Have you heard the term HYPOTONIA before? What about low muscle tone? It’s something that pediatric PTs are very familiar with. The word hypotonia means ‘low or decreased muscle tone’ - not to be confused with weakness or decreased strength. Muscle tone is a spectrum and it describes a muscle’s tension or resistance to stretch. Think about muscles like a rubber band. Healthy muscles at rest always have a little bit of tension so that they are ready to spring into action when they are activated. Children with low muscle tone have muscles like a loose or stretched out rubber band. So muscle tone is describing how the muscles are at rest, and strength is describing how they work when active. Confused yet? It’s a hard concept to wrap your head around.

There are many disorders that may cause hypotonia (ie: Down Syndrome, some forms of Cerebral Palsy etc.), but it also can have no underlying cause in which case it is called Benign Congenital Hypotonia.

While hypotonia does not describe the strength of a child’s muscles, this condition does frequently occur alongside muscle weakness. Some may have heard the term “floppy baby syndrome” as this term has been used to describe the “rag-doll” feeling when handling an infant with significant hypotonia. Hypotonia can range from minimal to severe and the effect that it has on a child’s development depends on the severity and the underlying cause.

Early signs of hypotonia in infants include:

- Poor head control

- Difficult to carry, feel “slippery”

- Persistent head lag when pulling them up to sit

- Slumped sitting posture

- Delayed in reaching milestones such as sitting, crawling and walking

- Infants often prefer to bottom scoot instead of crawling

- Difficulties with feeding or nursing

- Excessive drooling and mouth hangs open

Young children with hypotonia may demonstrate:

- W Sitting

- Open mouth with protruding tongue

- Clumsiness

- Poor endurance

- Motor planning deficits

- Sensory processing difficulties

- Poor balance

Older children can display:

- Frustration during sports/physical activities

- Altered walking patterns

- Fatigue easily

- Flat feet

- Problems with handwriting

- Slumping in their seats at school

While there is no ‘cure’ for hypotonia, the deficits listed above are things that can be significantly improved with treatment. Most children with hypotonia will benefit from Physical Therapy, Occupational Therapy and/or Speech Therapy.

If your child is demonstrating any of the above symptoms, I encourage you to seek out a PT evaluation to determine if they would benefit from intervention. Feel free to reach out to me for a free phone consultation!

**This information should not be treated as medical advice. The purpose of this blog is for education only.  If you have a medical condition or need medical advice please contact your physician. All activities are to be performed at your own risk. Progress Through Play, LLC is not responsible for any injury or damage done while performing an activity or from any information contained in this blog. Adult supervision is recommended for every activity featured in this guide. Please decide based on each individual activity if it is appropriate for your child. Any participation related to this site or social media does not result in a physical therapist-patient relationship with Brita DeStefano PT, DPT, PCS (@progressthroughplay).