Muscle tone refers to the amount of tension within a muscle when it is relaxed. It helps us maintain posture and positioning, control movement, and is fundamental to the development of motor skills, balance and coordination.
Muscle tone can be thought of as a spectrum, with some people having higher tone and others having lower tone.
What Is Low Muscle Tone?
Low muscle tone, also known as hypotonia, refers to muscles which have less tension or resistance to movement. It is the resting state of a muscle (not the power it can actively create against resistance, which is strength). Hypotonia occurs when the muscle is abnormally long and the muscle fibres do not overlap at an optimal level. Less tension within the muscles causes less support of the joints, so the muscles need to work harder to get the same level of joint support as people with higher tone.
Signs of Low Muscle Tone
W-sitting, or hands braced on the floor to widen their base of support and reduce the demand on core muscles (this can make it hard to sit cross-legged with hands in laps in class)
Slouching or being unable to maintain postures at the table
Fatigue or poor endurance due to the extra effort required to activate muscles
Mouth hanging open due to stretched mouth muscles
Leaning against objects
Dyspraxia: difficulties controlling and coordinating movement
Hyper-extending or locking joints, or dislocations, due to floppy muscles that are less effective at holding joints together
Applying too much or too little pressure to a pencil, as they are not getting enough feedback from their muscles
Slower protective reflexes, like putting a hand or foot out when losing balance
Impacts of Low Muscle Tone
Children with low muscle tone often experience difficulty maintaining posture and stability, and coordinating and controlling movement. As a result, low muscle tone can cause delayed motor skill development and difficulty with functional tasks such as feeding and toileting. Children with low muscle tone may also find fine motor tasks, such as grasping a pencil and manipulating objects in the hand, difficult. They often also present as hypermobile, meaning that their joints move beyond the normal limits. Both speech and breathing are also often impacted by low muscle tone.
A key challenge associated with low muscle tone is becoming easily fatigued. Low tone means extra energy is used to maintain posture and produce movement, which increases fatigue. Often, children with low muscle tone avoid gross motor tasks and find it difficult to persist with them.
Can You Improve Muscle Tone?
Although muscle tone itself cannot be improved, there are many ways to improve muscle strength and physical endurance. Muscle strength is the ability of muscles to produce force against resistance, allowing appropriate movement to occur. As muscle strength and endurance improve, low muscle tone can become less of a barrier. Some great strategies to help improve muscle strength include:
Warm up (preparatory) activities
Warm up activities train the muscles to activate more quickly. Activating the muscles needed for a specific task helps improve strength and extends how long your child can take part in the activity. Depending on the task, warm up activities may include climbing the stairs into the clinic, completing an obstacle course on the way into the therapy room, bouncing on a trampoline, doing star jumps or playing with play dough or putty.
Gross motor activities
Gross motor activities which use the whole body help build muscle strength and endurance. These activities may include:
Playground activities (such as swinging on monkey bars and climbing): a great way to improve upper body strength and encourage positive engagement in gross motor tasks.
Animal walks (such as frog jumps and bunny hops): a fun, simple way to encourage gross motor movement and build muscle strength.
Obstacle courses with running, jumping and climbing: these activate different muscles in each part of the course, building strength and endurance while keeping your child motivated.
Swimming: engages every muscle in the body and encourages the development of postural control.
Gymnastics: builds muscle strength and endurance and improves balance and postural control.
Regular rest breaks
Providing regular rest breaks and opportunities to recover is key for children with low muscle tone. This prevents excessive fatigue and possible injury, and keeps your child motivated to take part.
Tips for Success
Give your child feedback during activities to help them develop awareness of tone and posture
Break larger tasks down into smaller, manageable steps
Keep activities fun and engaging to help improve alertness and tone
Allow your child to work lying on their tummy, propped on their elbows
Allow opportunities to change position in class
Give lots of encouragement and positive reinforcement to keep your child motivated
