Written by: Kendall Cunningham, PT, DPT

Low muscle tone, also known as hypotonia, can occur for many reasons. There is a high correlation between autism and low muscle tone. About half of children with autism have low muscle tone. While there is no reason as to why this is, there is a high correlation between these two diagnoses.  

 Symptoms of Low Muscle Tone

The first thing you might notice in a child with hypotonia is they are generally weaker than other children their age. Their muscles will not be able to contract strongly, so there will be a springy feeling to their muscles.  

The lack of contraction within the muscle can cause dysfunction from the ground up in their joints. 

In their feet, they may be overpronated- or flat footed- and they may toe walk. You may also notice that they walk with their feet turned out like a duck. All of these can cause pain into their ankles, knees and hips. This condition may also cause knee hyperextension- which can affect the ankles and hips as well.

Additionally, the lack of contraction in their core muscles may cause children to walk a large arch in their back and their tummy stuck out.  

You may also notice that, because hypotonia causes children to be hyper-flexible, they may sit in a W position on the floor.  

Because of the lack of muscle contraction, the child may have pain in their back or any of their joints. Your muscles work to provide your skeleton structure and stability, and, without this, pain can occur.  

Physical Therapy for Low Muscle Tone

 Spooner pediatric physical therapists work on your child’s individual needs. We want to build up the strength and the stability of your child, but we want to target their specific needs in a way that makes it fun for them.  

If your child is missing major movement milestones- like walking, running, and jumping- we want to help them achieve that. We also want to know what they can’t do on the playground or at soccer practice.  

If your child is flat footed, we can help you find the right shoes and orthotics to increase their stability with walking. If they have an increased back arch, we will work on core stability. A physical therapist can assess these milestones and provide individualized treatment incorporating your child’s favorite games, toys, and sports. While we are helping them move and feel their best, we always want to encourage fun! 


If your child has low muscle tone, schedule an appointment with a Spooner pediatric therapist today!