Click here for photo creditMuscle tone is a term used to describe how much tension is in a muscle when it is at rest or how much resistance the muscle has to movement. A person needs enough muscle tone to support good posture and be able to hold their body against gravity but not so much muscle tone that it interferes with volitional movement. There is no such thing as perfect muscle tone. This is why muscle tone is often described as a spectrum or range. Some individuals are born with muscle tone on the higher end of the normal range, while other individuals have muscle tone on the lower end of the normal range. It differs from person to person, and it can change with age. Having muscle tone at either end of the spectrum does not necessarily mean anything is wrong, it is just a reflection of the physiological make-up of a person.
Although muscle tone and muscle strength are related, it’s important to note they are not the same thing as muscle strength. Muscle tone describes the underlying tension that exists in your muscle while muscle strength describes your muscle’s ability to generate force. Children who have low muscle tone often appear weaker. This is because the muscle is looser at rest and when the muscle attempts to contract it must contract harder to generate the same force. Muscle tone can not be changed, but a child’s muscle strength, motor control and muscular endurance can be changed.
Muscle tone is important because it helps us hold our body upright against gravity, helps us produce controlled movements and helps with endurance when completing activities. Muscle tone also helps prevent injuries by providing support and stability to joints. When a child has lower muscle tone, they might be slower to achieve their gross motor milestones, they might not naturally be good at physical activities, or they might need to be encouraged to participate and practice their gross motor skills.
For most children, low muscle tone is part of their physiological makeup. I have low muscle tone and my oldest child also has low muscle tone. Changes in muscle tone does not necessarily mean there is an underlying neurological issue, however, there are many disorders that can cause a change in muscle tone (i.e. cerebral palsy, Down Syndrome). For these children, their reduced muscle tone is usually much more impactful and significantly interferes with their ability to reach developmental milestones.
Changes in muscle tone can affect a child’s development in multiple ways.
Hypotonicity is a term used to describe when a child has lower muscle tone. In these cases the child might look floppy or limp. This is why you will sometimes hear the term “Floppy Baby Syndrome” or “rag doll”. Think of a rubber band that has been stretched too far and now it lacks tension.
Hypertonicity is a term used to describe when a child has higher muscle tone. In those cases the child’s movements might appear rigid or stiff. In both instances the child will need to improve their motor control and overall strength in order to compensate for the changes in their tone. This post will focus on hypotonicity as that is seen at a much higher prevalence than hypertonicity.
Infants with low muscle tone may:
Toddlers with low muscle tone may:
Reduced muscle tone may cause a child to experience delays in the acquisition of gross motor skills (i.e. sitting, crawling, walking). Children with decreased muscle tone also fatigue easily due to the extra effort they have to exert in order to maintain their posture or activate their muscles.
It especially impacts their ability to sustain postures and hold them against gravity for extended periods of time. In some cases, lower muscle tone can also show up as hyper-flexibility, which is when the child can bend their joints or limbs further than usual. When a child has changes in their muscle tone (whether higher or lower) it places them at a higher risk for developmental delay. They may also find it more difficult to engage in activities and play with other children. The impact that hypotonicity has on development greatly depends on how low the muscle tone is.
Low muscle tone is typically associated with muscle weakness, ligamentous laxity and joint hypermobility. School aged children with low muscle tone can sometimes be thought to be lazy, fidgety, and have poor attention as a result of the behaviors and strategies they use to cope with their low muscle tone and fatigue. The reality is that these children are not being lazy or have a poor work ethic; they are literally just not physically able to do the activities as well as their peers or for as long as their peers. It is up to us to modify the activity to accommodate the child’s needs.
Parents can help by:
These are just a few strategies that can be used to help children of varying ages. Most children with hypotonia benefit from physical therapy even for a short period of time to help strengthen muscles in the core that are needed for prolonged sitting and the acquisition of gross motor skills.
If your child’s low muscle tone is impacting on their ability to do things they need to do in their daily life, then it might be worth seeking out the help of a physical therapist, occupational therapist or even a speech therapist. A health professional will help you and your child to determine strategies that will help them to improve their skills and to manage any fatigue or difficulties they might be having.
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