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"What is low muscle tone?" was a question often asked by parents when I worked as a pediatric occupational therapist in private practice.
They often confused tone with muscle strength.
Here is a simplified overview and a brief description of normal, high and low tone and their effect on movement.
Normal tone means that there is the right amount of “tension” inside the muscle at rest, and that the muscle is inherently able to contract on command.
Put simply, you can “tell” your muscle to stop and start and it does what you want, when you want, with the appropriate amount of force.
Here is an everyday example: Reaching for a cup of coffee!
You are sitting in your armchair, arms resting on your lap (your arm muscles are “at rest”). You decide to have a sip of your coffee, which is on the table next to you. With your normal muscle tone, you reach out with your arm, your hand makes connection with your cup of coffee, and you bring it back to your mouth. No spills, no fuss!
Your muscles did exactly what you wanted them to do, at exactly the right speed, without wasting energy or effort.
High tone means there is too much tension in the muscle at rest. In other words, the muscle is tight and tense even though it is not doing anything.
A child with spastic cerebral palsy has high tone, which causes the arms and legs to be tightly contorted. When the arms and legs are not regularly stretched and moved through physical therapy, then “contractures” may occur, which mean less and less range of movement is possible.
Reaching for a cup of coffee:
In the everyday example I gave above, if you had increased tone, you would have to concentrate very hard and expend a lot of effort overcoming the tension in your biceps in order to stretch out your arm.
You may well end up moving your whole body towards the coffee, as the tension in your arm muscles is too high to be overcome with ease. Your movements are also likely to be jerky.
Low tone means there is not enough tension in the muscle when it is at rest.
The muscle may have a slightly mushy or floppy feel to it, and there is a lack of graded control of the muscle when it is being used (graded control means that just the right amount of movement and effort is used as appropriate to the task at hand).
Reaching for a cup of coffee:
To use the coffee example again, when you decide you want to have a sip of coffee, there is not enough tension in your muscles at rest. So you use a bit extra momentum, maybe by flinging your arm out!
You bump the cup a bit, get your fingers around the handle and then drag it back, but the cup is heavy, and you use too much oomph at first (to overcome the lack of “tension” in your muscles) with the result that the coffee sloshes out!
Children with low tone in their muscles may battle to sit upright for any period of time, and may slouch over like the child in this picture.
They may also lack endurance for gross and fine motor activities and may struggle with games that require coordinated, controlled movements.
The tone of the muscles affects postural control and postural stability. Postural control and postural stability give you the “background” control of your body that is necessary for helping you to stay upright and to stabilize you during movement.
Postural stability needs to develop in 3 main areas:
Follow the links above for other articles on my site with more information and lots of fun, free activities!
This webpage serves to inform, not to diagnose. Please contact your health professional if you have any concerns about your child's muscle tone, postural control or any other aspects of development.
1) Mathiowetz and Haugen. Evaluation of Motor Behavior: Traditional and Contemporary Views. Occupational Therapy for Physical Dysfunction, Baltimore: Williams & Wilkins, 1995.
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