Torticollis Massage

A Torticollis Massage is a focused manual therapy for addressing involuntary neck muscle contraction and abnormal head posture common to torticollis (“wry neck”). The goal is to reduce pain, relax contracted muscles (typically the sternocleidomastoid or SCM), restore range of motion, and prevent recurrence. Massage methods—always gentle—are adapted to whether the case is acute, chronic, congenital, or acquired.​

Signs & Symptoms

  • Abnormal, tilted, or rotated head posture to one side

  • Stiffness and pain in the neck, sometimes radiating to the shoulder or upper back

  • Palpable muscle spasm or tightness (often SCM, scalenes, upper trapezius)

  • Decreased range of neck motion and sometimes difficulty swallowing or headache

  • In infants: flattening of one side of the head (plagiocephaly), asymmetrical facial features, or delayed motor milestones.​

Contraindications

  • Avoid painful or forceful passive stretching during acute spasm phases

  • Do not massage over open wounds, infection, vascular lesions, or suspected cervical spine injury

  • In infants/children, always use lighter pressure and monitor for distress​

  • Avoid carotid artery and unyielding or forceful movement, especially if vertebral artery test is positive or client is dizzy​

  • For spasmodic or neurological torticollis, limit local direct massage; no joint play.​

Assessment

  • Review history of onset, duration, trauma, birth history, and aggravating factors

  • Inspect head and neck position, movement, muscle symmetry, and compensatory postures

  • Palpate muscles of the neck and upper back for spasm, pain, and tightness

  • Passive and active range of motion (ROM) of neck, check for pain or guarding

  • Rule out serious causes: cervical nerve root or vertebral artery compromise, fever, trauma.​

Treatment

  • Begin with diaphragmatic breathing for relaxation and muscle inhibition​

  • Slow, gentle effleurage and kneading on the unaffected side first, then progress to the affected side as spasm reduces​

  • Gentle GTO (golgi tendon organ) release, origin/insertion work, and trigger point technique to SCM and involved muscles

  • Passive ROM and stretching within pain-free range—progress intensity as tolerated

  • In infants: gentle stroking, finger kneading, and myofascial work to shortened SCM, scalenes, and upper trapezius; avoid pressure near airway or carotid​

  • Address compensatory muscles—scalenes, upper trapezius, suboccipitals—and treat posture if needed​

  • End sessions with relaxation massage and postural retraining cues

Self Care

  • Practice gentle self-stretches for neck within tolerable range—side bending, rotation, and chin-tucks​​

  • Use moist heat or cold packs as directed for pain management (avoid high heat in children or with swelling)

  • Encourage diaphragmatic breathing and relaxation

  • Adopt ergonomic posture for sleep and daily activities; avoid prolonged awkward head positions

  • In infants: increase tummy time and vary positional stimuli to develop neck strength and symmetry; parents taught safe massage and stretching