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Understanding CMT: What Parents Need to Know

Growing in Motion
UNDERSTANDING CMT: WHAT PARENTS NEED TO KNOW

By: Christine Egan MPH, PT C/NDT | March 3, 2026

The natural state of infancy is symmetry. When a baby’s posture consistently looks uneven—whether the head tilts to one side, the neck seems stiff, or the body curves in one direction—it may be a sign that early evaluation is needed. Subtle asymmetries can be easy to miss, but when identified early, they are highly treatable.

As a pediatric physical therapist with more than 45 years of experience, I want to share important updates from the American Physical Therapy Association about early diagnosis and treatment of Congenital Muscular Torticollis (CMT). I’ve shared this information with pediatricians and neonatal specialists, but parents are often the first to notice something is off. When parents recognize the early signs, babies can be evaluated sooner—and early treatment makes a remarkable difference.

Common signs include:

A consistent head tilt or preference for looking in one direction
Limited ability to turn the head fully
Flattening on one side of the head (plagiocephaly)
A preference for breastfeeding on one side
A small, firm lump in the neck muscle

Recognizing these patterns early matters. Without treatment, CMT can contribute to postural asymmetries and delays in typical motor development.

What You Can Look for at Home

You can gently check your baby’s neck motion by turning their head left and right and tilting it toward each shoulder. If one direction feels tighter, or if your baby always holds their head the same way, it’s wise to speak with your pediatrician and request a referral to a pediatric physical therapist.

Flat Spots on the Head

Plagiocephaly—flattening on the back or side of the head—is common when CMT is present. Babies’ skulls are soft, so flattening can develop quickly. Correcting it takes longer, and some infants may eventually need a helmet. Early diagnosis and consistent therapy greatly reduce that likelihood.

Why Early Referral Matters

Research consistently shows that the earlier physical therapy begins, the better the outcome. Babies who start therapy before one month of age typically make rapid, complete progress. Waiting even a few months can lengthen treatment time and may limit how fully neck motion returns. CMT rarely resolves on its own, and simple stretching at home is usually not enough. Early referral is key.

How Physical Therapy Helps

Therapy for CMT is gentle, individualized, and play-based. A pediatric physical therapist evaluates your baby’s neck motion, head shape, and how they use both sides of their body. Treatment may include guided stretching, strengthening, positioning strategies, and activities that support balanced, comfortable movement.

The Role of Tummy Time

Since the NIH launched the Back to Sleep program in 1994, placing babies on their backs to sleep has significantly reduced SIDS rates. Because infants now spend all sleep time on their backs, tummy time during awake periods is essential for developing head, neck, shoulder, and overall body symmetry. Beginning tummy time from day one—on your chest or another comfortable surface—helps prevent postural asymmetries and supports healthy motor development.

The Bottom Line

CMT is common, treatable, and responds exceptionally well to early physical therapy. When parents know what to look for and seek help early, babies progress more quickly, require fewer therapy sessions, and experience fewer long-term issues. If you notice your baby consistently tilting or turning their head to one side—or see a flat spot developing—talk with your pediatrician about a referral to a pediatric physical therapist. Early action truly makes a difference.

Christine Egan, MPH, PT, C/NDT, is a pediatric physical therapist with more than 40 years of experience in pediatric rehabilitation. A native New Yorker and graduate of Hunter College, she spent the first decade of her career learning from some of the leading therapists in the field before establishing her private practice in Marin County, California, where she has worked for the past 35 years. She is highly regarded by both parents and professionals for her expertise, insight, and compassionate care.

The foundation of Christine’s clinical approach is Neurodevelopmental Treatment (NDT)—a framework grounded in a deep understanding of typical human movement and the sensory-motor facilitation needed to support children whose development may be delayed or disrupted. She also brings extensive skill in posture and alignment, incorporating orthotics, manual therapy, and a range of traditional and complementary techniques.

Christine has followed hundreds of infants with torticollis, plagiocephaly, and developmental delays, guiding families through early intervention with clarity and confidence. A central focus of her work is parent education—teaching caregivers how to play, move, and interact with their baby in ways that support natural motor patterns and emerging skills.

Her advanced training includes NDT certification, orthotic evaluation, casting and fitting, kinesiotaping, whole-body vibration, and numerous manual therapies, including craniosacral techniques.