Low Muscle Tone or Hypotonia

What does muscle tone mean?

Muscle tone is the resting tension in a relaxed muscle. This is different from muscle strength, the ability the contract and resist forces. Note there is a wide range of tone and what is considered normal. (1)

Did you know… “Hypotonia is the most common condition that affects a newborn’s motor skills.” (1) 

How does ‘low tone’ or hypotonia present and how does it affect my child?

If a baby or child is exhibiting low tone, their muscles may feel floppy at rest. They may feel more flexible than expected. Due to a lower resting state of tension, a child or baby may require more effort to achieve motor milestones such as rolling, sitting, crawling, or walking (2). A child may have less muscular endurance during certain tasks and would benefit from increased breaks/recovery time. 

Examples of how hypotonia may affect children of different ages: 

  • Feeding difficulties + swallowing, excessive drooling

  • Decreased head control in babies

  • Postural control required for sitting, potentially resulting in W sitting

  • Gait pattern

  • Dynamic activities such as jumping and stair climbing

  • Overpronation or flat feet

  • Handwriting when gripping a pencil in school 

  • Sports participation endurance

Where does low tone come from?

Tone may be related to idiopathic (unknown origin) causes. Other times it may be a symptom of an underlying neurological or genetic condition (1). If you have concerns regarding your child’s muscle tone, follow up with your pediatrician who may recommend skilled physical therapy to progress your child appropriately. Hypotonia is not related to intellectual abilities. (2) 

What will physical/occupational therapy do to help my child?

While muscle tone is not something that will generally change over time, physical or occupational therapy can offer strategies to build strength to compensate for lower tone. 

  1. Child Neurology Foundation. Hypotonia. (https://www.childneurologyfoundation.org/disorder/hypotonia/) Accessed 6/13/2023. 

  2. Hypotonia in babies: Symptoms, causes & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22223-hypotonia-in-babies

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Foundations of Fine Motor Skill Development