Hypotonia and Hypertonia

What Are Hypotonia and Hypertonia?

Children with muscle tone disorders usually have either hypotonia or hypertonia.

Hypotonia, which means low muscle tone, causes increased flexibility and looseness of the muscles.

Hypertonia, which means high or too much muscle tone, causes rigidity, spasticity and inflexibility of the muscles.

All muscle tone disorders affect muscle strength, motor nerves and the brain.

A child with a muscle tone disorder may have:

  • Feeding issues
  • Drooling
  • Breathing issues
  • Speech problems
  • Apraxia
  • Oral motor issues
  • Hypermobile or hyperflexible joints
  • Rigidity
  • Inflexibility
  • Rounded shoulders
  • Poor posture
  • Fine motor difficulties
  • Gross motor difficulties
  • Lack of appropriate body awareness
  • Poor head control (infant)
  • Weakened muscle tone
  • Poor reflexes
  • Low stamina
  • Low endurance

Muscle tone disorders affecting the brain, nervous system and muscles are:

  • Cerebral Palsy
  • Muscular Dystrophy
  • Traumatic Brain Injury (TBI)

Muscle tone disorders caused by genetic conditions are:

  • Prader-Willi Syndrome
  • Tay-Sach’s Disease
  • Down’s syndrome

Although neurodevelopmental disorders such as autism, ADHD and Sensory Processing Disorder are not diagnosed as muscle tone disorders per se, these children commonly have:

  • Hypotonia
  • Low muscle tone in the upper part of the body
  • Body language difficulties
  • Coordination difficulties
  • Motor planning difficulties
  • Poor motor skills
  • Speech difficulties
  • Oral motor issues

What Your Doctor May Tell You About Hypotonia and Hypertonia

Your child’s doctor or specialist will likely tell you that there is no cure for muscle tone disorders, but with various treatment protocols it is possible to improve the muscle tone to maximize physical function, increase independence and improve your child’s general quality of life.

Treatment protocols may also slow down the progression of other symptoms associated with muscle tone disorders such as muscle contractures, joint deformities and loss of function.

Your child’s doctor may suggest medications to help improve muscle function, stop seizures and reduce pain; however, in certain cases surgery may be advised as an alternative option.

Your child’s doctor may also let you know that early intervention therapies are going to help your child maximize the most benefits to assure the best long term outcomes.

He or she also will probably suggest any of the following therapeutic treatment options:

  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Language therapy
  • Aquatic therapy
  • Rehabilitation
  • Braces/orthoses
  • Customized seating
  • Mobility training and equipment
  • Assistive technology devices
  • Augmentative communication devices
  • Medication

Another Way to Think About Hypotonia and Hypertonia

The Microbiome

The microbiome is the newly discovered organ in our gastrointestinal system that is home to trillions of bacteria (microflora).

The human gut “microbiota” is the name given to the colonies of microbes that live in our digestive system.

These gut microbes are essential for communication with the brain and the immune system.

This connection between the gut and the brain is called the gut/brain axis.

The body makes muscle tone because we eat protein and in a healthy gastrointestinal tract, the protein gets broken down into amino acids.

These amino acids are vitally important because they feed the neurotransmitters in our brain which sends messages to the brain cells to tell the body what to do, and in this case, to create muscle tone.

If the microbiome is altered due to inflammation, not enough oxygen in the cells, and bad bacteria, then the normal digestive process is disrupted.

When this happens, not enough stomach acid is created to break down proteins, so amino acids are not feeding the neurotransmitters.

Without the amino acids, communication with the brain is limited and the neurotransmitters misfire, sending inappropriate messages.

Therefore, in order to have healthy brain functioning and a healthy body creating good muscle tone, a healthy microbiome is crucial.

The Krebs Cycle

Muscle contraction, on the other hand, requires ATP, known as adenosine triphosphate.

How is ATP created in our cells?

