What is hypotonia?

“Hypotonia” is the medical term for low muscle tone. If hypotonia is detected in a new born baby or child they will be referred to a specialist. In some cases, hypotonia can also be discovered later in life.

Healthy muscles are never fully relaxed – they retain a certain amount of tension and stiffness (known as “muscle tone”) that can be felt as resistance to movement.

For instance, a person relies on the tone in their back and neck muscles to maintain their position when standing or sitting up. Muscle tone decreases during sleep, so if you fall asleep sitting up, you may wake up with your head flopped forward.

Hypotonia is not the same as muscle weakness, although it can be difficult to use the affected muscles. Having said that, in some conditions, muscle weakness sometimes develops in association with hypotonia.

The symptoms of hypotonia

The symptoms of hypotonia in children include:

  • Reluctance to eat
  • Hypermobility (sometimes referred to as being “double-jointed”)
  • Bottom shuffling - moving on the bottom instead of crawling
  • Fatigue when performing “gross motor skills” – movements such as rolling over and sitting — that use the large muscles in the arms, legs, torso, and feet.
  • A preference of sedentary activities instead of being active
  • Delays in gross motor skills
  • Low muscle tone (floppiness)

Causes of hypotonia

Hypotonia can be caused by a number of different underlying health problems, many of which are inherited.

Hypotonia can also sometimes occur in cerebral palsy, where a number of neurological (brain-related) problems affect a child's movement and co-ordination, and after serious infections, such as meningitis.

In some cases, babies born prematurely (before the 37th week of pregnancy) have hypotonia because their muscle tone is not fully developed by the time they're born. However, provided there are no other underlying problems, this should gradually improve as the baby develops and gets older.

Treating hypotonia

Treatment usually focuses on improving the child’s muscle function and the professionals that will be involved are physiotherapists, occupational therapists and speech and language therapists.


Regular physiotherapy is essential to help improve muscle tone, to improve posture and co-ordination and to strengthen the muscle around the joints of the limbs to provide more stability and support.

Special toys and assistive devices may be used by your physiotherapist to encourage development of fine and gross motor skills. Physical therapy programmes often include parent training to ensure that therapies are conducted correctly at home.

To read more about child physiotherapists have a look here

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