When your child seems floppy, tires easily, or misses physical milestones, you may hear the word hypotonia—also called low muscle tone.

But what does that actually mean? And more importantly, how can you support your child if they have it?

At HEROES Physical Therapy, hypotonia is one of the most common reasons families come through our doors. It is not a diagnosis in itself. It is a clinical description of how a child’s body manages tension and control.

This article will help you understand what low tone is, how to recognize it, and how physical therapy can make a powerful difference in your child’s strength, movement, and confidence.

What Is Muscle Tone?

Muscle tone is not the same as muscle strength.

Tone refers to the resting tension in a muscle when it is not actively being used. It is what helps the body stay upright, move smoothly, and respond to postural changes automatically.

Children with low muscle tone have muscles that feel soft, loose, or floppy at rest. This makes it harder for their body to activate quickly when movement is needed. It also means their joints may not be as stable, and their posture may require more effort to maintain.

What Causes Hypotonia?

Hypotonia can occur on its own, or as part of a larger condition. Some common causes include:

• Genetic conditions (such as Down syndrome, Prader-Willi syndrome, or connective tissue disorders)

• Prematurity

• Neurological conditions

• Global developmental delay

• No known medical cause (sometimes called benign congenital hypotonia)

Whether or not a diagnosis is present, low tone can impact development—and intervention can help.

Common Signs of Low Muscle Tone

Children with hypotonia may:

• Feel floppy or “mushy” when held as infants

• Struggle with head control or tummy time

• Appear to collapse into sitting positions

• Avoid crawling or take longer to reach motor milestones

• Fatigue easily during play or walking

• Have poor posture and difficulty sitting upright

• Use compensatory positions like W-sitting or leaning on furniture

• Show uncoordinated or slow movement

• Seem clumsy or unbalanced

• Avoid playground equipment or active games

They may also struggle with fine motor tasks, speech articulation, or feeding skills—all of which rely on postural stability.

How Hypotonia Affects Daily Life

Low muscle tone can impact much more than just movement. Children with hypotonia often:

• Need extra support to sit at a table

• Avoid active play due to physical fatigue

• Have difficulty staying focused during seated tasks

• Fall more frequently

• Show frustration when they cannot keep up with peers

• Feel less confident exploring new environments

The effort required to maintain posture and control often leaves less energy for learning, social interaction, or emotional regulation.

This is not laziness. It is a physical limitation that can be supported with the right approach.

How Physical Therapy Helps Children With Low Tone

At HEROES Physical Therapy, we use a combination of targeted strengthening, postural control work, and sensory-informed movement strategies to help children with hypotonia build function and independence.

Therapy goals may include:

• Improving trunk and core strength

• Increasing endurance for movement and posture

• Supporting head and neck control

• Training balance reactions

• Building motor coordination and timing

• Encouraging upright play and movement exploration

We use engaging, play-based activities that motivate your child while challenging their body in safe, structured ways.

Sample Activities That Support Low Tone

Some of the tools and techniques we use include:

• Therapy ball exercises to activate postural control

• Tummy time with incline to build head and trunk strength

• Obstacle courses for endurance and coordination

• Crawling over soft surfaces for core engagement

• Kneeling and half-kneeling play to support balance

• Movement games like animal walks, scooters, or wheelbarrow play

• Weight-bearing tasks (such as pushing weighted objects)

Each activity is tailored to your child’s specific needs and progress level.

What Parents Can Do at Home

You do not need special equipment to support your child with hypotonia at home. Small changes in your daily routine can make a big difference.

Try:

• Encouraging floor play instead of seated play

• Using vertical surfaces (like easels) for drawing

• Offering climbing, crawling, or bouncing time each day

• Providing frequent breaks for movement during seated activities

• Reducing time in passive containers like bouncers, jumpers, or car seats

• Letting your child explore active play even if it’s messy or slow

Your physical therapist can help you create a home program that works in your space and fits your schedule.

When to Seek an Evaluation

If your child is missing milestones, seems unusually floppy, or struggles with posture, movement, or endurance, a physical therapy evaluation is a helpful first step.

At HEROES, we use standardized assessments, play-based observation, and parent input to understand your child’s needs and create a personalized plan.

You do not need a referral, and you do not need to wait for a formal diagnosis. Early support often leads to better outcomes.

Low muscle tone may be part of your child’s story—but with the right support, it does not have to limit their potential.

To learn more, visit heroespt.com.