The Krebs cycle, found inside the mitochondria, is responsible for converting our food – carbohydrates, protein and fats – into energy.

The mitochondria are found inside our cells and have the primary job of converting this energy from the Krebs cycle and storing it in the ATP.

ATP needs a constant supply of energy from the Krebs cycle to create muscle contraction.

The Krebs cycle requires the following to supply energy to the body to create muscle contraction and many other processes:

  • Oxygen
  • Co-enzyme A (CoA)
  • Co-enzyme 1 (NADH)
  • Co-enzyme Q 10 (CoQ10)
  • B vitamins

So if the Krebs cycle is not working appropriately because it lacks oxygen and/or the nutrients it needs to make it function, then there is going to be a breakdown in creating muscle contraction properly.

Muscle Tone Can Be Improved

The good news is the microbiome and gastrointestinal tract can be healed so that muscle tone can be improved.

The Krebs cycle can also be improved by giving the right nutrients to increase the production of energy to regulate muscle contraction.

There are also many important nutritional supplements for improving muscle tone and increasing protein and protein absorption in the body.

In addition, today there are many effective therapies for muscle tone disorders that can make a significant difference in a child’s life.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) in a hard chamber provides oxygen under pressure improves muscle tone, increases oxygen to the brain and revives the idling neurons to make significant improvement in muscle tone disorders.


Pediasuit is another effective approach to treating muscle tone disorders.

The pediasuit accelerates the development of new motor skills and eventually over time strengthens muscle.

The goal is to have the child learn how to sit, stand and walk.

To find out about more exciting holistic and alternative approaches available to improve muscle tone disorders, see below.

Hypotonia and Hypertonia Checklist to Start

Make dietary changes:

Is your child craving and eating primarily a refined carbohydrate, high sugar, trans-fatty acids and fast food diet?

Eliminate all processed foods, and eat a whole foods diet.

Gluten- and dairy-containing foods are commonly known to produce an inability to focus when eaten.

  • Eat whole foods
  • Buy organic foods
  • Remove all GMO foods
  • Remove all fast and processed foods
  • Remove all foods with:
    • Artificial colors
    • Artificial ingredients
    • Preservatives
    • Phenols
    • Salicylates
  • With an elimination diet, remove potentially inflammatory foods such as:
    • Casein
    • Gluten
    • Soy
    • Corn
    • Eggs
    • Fish
    • Shellfish
    • Nuts
    • Peanuts
  • Strictly limit:
    • Sugars
    • Refined salt
    • Refined carbohydrates
  • Consider implementing a low glutamate diet and/or the Feingold diet

Include plenty of good quality fats, such as:

  • Coconut oil
  • Olive oil
  • Avocados
  • Wild salmon
  • Organic chicken
  • Organic turkey
  • Grass-fed ghee
  • Pasture-raised eggs
  • Grass-fed beef
  • Essential fatty acids from:
    • Cod liver oil
    • Hemp seeds
    • Flax seeds
    • Evening primrose oil
    • Borage oil
    • Walnut oil

Remove vegetable oils such as:

  • Canola
  • Corn
  • Soy
  • Safflower
  • Sunflower

Include plenty of high-quality proteins with every meal, such as:

  • Pasture-raised eggs and chicken
  • Grass-fed beef
  • Wild-caught fish
  • Legumes
  • Nuts

Heal the gut with special diets such as:

Learn more about healing diets and foods.

Use digestive aids with your practitioner’s guidance:

  • Betaine hydrochloric acid
  • Digestive enzymes with DPP-IV for gluten and casein intolerances
  • Proteolytic enzymes
  • BiCarb
  • Bromelain
  • Papaya

Clean up your environment:

Have you identified and removed possible environmental triggers, such as mold, dust, pet dander, and electromagnetic fields (EMFs)?

Have you identified and removed possible toxic exposures in the home from purchased products, such as detergents, soaps, lotions, and other cleaning and personal care products?

