Many times in my work I meet parents who find themselves in a paediatric physiotherapist referred by a doctor due to muscular tension disorders In their little one. I often hear that a child has increased or decreased muscle tone... but what is it really like with muscle tone? The answer to this question is not so simple at all. In this article I will try to answer the question - why muscle tone in babies is so important.
What is muscle tension anyway?
In one of her books, Dr Maria Borkowska, a paediatrician and rehabilitation doctor with many years of experience, explains this issue very well: It is a certain constantly sustained, although changing according to the needs and condition of the body, muscle contraction [Borkowska, 2012].
Paediatric physiotherapist, evaluating muscular tension in infants, takes into account its size and how and where it is distributed. You need to know that muscle tone is an individual characteristic and is influenced by genetics, fetal life, type and course of birth and environmental factors.
Its assessment requires a great deal of knowledge and experience, as effect on muscle tone can have many factors, such as the time of day, the state of health, the child's mood, whether he or she is full and sleepy, and many others.
What do you need muscle tension for?
First and foremost, it serves to hold our entire body in specific positions, against the force of gravity, and to perform age-appropriate and qualitatively appropriate movement activities. Any movement, or even the maintenance of a given posture, requires the cooperation of entire muscle groups. Muscle tension disorders whereas they can contribute to the development of abnormal loads and subsequent changes in muscles and joints.
How do we classify muscle tension?
The doctor or paediatric physiotherapist, by performing appropriate tests, can classify muscle tension on a five-point scale:
- Correct
- Slightly reduced
- Low
- Significantly reduced
- Exceptionally low
What do we call increased muscle tone?
Increased muscle tension often occurs in the proximal and distal parts of the child's body (head-neck, shoulder girdle, hip girdle) as compensation for reduced postural tension. Many times children who come to me with a diagnosis of increased muscle tone actually have decreased muscle tone, and consequently it is increased in peripheral parts of the body. If the muscle tension is increased centrally, this may indicate a disease of the nervous system. Then further diagnostics and a visit to paediatric neurologist.
When do we talk about reduced muscle tone?
If the tension is too low, it makes it much more difficult for the child to perform a specific movement. The body is so 'flabby' and weak that it is difficult for it to counteract the force of gravity. Parents sometimes, when describing children with low tension, say that the baby is very soft or that "overflows through the hands".
Infants with low muscle toneWhen lying on their back, they find it difficult to lift their arms and legs, because they use them to support themselves against the ground for better stability. In older children it is the same with sitting down. child with low muscle tone often has problem with trunk control in sitting position, he has to support himself with his hands in order not to fall. In both cases, the hands are busy stabilising and supporting, which makes grasping and playing impossible. As a result, the child's development, both motor and mental, is impaired.
U school children reduced muscle tone can cause difficulty in maintaining a stable sitting position, leading to problems with writing and concentration.
What could be signs of muscle tone problems in infants?
In a child with a muscle tension disorder, we may observe the following symptoms:
- Clenched fists
- Marbled leather
- Rigid movements
- Difficulty in achieving head control
- Feeding and dressing problems
- Impaired grooming associated with "straining"
- Flexion position of body and head
- Reluctance to lie on stomach
- No lifting of arms and legs in supine position
- High alignment of the shoulder girdle (invisible neck)
- Walking on tiptoe
- Toe curl
What consequences can muscle tone disorders have?
Reduced muscle tension is the most common cause of postural defects in children and adolescents. Of course, they can also be caused by other factors, such as visual, auditory and respiratory disorders, lack of movement or incorrect postures [Borkowska, Geletta 2020]. Elevated muscle tone and asymmetries are also not conducive to harmonious development or correct posture.
How can we help our child?
The most important thing is proper diagnosis and the selection of appropriate therapy and exercises tailored to the child's needs. A visit to a specialist is essential - fpaediatric isiotherapist.
What can every parent do to avoid harming their child?
- Avoid rockers/recliners/chairs
- Increase the amount of time the child spends in the supine position on the floor
- Implement proper baby care
- Do not seat a child who cannot sit up on their own
- Avoid leading by the hands a child who does not walk independently
Dear parents, for muscular tension The nervous system is responsible, so this subject should not be underestimated. If you have doubts about your child's muscle tone, don't hesitate to sign up for a paediatric rehabilitation.
Abnormal muscle tension does not always mean neurological diseases, but it can have a huge impact on your child's future.
Bibliography
1 Borkowska M. [2012]: Muscle tension, : Child with motor disability, edited by M. Borkowska, Wydawnictwo Lekarskie PZWL, Warsaw.
2 Borkowska M., Geletta I. [2020], Postural and foot defects in children, Wydawnictwo Lekarskie PZWL Warsaw.
3 Matyja M., Gogola A. [2007], Predicting children's postural development based on postural tension quality analysis in infancy, Child Neurology
Paediatric physiotherapist
