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Today, there is a large population of children who present with low or low-average muscle tone. Muscle tone is something that a child is born with; it is not taught or learned. The importance of understanding your child’s muscle tone is to help protect joints, build strength, improve body awareness and promote overall coordination/motor planning.
How Do We Define Low Tone?
Low muscle tone happens when the length of the resting muscle is slightly longer than normal. So, this means that the muscle will require more force to contract. Low muscle tone is characterized as a floppiness in the muscles and/or your child might have extra flexibility in their joints. Although you cannot change muscle tone, you can work on strengthening exercises to make your child stronger, meet milestones, improve posture, and improve endurance for play, sports, and school!
What is Low Average Muscle Tone?
This is when your child demonstrates average range of motion and is able to move between positions independently. Although they have increased “flexibility,” this can lead to joint damage over time. Examples of this would be “W sitting”, hyperextending joints with isometric exercises and/or locking joints for fine motor tasks.
How Does Low Muscle Tone Present?
A baby with low muscle tone might have decreased head control and sitting balance that might not be “noticed” until it is time to introduce solid foods. Or a baby with low muscle tone might take a longer time to crawl. With children, a child with low muscle tone will present with decreased endurance for playtime, sports, school, or may sit with poor posture.
Signs of Low/Low Average Muscle Tone
If you believe your infant may be experiencing low muscle tone, you might see:
Child feels limp when lifted (like a rag doll)
Child has increased flexibility/relaxed joints
Delay in gross motor milestones such as rolling, sitting, crawling, walking
Tires easily/decreased endurance during play
Decreased functional strength
Decreased head control after 3 months
If you believe your child may be experiencing low muscle tone, you might see:
Child is limp when lifted (like a rag doll)
Child has increased flexibility/relaxed joints
Delay or decreased coordination with such as throwing, catching, running, skipping, and galloping.
Tires easily/decreased endurance during play, sports, and school
Decreased functional strength
Does low muscle tone mean my child has another diagnosis? NO!
Low muscle tone can be associated with various syndromes and diagnoses. However, it also can be present in a child without any other diagnoses, in which the cause is unknown.
When an infant has low muscle tone, it can affect the infant’s endurance for playtime, achieving fine and gross motor milestones, and may have difficulty feeding. It may also be difficult for him to participate in everyday tasks and activities at home and school. This can be frustrating for a child as he grows and realizes that his siblings or other children can do certain skills or activities that he has difficulty with.
How to Work on Low Muscle Tone?
Strengthening muscles, specifically the muscles that stabilize your child’s shoulders, hips, and core, can help give your child more stability for various tasks and activities. Depending on the severity of the muscle tone, some children can eventually catch up to their peers with some strengthening.
Exercises/activities for your infant with low muscle tone:
1. Lots of tummy time! Work on tummy time in small increments as you build endurance and tolerance in your baby. You can do tummy time propped up on a pillow to give your baby more support, on a floor mat, or on the caregiver’s lap or chest.
2. Work on reaching for toys in different positions such as lying on their back, belly, side, and sitting/standing (once developmentally appropriate).
3. Once your baby is crawling, continue to encourage crawling on different surfaces and areas— hardwood, carpet, grass, over pillows, up stairs to strengthen core and arm muscles.
4. Once your baby is standing/walking, encourage lots of walking on various surfaces and lots of reaching and squatting for toys to strengthen the core and hip muscles.
Exercises/activities for your child with low muscle tone:
Gross motor activities:
1. Bounce on a therapy ball. This activity requires the help of an adult to stabilize the child as they sit on the ball. The adult can then bounce the child up and down, and gently roll the ball side to side, and front to back to further challenge the child’s core muscles to stay upright.
2. Animal walks. Children can move like different animals such as a crab walk (moving on hands and feet with bent knees/elbows with belly button facing the ceiling), bear walk (moving on hands and feet with bottom in the air), snake crawl (belly crawl), bunny hop (two-footed hopping).
These movements require your child to use different positions and different muscles and provide weight-bearing input to your child’s joints.
3. Tug of war. A gentle pull on a thick rope will engage your child’s core and hips. You can hold the same rope or toy as your child as long as they have a good grip and take turns pulling backward for 10-15 seconds or as long as your child can tolerate. Just make sure they have pillows behind them for a soft landing!
4. Laundry. Have your child push and pull the laundry basket around the house! You can fill the laundry basket with some books or toys to add resistance, all to your child’s tolerance! This activates the core and provides good weight bearing to your child’s joints.
5. Play with a ball. Any type of throwing, kicking, hitting, catching game will help your child work out their bodies. Give a whole lot of encouragement, too, since often kids with low muscle tone may not be the most coordinated. However, in this instance, it’s not about catching or hitting well, it’s about making it fun to work out.
Fine motor activities:
1. Scrunching, ripping, balling up paper. Hand exercises are just as important for a kid with low muscle tone as the big muscle workouts are. Writing and drawing are often harder for kids with low muscle tone, as the activity of sitting up can be a challenge, as well as the act of holding a writing instrument
2. Watering the flowers with a spray bottle. Again, hand exercises are so important so your child can build those muscles that will make schoolwork easier. The act of squeezing a spray bottle will help make their hand muscles stronger.
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