A Clinical Algorithm for Early Identification and Intervention of Cervical Muscular Torticollis

Clin Pediatr (Phila). 2016 Jun;55(6):532-6. doi: 10.1177/0009922815600396. Epub 2015 Aug 24.


Congenital muscular torticollis (CMT) is a common newborn pediatric muscular deformity of the neck. The purpose of this article is to suggest a clinical algorithm for pediatric clinicians to promote prompt identification and intervention for infants with CMT. Early intervention for a child with CMT at less than 1 month of age yields a 98% success rate by 2.5 months of age, with the infant achieving near normal range of motion. Intervention initiated at 6 months of age or later can require 9 to 10 months of therapy with less success in achieving full range of motion of the cervical musculature. The clinical algorithm proposed here incorporates the American Physical Therapy Association guideline for CMT to optimize outcomes for the child and reduce health care expenditures. Current evidence and guidelines demonstrate that primary care providers are the primary diagnostic clinicians, while physical therapists are the preferred provider for the treatment of CMT.

Keywords: congenital muscular torticollis; early intervention; infants; newborns; physical therapy.

MeSH terms

  • Age Factors
  • Algorithms*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pediatrics / methods
  • Physical Therapy Modalities*
  • Practice Guidelines as Topic
  • Torticollis / congenital*
  • Torticollis / diagnosis
  • Torticollis / therapy

Supplementary concepts

  • Congenital torticollis