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The Dangers of Too Much or Too Little Muscle Tone in Cerebral Palsy Patients

cerebral palsy muscle tone

Wondering how too much or too little muscle tone can affect your child’s growth and development?

This article will explain the risks associated with extremes in muscle tone and the best ways to manage them.

How Cerebral Palsy Affects Muscle Tone

Cerebral palsy is caused by damage to areas of the brain that control motor functions like movement, balance, and coordination.

So although there’s nothing wrong with the body, its movements are negatively affected by the brain damage.

Movement occurs through the regular contracting and relaxing of our muscles.

When there’s irregular muscle tone, movements get harder to control.

Normally, the brain will send signals down the spinal cord in response to stimuli for your muscles to appropriately contract and relax.

However, the brain damage that caused cerebral palsy can negatively affect communication to the body, resulting in abnormal muscle tone.

Types of Cerebral Palsy Muscle Tone

There are two types of abnormal muscle tone: hypertonia and hypotonia.

Hypertonia is high muscle tone, which causes stiff, rigid movements due to continuously contracted muscles.

The second type of muscle tone is hypotonia, and it’s much rarer than hypertonia. It is when there’s low muscle tone, and muscles are floppy and loose due to constant relaxation.

Next, we’ll further differentiate between the two.


high muscle tone in children with cp

Hypertonia is most evident in individuals with spastic cerebral palsy, which is the most common type of CP and makes up over 75% of CP cases.

Signs of High Muscle Tone

Depending on the severity of one’s cerebral palsy, experiences with high muscle tone can vary.

Some of the most common signs of high muscle tone include:

  • Spasticity
  • Slow, firm movements
  • Musculoskeletal deformities when growing due to an uneven muscle pull
  • Joint and muscle pain
  • Spasms and other involuntary movements
  • Delays in motor development
  • Lack of flexibility
  • Abnormal walking patterns

Treatments for High Muscle Tone

  • Rehabilitation therapy. Physical therapy hones in on your child’s gross motor skills through exercise while occupational therapy will work on your child’s fine motor skills through practical activities of daily living. Stretching can help lengthen contracted muscles to ease movement.
  • Orthotics. Braces can help lengthen muscles when the child is not stretching or participating in any exercise. Because it creates a mold around the limb, bracing makes it form difficult to compromise form.
  • Muscle relaxants can be taken orally, through injections, or from a pump. The most commonly used medications for high muscle tone are baclofen and Botox.
  • Surgery. The main surgical intervention to treat high muscle tone is Selective Dorsal Rhizotomy. Nerve fibers are selectively cut, and because they can’t grow back, the procedure results in permanent spasticity reduction.


low cerebral palsy muscle tone

Hypotonia is generally associated with damage to the cerebellum (which is responsible for balance and coordination) but not always.

It’s most commonly observed in cases of ataxic cerebral palsy, but also in athetoid and mixed cerebral palsy, in which a combination of both high and low muscle tone is apparent.

Signs of Low Muscle Tone

It’s generally agreed among PTs and OTs that children with hypotonia display:

  • Lack of strength
  • Low activity tolerance
  • Delays in motor skill development (rolling, sitting, crawling, walking)
  • Rounder shoulder posture
  • Tendency to lean forward
  • Joint hypermobility
  • Increased flexibility
  • Poor head control

Treatments for Low Muscle Tone

Physical and occupational therapy for low muscle tone will focus on activating and strengthening muscles to improve posture and coordination.

Speech therapy will help children who have feeding or speech difficulties develop muscle strength in the face.

Severe hypotonia can make it difficult to chew or swallow, so it’s important to pay extra attention to nutritional intake and ensure that your child is consuming enough calories to prevent malnourishment.

Some individuals may even need to use a feeding tube.

Additionally, orthotics like braces and compression garments can help improve low muscle tone by promoting proper alignment and form.

Cerebral Palsy and Muscle Tone

Cerebral palsy is nonprogressive, meaning that it will not get worse over time.

However, if not properly managed, abnormal muscle tone can worsen and further impair movement.

Both high and low muscle tone can cause your child to develop poor posture, control, strength, and balance.

Now that you know the symptoms of irregular cerebral palsy muscle tone, make sure to keep an eye out for them in your child and don’t hesitate to seek a professional evaluation.

Good luck!

Keep It Going: Discover a home exercise program for CP that’s actually fun to do!

adult with cerebral palsy smiling while using FitMi home therapy

Finally! There’s a recovery device for CP that’s actually fun to use. See how Flint Rehab’s tools are helping with CP recovery:

“The FitMi and MusicGlove have done wonders for my son with hemiparesis from cerebral palsy and stroke.

It motivates him to do his exercises. It does not seem like therapy for him since it is fun. It monitors his progress so it is a great reinforcement for him.

Music is a motivator for him. He has been using it on his arm and we will try the leg exercises soon.”

FitMi works by motivating high repetition of therapeutic exercises while playing an engaging game. This gamification has been particularly great for motivating individuals with cerebral palsy to recover.

To see how FitMi works, click the button below:

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