careful assessment and precise, hands-on treatment, we can help your child achieve balanced growth and comfort.