Tips for identifying and managing low muscle tone
Rosemary Marchese – Physiotherapist
Low muscle tone is a condition we commonly see in our physio clinic due to the large number of children walking through the door. Low muscle tone is a condition where there is abnormally low levels of tension or resistance to the movement of a muscle. The length of the resting muscle is slightly longer than what is considered ‘typical’. When there are normal levels of tone the muscle fibres overlap at an optimal level and there are plenty of points where the fibres can attach to create a pull on the muscle. In low muscle tone the muscle fibres are not overlapping at an optimal level. These children have fewer points in their muscles where they muscle fibres can attach and create a force or pull. It takes a lot of effort for these children with low muscle tone to create muscle force.
Features of low muscle tone
Children with low muscle tone require greater stimulation of their muscles for their muscles to activate. This also results in an increase in response time so their reflexes and reactions in sports and physical activity tend to be slower than other children. This directly influences the child’s ability to participate in fun gross motor activities such as bike riding, walking, climbing and sports.
Common features of children with low muscle tone include:
* Reduced strength compared to their peers
* Increased flexibility and movement in their joints
* They have poor endurance and tend to fatigue quickly
* They have poor posture and struggle to sit up straight in class
* They are susceptible to injuries
* They give up easily when it comes to trying gross motor tasks, such as bike riding
* Lack of appropriate body awareness feedback
* Prefer to participate in sedentary activities over gross motor activities
* Struggle with fine motor skills
* Avoids foods that require lots of chewing.
Physical therapy approaches to low motor tone
Supporting a child with low muscle tone is best done as soon as it’s identified. Social isolation can occur very quickly when the child doesn’t want to participate in otherwise fun gross motor activities in the playground. At Max Sports Physio we have found that short, frequent sessions, with the involvement of a parent, is the most effective way to get results. We aim to make it fun, so the child doesn’t feel like they are in ‘therapy’, but rather the focus is on games and ‘helping them get stronger’.
An individualised program for improving muscle strength, balance, reaction time, fitness and coordination is important. A ‘whole of body’ approach, with consideration of any tips from other professionals involved, if any, such as a psychologist, is important.
We work on:
1. Gross motor skills and encourage increased participation in these types of activities
2. Postural strengthening in the form of games and fun play, depending on the child’s age
3. Improving skills related to postural control, body awareness, reaction times, coordination and balance
4. Improving fitness, so as to improve the function of the lungs and the muscles of the rib cage and diaphragm
5. Progressive activities so that the child is only challenged just beyond what is ‘easy’ for them to do. Success in each session is very important
6. Games and strategies that are easy for the family to integrate into their lives
When should I get help for my child with low muscle tone?
Once you have recognised the possible signs of low muscle tone it is important to get the right team of people around you. Diagnosis is the beginning of the journey. You will need the support of:
1. A team including yourself, your child, the teachers and any other carers.
2. A team of allied and medical professionals, depending on the issues involved. Sometimes some children have more problems in one area than another. In some cases, a psychology report can help give an insight into concentration issues at school, if relevant. As physios we welcome working with paediatricians, occupational therapists and speech therapists, to name a few, if and when required. The physical assessment at physiotherapy sessions will help identify if any further referrals are required.
How does the diagnosis of low muscle tone in my child affect them?
Each child is different, but the diagnosis is the beginning of helping you find the best strategy for your child. This will help you to find out and navigate:
* Other common issues that often occur simultaneously with low muscle tone
* Whether or not medication, if any, is appropriate
* What therapies are appropriate
* What steps of intervention are required
* What you can do at home to help
Contact Max Sports Physiotherapy to make an initial enquiry or book an assessment for your child. These sessions need to be one hour long to allow for a full assessment and discussion to take place. We can also devise specific action plans for families that do not live in Sydney and have to travel a fair distance to the appointments. Ph: (02) 89140508