LOW MUSCLE TONE EXPLAINED
If your little one has been described as “floppy’”or has a weak sucking reflex, he may have low muscle tone. Here’s what you need to know.
If your child seems to trip over his own feet, slouches, leans or lies down while playing, he may have low muscle tone, also known as hypotonia. More severe cases are usually picked up by a paediatrician, if your child is not meeting certain milestones like sitting, crawling and walking, but less severe cases can go unnoticed and untreated.This can lead to discomfort and frustration for the child – especially when he struggles to sit at school for longer periods.
“Muscle tone is the readiness of a muscle to move,” explains Liz Senior, occupational therapist and founder of Clamber Club.“It is genetic and can’t be changed, so the muscle tone you are born with is what you will have for the rest of your life,” she explains. “Muscle tone can be defined as the amount of continuous contraction of a muscle at rest,” explains Claire Malone, a physiotherapist working in the UK. “Muscles require a certain amount of contraction at all times in order to maintain structure and function. If there wasn’t a degree of contraction, our bodies would become floppy and distorted when we slept, due to gravity.” She says it’s also important for parents to know there is a difference between muscle tone and strength. “Although the two are related, tone relates to resistance to passive movements and strength relates to the ability to perform active movements.”
Understanding a diagnosis
In a paper published in African Journal of Disability, the author states:“Clinical assessment of hypotonia is challenging due to the subjective nature of the initial clinical evaluation,” and that “the presentation of hypotonia can be either a non-threatening or malevolent sign.” “Hypotonia itself is an easily recognisable condition, but determining the disorder causing the low tone is often difficult,” explains Claire. Low tone can’t be viewed in isolation as it is always caused by an underlying condition, which could range from hypermobility of the joint and treated through strength and stability exercises to more serious congenital and genetic disorders that will require medical intervention, such as cerebral palsy, meningitis, muscular dystrophy or spina bifida.A February 2012 memo from Johns Hopkins Medical Center urged paediatricians to screen all babies for vitamin D and calcium deficiencies and stated that this relatively easy issue to correct could be an underlying cause for the number of children presenting with low muscle tone, as vitamin D is involved in the absorption of calcium.“Much of our lifelong health is pre-programmed in childhood, and many adult diseases are rooted in exposures, lifestyle and diet during the first decade of life, experts say.Vitamin D, or lack of it, is a classic example,” wrote the authors. “For differential diagnosis, your doctor may request further investigations such as an MRI, a CT scan, blood tests or genetic testing,” explains Claire.
Spotting the signs
“When my son was two years old, his nursery school teacher mentioned in our first parent/teacher conference that he has low tone. I was shocked by the suggestion, because our paediatrician and doctor hadn’t mentioned anything,” says Rebecca Todes, mom of Blaine (2). “I was worried about what this meant for my child and had little understanding of the implications,” says Rebecca. Blaine’s teacher was the first to pick up his low muscle tone, because he struggled to sit still during
morning ring and often ended up slouching or lying down by the end of it. His speech was also slightly behind that of his peers and he would run in an awkward way – often from his hips – if he was overly excited. “Once I started researching, things began to fall into place. Blaine did drool excessively when he was a baby and crawled slightly late at 10 months.We didn’t think anything of it because he started walking soon after at around 12 months.” Liz says the implications of low tone can include your child avoiding socialising and playground activities that require physical strength, fearing he won’t be able to keep up. “Alternatively, a child may completely dominate situations in order to control them,” she says. Claire explains that hypotonia ranges from mild to severe, so it’s important for parents not to panic if their child presents with a few of the symptoms, but to be vigilant as early diagnosis can go a long way in assisting the child. “The underlying condition has not yet been found, but Blaine’s symptoms have improved through encouraging certain play activities, particularly jumping on a trampoline, ”says Rebecca.
Bouncing your baby on your lap is a great way to encourage weight bearing.