Increased muscle tone in infants – symptoms, causes, exercises
Is your baby arching or flexing while lying on their tummy, or is their fists clenched almost constantly? Are you wondering if this is simply a developmental stage or a sign that your baby is struggling with increased muscle tone? Don't worry—clenched fists and arching (also known as flexing) aren't always a cause for concern, but there are symptoms of increased muscle tone in babies that are worth knowing so you can consult a specialist as soon as possible.
In this article, we explain what increased muscle tone in infants is and its distribution disorders.
We'll also answer questions parents frequently ask: when does increased muscle tone in infants end, and how to treat it. You'll also find simple, safe treatments. exercise helpful in cases of increased muscle tension in infants, which can be an excellent complement to therapy conducted by a physiotherapist.
What is increased muscle tone in infants and how does its distribution in the body change?
Before we explain what exactly it is increased muscle tone in the infant, it is worth knowing that every child - just like an adult - has muscle tension, or so-called muscle tone. This is the physiological state of active skeletal muscle tension, which, when properly regulated, allows for maintaining body posture, as well as movement and working against the force of gravity. Increased muscle tone in an infant (so-called hypertonia) means abnormal increase in resistance during passive movementsIn infants, disorders rarely concern the "amount" of voltage itself, but mainly its distribution in the body—the so-called distribution.
In another article you can read more about decreased muscle tone in infants.
When does increased muscle tension subside and clenched fists and arching cease to be physiological?
Parents often worry when they see clenched fists in an infant or that the baby arches and tenses. When it passes physiologically increased muscle tensionthat we observe in a newborn?
Expert advises
Increased muscle tone in a newborn is physiologically observed around the periphery (in the arms and legs), and the baby reacts reflexively, including with a grasping reflex, which weakens over time. When does increased muscle tone around the periphery of an infant's body subside? It's a gradual process, but by around 3-4 months of age, the core muscles should become strong enough and infant reflexes integrated enough for the child to gain greater freedom of movement in their upper and lower limbs.
When increased muscle tension in infants does not go away – symptoms that should alert parents
🔹 Lack of symmetry after 3 months of age
Around the third month, a baby should be able to hold their head in the midline and bring their arms together over their chest. If they still can't do this after the fourth month, it's a red flag, a symptom that may indicate a disturbance in the distribution of tension in the body. This is the point at which many parents begin searching the internet for information, typing phrases like "increased muscle tension photos", wanting to compare the symptoms observed in your child with them.
🔹 Persistently clenched fists with the thumb tucked in (thumb inclination)
If after the third month your baby still clenches their hands, stiffens their arms or raises their shoulders towards their ears (whether lying on their back or on their tummy), this may be a sign of over-tension and over-compensation.
🔹 Difficulty dressing the baby (stiffness of the limbs when putting on clothes), rash under the baby's armpits and on the neck.
If, despite the passage of time, it still remains a challenge to put on sleeves and pant legs freely, it may mean that the child has increased muscle tone.
🔹 Tensing and arching – is this always a symptom of increased muscle tension?
If a baby arches or tenses only occasionally, for example, during intense crying or momentary discomfort, there's usually no reason to worry or suspect increased muscle tone in the baby. This is a natural response to stress and emotions.
However, it is worth being vigilant if your baby is constantly tensing up and his or her body often forms a characteristic arch when lying on his or her back – with the back lifted off the ground and resting on the back of the head and feet.
This is the position often depicted in photos of children with increased muscle tone, posted online as examples of the typical pattern in this disorder. In such a situation, it's a good idea to consult a specialist to assess whether the infant is experiencing increased muscle tone.
🔹 Difficulties during "Tummy Time".
Children with increased muscle tone often react to the tummy position by tensing their body, lifting their head too high too early and incorrectly, or having difficulty supporting themselves correctly on the forearms.
When, after the third month of life, the elbows remain "glued" to the body while lying on the tummy, the fists are clenched, and the head is tilted back significantly, this means that the baby arches and has difficulty actively supporting itself on the forearms.
This is another example of a child's body position that is often shown in photos of infants with increased muscle tone.
Expert advises
A symptom of increased tension in an infant (or rather – as already mentioned – a symptom of a disturbance in the distribution of this tension) is frequent, uncontrolled “rolling” from the stomach to the back – parents mistakenly interpret this as the first rotation, although in fact it is an incorrect, uncontrolled movement pattern resulting from increased muscle tension in the infant.
Increased tension in infants – the most common causes
Increased tension in a baby can have various causes – from harmless, temporary disorders of the maturation of the nervous system po more serious changes in the central nervous system (OUN).
Early observation of symptoms and a quick response from the parent are a great opportunity to start therapy early enough and prevent the entrenchment of incorrect movement patterns.
The reasons increased muscle tone in an infant - damage to the CNS
One of the causes of increased muscle tone in infants is early damage to the central nervous system (CNS).
They may result from, among others: perinatal injuries, hypoxia, hydrocephalus, leukodystrophy, and strokesIn such situations, hypertonia (excessive muscle tension) can develop gradually, particularly in the limbs. Premature infants are at increased risk, as they are more likely to experience neurological complications, such as intracranial bleeding.
Compensation for reduced postural tone, as cause increased muscle tone in an infant
However, it sometimes happens that increased tension in an infant is not caused by damage to the nervous system, but is a form of compensation.
Expert advises
When a child has slightly reduced tone in the core of the body (the trunk), they may unconsciously "help themselves" by increasing the tension in the periphery—that is, in the arms and legs. This refers to the muscle tone distribution disorder mentioned earlier in the article. In practice, this means frequent clenching of the hands, stiffening of the limbs, disturbances in the fluidity and quality of movement, and a strong backward tilt of the head (the infant arches and stretches). This compensatory mechanism may resemble symptoms of increased muscle tone in infants, although its cause lies elsewhere—in disturbances in the "distribution" of muscle tone, not in damage to the CNS.
