Hypotonia is a medical term for abnormally low muscle tone. It has also been referred to as Floppy Baby Syndrome.
Normally even relaxed muscles have a small amount of contraction that allows them to have a spring feel that provides some resistance to passive movement. Since muscle tone is regulated by signals traveling from the brain to the muscles via nerves telling the muscles to contract, it is not the same thing as muscle weakness, although they can often coincide.
Low muscle tone (Hypotonia) is usually detected between 6 months of age, however, it can also develop later.
Some common signs of hypotonia in children include “floppiness” which can often be seen as hanging arms and legs and little to no head control.
Children or toddlers may have difficulty transitioning in and out of different positions or even be delayed in achieving their motor milestones.
Hypotonia can also cause clumsiness and falls, difficulty with hand-eye coordination, and a preference to sit and be still vs. moving and exploring their environments like their peers.
Other signs can include problems with mobility and posture (i.e. difficulty sitting upright without support), breathing and speech difficulties, ligament and joint laxity, poor reflexes, and decreased frustration tolerance.
Depending on the presentation and overall skills the child has, a child may need both occupational therapy (OT) and physical therapy (PT).
OT can work towards addressing concerns related to fine motor skills, social skills, balance, emotional regulation, dressing, feeding, etc.
PT can work towards strengthening muscles important for posture and movement in order to help kids achieve their gross motor milestones.
Some examples of exercises for low tone are described below.
- For infants: pull to sit, tummy time, unsupported sitting, joint compressions, reaching for objects in different positions (i.e. sitting, laying on back or stomach, side lying, tall kneeling, standing, etc.), pulling into standing. Once your child can stand, trying to get them to squat down to pick up a toy or food is also an effective exercise. You can even practice crawling and walking over various surfaces.
- For toddlers/adolescents: They can also do activities listed under the infants depending on activity level, but may start to introduce higher level activities like animal walks, sit-ups, bridges, prone walkouts, squats, etc., as appropriate for your child’s skill level.