ELI5: Why is hypotonia not about muscle strength?

My 16.5 month old son was recently seen by a developmental pediatrician and was diagnosed with mild hypotonia. He met most of his milesstones until he turned one- though we noticed he was a bit slouchy- still is a bit and sits in the W position. It just took him a long time to start walking. He still doesn't walk on his own but he's getting there. The specialist didn't get into much when we were there- just said he should go to PT. As I'm looking it up online I just keep reading that muscle tone is not the same as muscle strength and I still don't get it. Also, is he good after going to PT or are there long term consequences of hypotonia? Certain sports a no-no?

Thanks in advance for your help.

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tinkerminx
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Hypotonia is not usually a disease on its own, it is usually a symptom to an underlying cause. Hypotonia can be a sign that there is a defect of the nervous system, or the musculoskeletal system. The question you need to ask the doctor is "What is causing the hypotonia?" There are several things that can cause hypotonia and knowing what is causing it will give you a better prediction as to his overall outcome. I wish I could help more, but not knowing what the underlying cause of the hypotonia makes it difficult to answer your questions properly.

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Why does he have hypotonia?

Hypotonia is not the same as muscle strength. You can describe hypotonia as an intrinsic property of the muscle itself. It is supposed to have a normal "tone" that is provided by nervous tissue. Physically, what you see is decreased muscle strength as a result of that.

It's kind of like if you wanted to close the door. Normally, you expect the door to be solid and thus, you can push on it with a certain amount of strength to make it move. However, if it was made out of jelly (lack of tone), you can push on it with the same amount of strength and it won't really move the same way. It needs more energy to move the same way as the regular door.

It's not a perfect analogy, but I hope that made it easier to understand.

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Thanks for your response. How do I go about finding out? Was the developmental pediatrician supposed to order further tests? He was also diagnosed with Mixed Responsive and Receptive Language Disorder. I've seen a few correlations with these two diagnosis but no further information. I'm starting to think I should get a second evaluation. She watched and interacted with him for a little while and asked us a few questions and then wrote down the DX on a RX pad that prescribed speech and physical therapy without any further information. I looked up MRELD the next day and started freaking out until on got on the SLP board and had some questions answered.

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It sounds to me like you should get a second opinion, but you need to make sure you get involved. Unfortunately some physicians don't have the best bedside manner and won't volunteer information unless asked. Ask questions when you see the doctor. Ask what the diagnosis is. It sounds to me like your son has some sort of neurologic issue going on, but I don't have his file and I'm not there to examine him so I can't say for sure. I think getting a second opinion would be wise. You can call the doctor's office where he is being seen now and ask for a copy of his medical records so you can take them with you to the second opinion. Good luck. I wish I could offer more help.

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