How to treat increased muscle tone in infants?
Effective treatment of increased muscle tone in infants requires an individual approach.
Photos of children with increased muscle tone viewed by parents on the Internet should not constitute the basis for diagnosing the problem.
The key is visit to a doctor and a pediatric physiotherapistWithout proper therapy, increased muscle tension and its disruption in the body can lead to abnormal movement patterns, delayed motor development postural disorders in the future.
How to Treat Increased Muscle Tone in Infants? The Role of the Physician and Physiotherapist
If you suspect a child has a muscle tone disorder, the first step should always be to consult a specialist.
- Pediatrician or neurologist – conducts a basic examination and decides on further treatment. If necessary, orders imaging tests or additional consultations, for example with a pediatric neurologist. The physician, in consultation with specialists in the field, decides, how to treat increased muscle tone in an infant.
- Pediatric physiotherapist – conducts therapy aimed at normalizing muscle tone and developing correct movement patterns. How to heal Does increased muscle tension occur in a physiotherapist's office? When working with infants, the therapist uses neurodevelopmental methods such as NDT-Bobath or the Vojta method, also supporting other techniques such as soft tissue therapy and manual therapy.
Early intervention allows you to take advantage of the brain's natural plasticity and increases the effectiveness of therapy.
Exercises for increased muscle tone in infants and friendly care
As a parent, you are closest to your child and spend the most time with them during the day, including caring for them, carrying them, and cuddling them to sleep. no specific way of carrying your baby will make the increased muscle tension go away, you can ask your physiotherapist to demonstrate several ways to position your child or suggest games to play with your child (exercises with babies at home are often done in a playful way). This can be helpful in maintaining the effects of therapy and positively influence the regulation of muscle tone in the infant.
🔹 Care - Daily exercises with your little one during routine activities.
Avoid sudden changes in position, rushing, bright lights and touching your baby with cold hands - such stimuli can cause discomfort in the baby, who may then react by excessive extension (so-called arching or tensing).
🔹 Correct wearing
It is suggested that in the first weeks of a child's life the dominant pattern should be flexion - we propose various positions of the child's body to provide him with a variety of movement experiences while avoiding excessive extension.
🔹 Scrolling and rolling
Daily exercise for increased muscle tone. Change the diaper by slowly turning the baby sideways, instead of simply lifting the baby's bottom. Talk to the baby and warn them about the movement. Maintain eye contact, provide plenty of movement experiences, and do this all in close contact with the baby.
🔹 Ensuring a stable position and contact with the ground.
If the baby arches and stretches when lying on its back, you can place your hand on its chest - this will allow you to gently press the torso towards the ground, the baby will feel more stable, and it may also turn out that increasing the support surface will result in the limbs relaxing.
🔹 Controlled tummy time is the best exercise for babies.
Lying on your stomach this is one of the most important exercise in the daily schedule of each infant.
- Often, but for a short time. Place your baby on his tummy several times a day, on a stable, harder surface.
- Pay attention to the tension. If your baby protests or tilts his head back too much, do not leave him in this position.
Expert advises
Simple exercises to increase muscle tone in this position? Make sure you're within the baby's field of vision and they can make eye contact with you. Talk to your baby, smile, and sing to you. You can offer a toy that's interesting at this stage, placing it slightly below their line of sight. It can be helpful to gently press the baby's pelvis against the ground with your hand—this gentle stabilization helps free up the arms for proper support.
Tip: Avoid long sleeves in clothes that irritate the hand and stimulate the grasp reflex (clenching the fist).
Support at home – mattress and environment for a child with increased muscle tension
The environment in which a child lives has a huge impact on his or her motor development.
Good mattress.
A baby with increased muscle tone needs stable body support, both during play and during sleep. The crib mattress should be medium-firm and even.
Do not put any pillows or stuffed animals in the crib + if the baby has a strong tendency to arch his or her back, make sure that there are no interesting objects/pictures above the baby's head that will encourage the baby to stretch (look back).
Avoid accessories that restrict movement.
Rockers, walkers, jumpers, or prolonged use of a car seat can make the torso lazy and worsen muscle tone disorders. Instead, it's worth focusing on floor activity and exercises—preferably on a hard mat.
Summary – when to react and how to treat increased muscle tone in infants
Although increased tension in infants in many situations is related to voltage distribution disturbance With regular exercises with a physiotherapist, a relative reduction in disturbing symptoms can be observed. When does increased muscle tone in infants subside?
If your baby arches his back, frequently strains, or has clenched fists after 3-4 months of age, and also doesn't like being on his tummy, it's worth consulting a specialist.
Early diagnosis and neurodevelopmental therapy help treat increased muscle tone in infants, preventing the entrenchment of abnormal movement patterns.
Bibliography:
- Matyja M., Gogola A.: Predicting the development of children's posture based on the analysis of the quality of postural tone in infancy, Pediatric Neurology, 2007.
- Straathof EJM, Hamer EG et al.: Development of muscle tone impairments in high-risk infants: Associations with cerebral palsy and cystic periventricular leukomalacia, European Journal of Pediatric Neurology, 2022, 37, pp. 12–18.
- Sanger TD, Delgado MR et al.: Classification and definition of disorders causing hypertonia in childhood, Pediatrics, 2003, 111(1): 89–97.
- Bagnowska K.: Factors influencing the effectiveness of NDT-Bobath rehabilitation in prematurely born children, New Pediatrics, 2014, 2/2014.
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