What is Pediatric Hypotonia?

You’ve been told by your pediatrician that your child has pediatric hypotonia, otherwise known as low muscle tone, and he or she may need pediatric therapy. Hypotonia in children can be very confusing, because sometimes your child can seem very strong, despite this diagnosis. In this blog, we share more about hypotonia in children and some pretty cool play therapies you can do to help your child overcome these challenges.

Toddler playing

Hypotonia is the term to describe muscles that are floppy. Children and babies with hypotonia often need to put in more effort to move properly, have a hard time maintaining posture and have delays in motor, feeding and verbal skills. Hypotonia can be caused by issues with the muscles or nerves, but often the cause is unknown. Fortunately, with pediatric therapy and at home activities, you can help your child to become stronger and hypotonia will be less of an issue as they age.

Babies with hypotonia will feel floppier than other babies. Children with hypotonia may have increased flexibility, poor posture, get tired easily and have delays in reaching motor milestones like sitting, crawling or walking. It’s even possible for a child with hypotonia to be very strong when they exert themselves, so it’s important to get an accurate diagnosis, so you can seek the proper pediatric therapy.

Is pediatric therapy needed for hypotonia?

Because children with hypotonia are unique, they often need a variety of therapies to help them reach their goals. This can range from occupational therapy, physical therapy and speech therapy.

Pediatric occupational therapy will help children with their handwriting, daily care activities, feeding, coordination and strength.

Pediatric physical therapy will help kids with low muscle tone develop gross and fine motor skills by strengthening muscles and addressing functional skills and physical delays.

Pediatric speech therapy may be needed if the muscles in your child’s face need strengthening.

In addition to structured pediatric therapy, kids can benefit from everyday therapeutic play activities that will also strengthen their muscles.

What therapies are good for my child with hypotonia?


Swimming is an ideal activity for children with hypotonia. Water adds buoyancy, resistance and engages muscles while also eliminating some of the weight of gravity. You can begin this activity when your child is a baby and continue it throughout his or her development. Water also tends to relax most children, making this an even better therapeutic activity because kids with low muscle tone tend to stiffen up when trying to support themselves.

There are a few flotation devices that can help a baby or toddler in the water. An “aquatic neck ring” is a great device for babies. Two common brands and varying prices worth looking into are Waterway Babies and Otteroo. In a neck ring, the baby is able to float comfortably with their entire body below the surface of the water and use their arms, legs, and trunk muscles to move about. For toddlers, a Puddle Jumper is a preferred option. You an find these devices online and via most major chain stores. Puddle Jumpers are coast guard approved and they encourage maximal movement and strengthening in the water. 

Always directly supervise your child whenever they’re playing or working in the pool for safety’s sake.


Many gyms and local park districts offer gymnastics classes, including parent-tot courses, starting around 18 months old. Gymnastics encourages body awareness, muscle strengthening, endurance building, postural control, coordination and balance. 

For young children under five years old, a typical gymnastics class will include climbing and playing in a foam pit, which requires use of almost every muscle in a child’s body. Children will learn to perform forward rolls, which encourages abdominal activation. 

Walking on a balance beam requires postural control, support of the trunk, and challenges balance. Time spent on a trampoline will build leg strength and assist with jumping if they have not yet mastered this skill. On bars, children learn to support their body weight through their arms, activating the shoulder girdle, pectoral muscles, and abdominal muscles. Swinging on the bar strengthens their grip as well. 

Play at Home

Games are a fun way to encourage overall improved strength, stability, and body awareness. Here are a few things you can do to encourage play to develop better strength:

  • Animal walks: have your child try walking like a crab, bear, frog, flamingo, you name it!
  • Fly like superman while lying on your belly and lift your arms and legs off of the ground. Also try swimming on the ground by kicking your legs and swinging your arms.
  • Ask your child to make a bridge by lying on their back with their feet flat and knees bent. Have them lift their bottom up off of the ground, and drive cars underneath to encourage holding this position.
  • Fill a large bag or a laundry basket with heavy items and encourage your child to both push and pull it around the house. Do races with siblings to add an extra challenge.
  • Play with bubbles. Have your child lay on their back. Blow bubbles above their legs and encourage them to lift their legs to pop the bubbles with their feet.
  • Do wheelbarrow walks. Adapt by holding your child at their hips, thighs, or knees if holding them at their ankles is too difficult.
  • Explore kiddie yoga.

Help Your Child Reach His or Her Potential

Remember, hypotonia is not a bad thing. It’s just something that certain babies and kids need help with. Your child with hypotonia can have great physical stamina, strength, and endurance. It just might take a little extra time and effort. Hypotonia is a passive state of being that has no bearing on what your child’s muscles can do when they kick into high gear. Swimming, gymnastics, and the above listed at-home activities are just small selection of activities that can help your child achieve a strong physical status. Attending our monthly Respite Night held at our Highland clinic is a great place to start.

Our goal is to provide your child with the best care possible with passion, patience and persistence. We’d love to meet you and help your child achieve his or her potential through pediatric therapy. Contact us today to learn more.