  • Remove animals (both live and stuffed!)
  • Remove carpets
  • Use non-toxic cleaners
  • Use non-toxic building materials
  • Green your home

Avoid exposing your child to chlorine, fluoride, and bromine because all three are in the same family as iodine and can displace iodine in the thyroid gland.

Ask your pediatrician to run some laboratory tests for:

  • Possible food sensitivities and allergies
    • Enzyme-Linked Immunosorbent Assay (ELISA) IgG, IgA, IgE and IgM
  • Nutritional deficiencies in vitamins and minerals. The NutrEval by Genova Diagnostics Labs covers the following areas:
    • Malabsorption
    • Dysbiosis
    • Cellular energy
    • Mitochondrial metabolism
    • Neurotransmitter metabolism
    • Vitamin deficiencies
    • Toxin exposure
    • Detoxification need
  • Bacterial and yeast overgrowth
  • Gluten and casein sensitivities
  • Organic acids: The organic acid test by Great Plains Laboratory for:
    • Yeast overgrowth (Candida)
    • Oxalates
    • Other microbial infections
  • Comprehensive Stool Analysis by Genova Diagnostic Labs to identify:
    • Malabsorption
    • Maldigestion
    • Altered gastrointestinal function
    • Bacterial/fungal overgrowth
    • Chronic dysbiosis
  • Neurosciences Laboratories for comprehensive testing on neurotransmitters

Add fermented foods and probiotics daily:

These will keep the gastrointestinal system and microbiome healthy and strong which in turn will keep the immune system strong.

  • Eat kefir yogurts
  • Eat fermented vegetables
  • Eat umeboshi plums (very alkalizing)
  • Eat miso soup, if soy is tolerated

Some good probiotics are:

  • VSL#3
  • Gut Pro
  • Dr. Ohirra’s Live Cultured Probiotics
  • Garden of Life
  • Culturelle
  • Klaire Labs

Use herbs, essential oils and natural supplements with your practitioner’s guidance:

  • Cod liver oil
  • D-ribose
  • Creatine
  • Co-enzyme A by Co-enzyme A Technologies
  • Co-enzyme 1 (NADH)
  • B vitamins
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • CoQ10
  • L-carnitine
  • Acetyl-l-carnitine
  • Free amino acid complex
  • L-glutamine
  • Branched-chain amino acids (BCAA)
  • Dimethylglycine (DMG)
  • Vitamin B complex
  • Omega 3 fats
  • Alfalfa
  • Ashwagandha
  • Dong quai
  • Raspberry tea
  • N-acetylcysteine (NAC): prevents upper respiratory infections for those prone to chronic infections
  • MSM transdermal cream
  • Epsom salts bath

Have protein shakes:

  • Whey protein if the child is not allergic or sensitive to casein or dairy or has a glutamate issue
  • Pea protein
  • Egg protein

Arthred is a predigested protein by Nutricology which is more absorbable and helps increase protein for better muscle tone quality. It can be added to the protein shake.

Do the PediaSuit protocol:

The PediaSuit can improve a child’s motor and cognitive functioning.

Do Hyperbaric Oxygen Therapy (HBOT):

HBOT in hard chambers can improve muscle tone, keep muscles from rigidity after physical therapy, and increase oxygen to the brain and tissue in the body.

Learn about retained primitive reflexes:

Most, if not all, children with neurodevelopmental disorders including learning disabilities, have retained primitive reflexes.

Find a therapist that is trained in integrating primitive reflexes, which can cause imbalances in the way your child’s brain performs.

See a chiropractic neurologist at a Brain Balance Center:

The Brain Balance program can help balance the right and left brain hemispheres and make neural connections to extinguish primitive reflexes.

See a neurofeedback practitioner:

Neurofeedback and biofeedback can strengthen muscles and muscle tone, improve spasticity and reduce muscle contraction.

Find a practitioner that can perform a QEEG (quantitative electroencephalograph) brain map first so you can understand how your child’s brain works.

