As I dive into treatment for low muscle tone, it seemed like a good time to touch on this topic. It is one more tool your therapist can use to help your child progress.
In 2007 I took the certification course Pediatric Kinesio Taping. For the past 9 years I have found Kinesio Tape to be very helpful in supporting body parts, stimulating muscles, alleviating pain, and reducing swelling.
What is Kinesiotape Tape? It is a flexible/stretchy tape that is put on a body part for 5 days at a time.
I have tried all of the brands of Therapy or Kinesio Tape, and found the original by Kinesio Tape International to stay on longer, and keep its tension longer; than any other brand.
Reasons to tape:
- Reduce swelling from an injury like a sprain or strain, or after surgery.
- Reduce pain from injury, swelling, surgery.
- Support a body part to help the body stay aligned. I might tape the side of a child’s neck to help remind them to hold their head up if they have torticollis, or ankles to help align them so the muscles can work more efficiently.
- Stimulate low tone muscles to activate and work harder than they are: I might tape the stomach area to strengthen the oblique abdominal muscles. Or the muscles along the spine, to help a child learn to sit up. The stretchy nature of the tape stimulates the muscles and improves feedback for improved postural control.
Here is an image of two children with two different methods for taping the stomach muscles.
Most of my taping is for low muscle tone and muscle weakness to stimulate and support an area. What follows is related to those uses.
Your therapist might use K tape for 4-8 weeks at a time, assuming there is no skin reaction. Generally I prefer the following sequence of wearing: 5 days on, two days off and repeat for 4-8 weeks. A child may sweat, swim, bath and in general do all the things they normally do. After a bath or shower, the area is patted dry- not rubbed, so that tape stays on. Tape removal involves using oil- like canola oil- and rubbing it on the tape letting it stay while the child sleeps overnight- and seeing if by morning it has soaked through and diminished the adhesion so the tape can easily be removed. If not you reapply oil the next night and let it again soak through the tape. A parent recently told me she cut up a clean kitchen sponge to use to apply the oil on the tape; less messy than her other attempts.
Who Can Use K Tape: Kinesiotape can be used for very young infants through adulthood. Reasons to avoid using it are generally related to skin reaction, or a strong behavioral reaction. Very sensitive skin may react to the adhesives used on the tape. More often I have found ways to tape around eczema on the belly, or a G tube. Usually a skin reaction is due to not following the procedure for tape removal. A strong behavioral reaction is the 5 year old who pulls the tape off himself. Besides irritating the skin, it shows that the child can not tolerate the sensation of a gentle pull on that body part. So building trust and decreasing tactile defensiveness need to be worked on first.
Does it work?: Yes it does for specific areas with specific goals. It is not a cure-all, it is one more tool to use. Here is a link to Research on Kinesio Tape.
Over the next few months I will post photos of children with K tape on and describe what it is doing for them.
Not sure if your child has low muscle tone, also called hypotonia; check out this post:
I always consider getting the biggest bang for my buck. When children come to see me they don’t have time to do every possible exercise that I may come up with to address a number of different areas. So I look to do activities that are going to address many areas at once, always thinking how it will stimulate the brain to grow and develop.
Positions that are important for your child to conquer:
Tummy time. Using a ball is more fun, and serves the purpose of stimulating their inner ear (vestibular system) and vision. Gently rock your baby back and forth and side to side, try a circular pattern, vary the speed but make sure you are holding them safely on the ball, and you have a good grip on the ball yourself.
The photo below shows a child lifting their head and arms up nicely. This is fine if done some of the time. It is not fine if this is all your child does, because it does not work their tummy muscles. While this child does not look like they have low muscle tone, in babies with low muscle tone we want to see them pushing up with their hands.
The child pictured below can now play because he can lean one hand on the supporting surface and reach with the other. Once they can do this they will spend more time on their tummy and you won’t have to work so hard.
This position is great for your 6-10 month old, it prepares them for crawling.
Check out other ideas for teaching your child to crawl with my three part series on crawling. Don’t let your child with low tone avoid crawling, it is one of the best skills they can learn and will develop their brain and body musculature in many ways.
Equipment that might be needed:
Hip Helpers: Are useful for the child with low muscle tone who has excessive hip mobility. If your child’s hips are floppy and they can do a split or straddle, then these shorts are needed to tighten up their muscles and joints. The shorts will help them strengthen their body and trunk muscles, because their base of support will be smaller as they will have to long sit, or side sit. They will not be able to frog sit or W sit. I don’t recommend wearing them all day, 2-3 hours in the morning and 1-2 in the afternoon. Wearing them for half of their standing time for 4-6 weeks. Once they start to walk fairly well, they should not wear them. These are inexpensive and easy to order.
Classic TLSO (thoracic lumbosacral orthosis) by SPIO : See below. This is a type of compression garment that will give your toddler sensory input, while also giving them some support. The sensory (pressure) input helps give them a sense of where they are in space so they feel more confident moving, and are less clumsy. The support gives them more endurance to stick with a task, or play activity. While the SPIO can be measured and ordered by you, if you go to an orthotist who works with children, he or she will be able to bill your insurance company. The garment can be worn all day, but generally it is recommended to be worn for 2-4 hours once or twice a day. In this way your child will not accommodate to the feel and start to sink into the support, but will stay stimulated by it. Some children need more support than this garment will provide. Your child’s care givers- orthopedist, physiatrist, physical therapist, may recommend one of the following garments as seen on this site, instead: Complex Child
Sensory stimulation that is needed:
The following ideas are to help your relaxed happy baby who is totally content sitting and getting you to do all their work- to change- and become the exploring machine they need to be. These techniques tap into their brain, and important sensory systems ( vestibular and proprioceptive), and will actually improve your child’s muscle tone, and stimulate them to move.
