Have you ever noticed your baby tilting their head to one side or developing a flat spot on their skull—and wondered if it’s just a phase or something more? You’re not alone. As a physiotherapy student and someone who’s observed many parents worry over these subtle but concerning signs, I can tell you this: early intervention makes all the difference.

Two of the most common concerns in infants—plagiocephaly (flat head syndrome) and torticollis (tight neck muscles)—often go unnoticed in the first few months. But with the right approach, particularly paediatric physiotherapy, you can prevent these conditions from affecting your child’s development.

In this guide, I’ll break down what these conditions are, how physiotherapy helps, and share real examples from clinic experience and expert advice—so you feel informed and empowered, not overwhelmed.

What Is Plagiocephaly?

Plagiocephaly refers to the flattening of one part of a baby’s skull, typically caused by prolonged pressure on that area. This might happen due to sleeping in the same position (back sleeping), restricted movement in the womb, or even a preference for looking in one direction—often linked to torticollis.

There are two types:

• Positional Plagiocephaly – most common, non-surgical, responsive to therapy.
• Craniosynostosis – rarer and usually requires surgical intervention.

The good news? Physiotherapy is extremely effective for positional plagiocephaly, especially when started early (between 2–6 months).

What Is Torticollis?

Torticollis (from Latin: “twisted neck”) involves the tightening or shortening of the sternocleidomastoid muscle, causing the baby to tilt their head to one side and rotate it to the opposite side.

You might notice:

• A constant head tilt
• Preference for looking one way
• Difficulty breastfeeding on one side
• Asymmetry in the face or skull

Torticollis and plagiocephaly often occur together—with one exacerbating the other. But again, physiotherapy can help manage both simultaneously with great success.

How Physiotherapy Can Help: Expert-Backed Insight

“Early physiotherapy intervention improves outcomes significantly in infants with positional plagiocephaly and torticollis,”
— Dr. Fiona Mayers, Consultant Paediatric Physiotherapist, UK Paediatric Therapy Association

Through tailored, gentle interventions, physiotherapy targets the root cause, encourages symmetrical development, and supports normal motor milestone progression.

Here’s what’s typically included:

1. Manual Stretching and Range of Motion Exercises

These involve gentle neck stretches to lengthen the tight muscle (usually SCM) and improve the baby’s ability to turn their head both ways.

In my training placement, I assisted with a 3-month-old boy who had right-sided torticollis. After four weeks of consistent home-based stretches taught to the parents, we noticed remarkable improvement in his neck movement and feeding posture.

2. Tummy Time & Positional Therapy

Encouraging supervised tummy time strengthens neck and shoulder muscles and reduces skull flattening.

• Place your baby on their tummy 3–5 times daily (start with short intervals).
• Position toys or mirrors to encourage head turning.
• Vary sleep and play positions.

3. Parent Education & Handling Techniques

The physiotherapist teaches parents how to hold, feed, and play with their child in ways that promote symmetry and reduce pressure on the flattened side.

• Alternate feeding sides.
• Carry baby facing outward to stimulate head control.
• Use a rolled towel or special cushions during naps (with caution and professional supervision).

4. Motor Development Support

Physios guide parents in age-appropriate motor play to encourage rolling, sitting, and crawling—all key to balanced head shape and postural control.

When to See a Physiotherapist

The sooner, the better. According to a study published in the Journal of Paediatrics & Child Health (2021), infants who begin therapy before 4 months have over 80% improvement, compared to 50–60% for those who start after 6 months.

Red Flags to Watch For:

• Flat spot not improving by 3 months
• Baby consistently looking one way
• Difficulty breastfeeding from one side
• Visible tilt or rotation of the neck
• Delayed rolling or crawling

Speak to your GP or paediatrician to get a referral to a qualified paediatric physiotherapist.

Helmet Therapy vs Physiotherapy: What’s Better?

Many parents ask: “Do we need a helmet?” The answer often depends on severity and age.

• Mild to moderate plagiocephaly: physiotherapy + repositioning is usually enough.
• Severe cases or late intervention (>6 months): helmet therapy may be recommended by a specialist.

“We prefer starting with conservative physiotherapy. Helmets are reserved for when we see no significant changes after 2–3 months of consistent therapy,”
— Sarah Dawson, Clinical Lead at BabySteps Therapy, Leeds

Real Parent Experience: Emily’s Story

Emily, a first-time mum in Manchester, shared her journey with us:

“At 2 months, I noticed Ava always slept with her head turned right. I thought it was nothing—until the health visitor flagged a flat spot. Our physiotherapist taught us positioning tips, and within a few weeks, Ava started turning both ways. Her head shape is almost fully round now at 7 months!”

This story mirrors countless others—and underscores the power of informed, early care.

Frequently Asked Questions

Can torticollis go away on its own?

Mild cases might improve with regular movement, but structured physiotherapy significantly improves outcomes and prevents developmental delays.

Is plagiocephaly painful for the baby?

No, it’s typically not painful. But it may lead to postural issues, asymmetry, or self-esteem problems later if left unaddressed.

How long does physiotherapy take to work?

Most babies show improvement within 4–8 weeks if therapy begins early and parents follow home plans.

Can older children be treated too?

Yes, but therapy becomes more complex. Early infancy remains the golden window for easiest correction.

Takeaways for Parents and Caregivers

• Don’t ignore the early signs: a slight tilt or flat spot today can become a bigger concern tomorrow.
• Start tummy time from day one—every minute counts.
• Partner with a qualified paediatric physiotherapist who can guide you with empathy and expertise.
• Be patient and consistent: progress happens gradually, but it does happen.

Final Thoughts

Torticollis and plagiocephaly might sound intimidating—but with early physiotherapy, most cases resolve beautifully without long-term impact. As someone studying the power of movement and muscle balance firsthand, I’ve seen how this simple intervention brings smiles and confidence to families across clinics.

Have you had experience with infant physiotherapy? Or do you have concerns about your baby’s posture or development?

👉 Share your story or questions in the comments below—I’d love to help!

Sources:

• Journal of Paediatrics & Child Health, 2021
• UK Paediatric Therapy Association