What is Hypotonia?
Hypotonia is a medical diagnosis that means low muscle tone. Low muscle tone is characterized by hypermobility in the joints. When there is excessive movement in the joints, the muscles surrounding those joints become over stretched and weak.
As babies, these children will feel “floppy” when you pick them up. They may feel like they are going to slip out of your hands. Normal tone newborn babies tend to rest with a slight bend in their arms and legs but babies with Hypotonia may hang their arms and legs straight.
These babies usually tend to sleep a lot, be very “easy” babies, may display difficulties sucking/swallowing, fall asleep often during feedings, poop less frequently, and dislike tummy time or anti-gravity positions. They like to be held and may seem extra cuddly. It may be difficult for these babies to lift their head, push through their arms and when you attempt to put them in these positions, they appear to be “lazy” or fussy.
As they get older, these children have a tendency to rely more on the bigger muscle groups for support. They like to lean on people/furniture or move around a lot to avoid using their postural muscles.
Children with Hypotonia may have decreased attention. The postural muscles in our core are very much connected to our vision so if they are weak, it may be hard for a child to stay still or stay on a task for an extended period of time. They may also need frequent breaks both in exercise or even just to do their homework.
A common compensatory technique for kids with low tone is to rely on their ligaments for stability. Many of these children may present with hyperextended knees, hyperextended elbows, flat feet, and rounded shoulders. They are often W-sitters or fidget a lot. When they walk, they may tend to turn their feet in to gain stability through their hips and pelvis or they may drag their feet.
Hypotonia can be a diagnosis all on it’s own known as Congenital Hypotonia and these children may or may not need therapy services. However, Hypotonia can also be a part of another medical diagnosis. Other diagnoses that commonly include Hypotonia are Down Syndrome, Microcephaly, Cerebral Palsy, Autism, Genetic disorders, and Ehlers Danlos Syndrome for examples.
Children with Hypotonia can benefit from a consistent exercise program tailored towards the areas of the body that display low tone. These children also benefit from activities that are less straining on their joints. Biking, swimming, and yoga are great exercise options as they get older. If these children play competitive sports, it should be noted that they may be at a higher risk for subluxations and dislocations due to the hyper flexibility in their joints.
They also respond very well to exercises on unstable surfaces such as a therapy ball, a water play mat, a vibration platform, or a swing because the unsteadiness causes them to tense up and use their postural muscles to stabilize.
In severe Hypotonia cases, children may benefit from external aids such as trunk supports, orthotics and adaptive equipment to obtain proper alignment and muscle strengthening for development. These children need multiple therapies including sensory organization/integration, Speech, Occupational, and Physical Therapy.