Swing, Rock and Roll
Karen Pryor DPT taught this technique at a course I attended recently. I suggest to parents to do this a few times a week. I am pleased with the changes I see in my patients who’s parents are doing this.
I would not do this technique if I suspected my child had seizures, hydrocephalus, microcephaly, any cervical or cranial problem.
whole body massage. This was also taught by Karen Pryor. This is not a “gentle put you to sleep massage”. This is one to increase alertness, attention, engagement, and body awareness. Gently but firmly with brisk strokes in a downward motion go over your child’s arms, legs, and the front and back of their body. An image I like to use: “After a day at the beach I need to brush the sand off my babies skin.” You can do this daily.
massage vibrator: For infants over 6 months. This will stimulate their muscles and help with body awareness. Generally children with low muscle tone enjoy having a vibrator run up and down their back, arms and legs. Avoid their bellies and heads. This is a fun toy, your baby can grasp it; and feel the vibration up to their shoulders. As toddlers they can learn to turn it on themselves and give you a massage! Here is an image of one that is inexpensive and easy to find at a drug store. I like this general shape because it is easy for young children to hold.
Music: Did you know that music stimulates all parts of our brain? So enjoy singing, to your baby and child. Hold your baby and dance with him as you sing. Or make up arm movements and gently move their arms as you sing “Itsy bitsy spider”, or ” The wheels on the bus”. Nursery rhythms are helpful for language development. Playing music in the car and in your home, is a great way to pass the time, and develop a family culture. Classical music is said to develop our brains in many ways. So mix it up and enjoy yourself.
Bounce your baby on your lap and sing “3 little Monkeys…,” or “Wheels on the bus.”
There are a number of walking harnesses out on the market today. They can help you as a parent not strain your back bending over to hold up your toddler. And if your child has low muscle tone, it is a good idea to avoid holding their arms in the overhead position as seen below:
Their shoulder girdle may not be strong and stable enough to be supportive for the rest of their body. And we don’t want to stretch out their little joints.
I would not use a harness on a child under ten months, and in general I do not recommend early walking (under eleven months) for an otherwise typically developing child. Remember the goal is to have them crawl for at least 2 months before walking.
I do recommend shortening the time when your child starts to pull to stand on their own, and cruise- and their actual first steps. If they have been cruising for more than two months and they are 14 months old, then I would increase the amount of time they are on their feet and walking. The biggest reason is that many children won’t take off with their language until they have mastered walking. Why is this? There aren’t enough hours in the day, nor energy in a child, to focus on two big skills at once. Developmentally there should be a burst of language around 18 months. So it is nice if your child is a confident walker by then.
Below are a number of Harness options and the pros and cons of each
A&S Creavention® BabyWalker Baby Walking Protective Belt Carry Trooper Walking Harness Learning Assistant Version 2.
The bar across the top is easy to hold and you can control your child’s body easily. You can help them to move forward or encourage them to go a bit slower, or help them not lean so far forward… you get the idea. You could hold the bar with one hand for a second if you needed to reach something.
The chest strap can end up pulling up under your child’s arm pits and raise their shoulders up. This position would be uncomfortable, and not the alignment of their body that you want for your child as they are learning to walk.
This design with two straps may be hard to coordinate with your arms if your child is unstable.
The Pro of the following design is the pelvic support will help control your child’s lower body somewhat. The chest straps may give enough support to the upper body for your child. And it has a bar which as we noted might be easier than straps for you to manage.
The Con: Because children at this age are top heavy, it leaves a good amount of their body unsupported above the axis of the harness. This may be fine for many children. If your child needs a fair amount of upper body support and they try to lean on the chest straps they may not feel secure.
Here is a video of a Toddler with Mom using the first type of harness.
When his parents first tried it a month earlier, we decided he was not ready to use the harness. He needed more support than the harness gave him.
Here are the skills he had that told me he is ready to use the harness:
Crawling- and in this case up an incline wedge:
Playing on hands and knees:
Pulling to stand on a vertical surface
Here he is after two weeks of using the harness with Mom and Dad; as well as doing lots of climbing activities at home with his parents. He is stronger, faster, more confident and well on his way to be an independent walker.
Here is another technique that can save your back: A home made push toy!
Pushing a kitchen or dining room chair across linoleum or wood floor will build up their upper body strength and give them practice walking. Hold the back of the chair and gently help them move it forward- for them- backward for you. Have a toy on the chair like a piano.
For more ideas on helping your child learn to walk check out this blog:
Just a heads up on the Boston Abilities Expo taking place at the Convention and Exhibition Center- Hall C. September 16-18.
Registration is free.
This is a great resource for families and professionals. From their web site:
” Every event opens your eyes to new technologies, new possibilities, new solutions and new opportunities to change your life. Where else can you discover ability-enhancing products and services, play a few adaptive sports, learn new dance moves, attend informative workshops and only scratch the surface of what Abilities Expo has to offer? Register for free today.”
Hope to see you there!