See a sensory-integration occupational therapist (OT):

These OTs address a variety of sensory issues with a child using hands-on equipment.

This type of therapy calms down the nervous system to help integrate the senses and retained reflexes.

See a chiropractor:

A chiropractor can improve body balance and muscle coordination and increase energy.

See a craniosacral practitioner:

Craniosacral therapy can reestablish central nervous system functioning. These practitioners use approaches rich in vestibular, proprioceptive and tactile input and may also do oral motor and myofascial therapy.

Find a therapist doing Brain Gym:

A Brain Gym practitioner can have your child do exercises for sensorimotor coordination, self-calming and self-management.

See a homeopath or naturopath:

These practitioners can diagnose and treat gastrointestinal disorders naturally so that the child’s immune, sensory, neurological and nervous systems develop without being compromised.

See a well-trained acupuncturist:

Acupuncture can help strengthen muscle tone and improve organ functioning.

See a speech pathologist:

See a Physical Therapist (PT), Occupational Therapist trained in Sensory Integration, speech pathologist (see GemIIni for home program)

Do adaptive yoga:

Adaptive yoga for children with special needs uses breathing practices and body postures to strengthen muscles, improve balance and increase body awareness.

Sources & References

Dehley, Leanna M., et al. The Effect of Mitochondrial Supplements on Mitochondrial Activity in Children with Autism Spectrum Disorder. J Clin Med. 2017 Feb; 6(2): 18.

Filipek, P.A., et al. Relative carnitine deficiency in autism. J Autism Dev Disord. 2004 Dec;34(6):615-23.

Hao, J., et al. Mitochondrial nutrients improve immune dysfunction in the type 2 diabetic Goto-Kakizaki rats. J Cell Mol Med. 2009 Apr;13(4):701-11.

Liu, J. The effects and mechanisms of mitochondrial nutrient alpha-lipoic acid on improving age-associated mitochondrial and cognitive dysfunction: an overview. Neurochem Res. 2008 Jan;33(1):194-203.

Long, J., et al. Mitochondrial decay in the of old rats: ameliorating effect of alpha-lipoic acid and acetyl-L-carnitine. Neurochem Res. 2009 Apr;34(4):755-63.

Mabalirajan, U., et al. Effects of vitamin E on mitochondrial and asthma features in an experimental allergic murine model. J Appl Physiol. 2009 Oct;107(4):1285-92.

Maes, M., et al. Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro Endocrinol Lett. 2009;30(4):470-6.

Maes, M., et al. Lower plasma Coenzyme Q10 in depression: a marker for treatment resistance and chronic fatigue in depression and a risk factor to cardiovascular disorder in that illness. Neuro Endocrinol Lett. 2009;30(4):462-9.

Noland, R.C., et al. Carnitine insufficiency caused by aging and overnutrition compromises mitochondrial performance and metabolic control. J Biol Chem. 2009 Aug 21;284(34):22840-52.

Power, R.A., et al. Carnitine revisited: potential use as adjunctive treatment in diabetes. Diabetologia. 2007 Apr;50(4):824-32.

Shen, W., et al. Protective effects of R-alpha-lipoic acid and acetyl-L-carnitine in MIN6 and isolated rat islet cells chronically exposed to oleic acid. J Cell Biochem. 2008 Jul 1;104(4):1232-43.

Shekhawat, P.S., et al. Spontaneous development of intestinal and colonic atrophy and inflammation in the carnitine-deficient jvs (OCTN2(-/-)) mice. Mol Genet Metab. 2007 Dec;92(4):315-24.

Spindler, M., et al. Coenzyme Q10 effects in neurodegenerative disease. Neuropsychiatr Dis Treat. 2009;5:597-610.

Zhang, H., et al. Combined Ralpha-lipoic acid and acetyl-L-carnitine exerts efficient preventative effects in a cellular model of Parkinson’s disease. J Cell Mol Med. 2010 Jan;14(1-2):215-25.

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