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5 High Muscle Tone Exercises to Try at Home for Hypertonicity

Jun 03rd, 2020 | by Kristen Maranan

Kristen Maranan

June 03rd, 2020

What is Muscular Hypertonicity? 

Tone can be described as the amount of tension a muscle has at rest. All muscles have a normal resting tone, which helps the body move freely against gravity and is needed for overall posture. In the case of muscular hypertonicity (hypertonia, high muscle tone, hypertonic muscle), even at rest, there is an increased state of active muscle contraction. 

To assess whether increased tone is present, a muscle is taken through passive movements. Let’s take your leg for example, if someone tries to bend your knee, without you helping at all, there would be more rigidity trying to get your knee to bend because of this increased resistance from your muscles. 

There are Typically 3 Kinds of Hypertonia: 

  1. Spasticity – velocity dependent
  2. Dystonia – involuntary muscular contraction when voluntarily moving
  3. Rigidity – resistance to movement, fast or slow.   


Signs and Symptoms of Muscular Hypertonicity

Hypertonia is commonly seen in cerebral palsy but may also affect infants, babies, children, and others affected by other pathological disorders such as a stroke or simply be a response to pain. High muscle tone in children or adults will often present as appearing rigid, it’s generally difficult to move and often involve muscles responsible for flexion, more than extension. In the leg, the knee may have a slight bend, the same will go for the elbow, while wrist and fingers are often fisted. In contrast, hypotonia is the term for low muscle tone.

Hypertonia can affect both arms and legs (quadriplegia), affect only the legs (diplegia), just one side of the body (hemiplegia) or can even affect only one extremity or one muscle group in a single limb. If gone untreated, hypertonicity (hypertonic muscle) can have the potential to lead to contractures or a permanent shortening in the muscles of the affected limb or limbs. It can present in babies as early as one year, sometimes earlier, all dependent on how severe the condition.   

5 High Muscle Tone Exercises to Try at Home

So, what can we do at home to combat hypertonia or hypertonic muscle? NAPA pediatric physical therapist Kristen shares 5 exercises below.

1. Passive Range of Motion 

Position your baby or child where they are most comfortable and move the affected body part slowly and safely through their available range of motion. Typically, your kiddos body will have a natural stop, which is why it’s important to move slowly. Stop just before this point, hold them to sustain that range for a few seconds, gently bring them back to the starting position and repeat. Hopefully as you continue this motion, their range increases further and their body is able to relax. 

2. Dissociated Positions 

Going into a half kneel or a captain’s pose is the perfect example of what this may look like. 

If your child typically postures in a global extension pattern, a child’s pose position – sitting on their heels and bringing their trunk to their thighs, may prevent increases in tone if in a heightened state. Initially these positions may be hard to maintain but more exposure can build tolerance.  

3. Joint Compressions 

Providing increased input to each major joint – ankle, knee, hip, wrist, elbow and shoulder, with short, gentle compressions. Placing one hand right above the joint, the other just below, gently bring both hands together while making sure not to pull your hands too far apart when returning to the starting position. If you feel like you are pulling too much soft tissue apart and/or together or their whole body is moving and grooving, that is far too much motion. Keep both hands as close to the joint as possible, the movement is extremely minimal. 

4. Weight Shifting

  • Gentle rocking – laying on their tummy or back over a therapy ball and rolling them forward and back or side to side 
  • Side stepping – hands can be supported by a table or even a wall, this forces them to shift their weight from one leg to another before taking a step.

5. Other Methods

  • Deep pressure to trunk/shoulders/legs: giving your child or baby deep, gentle squeezes to provide additional proprioceptive and sensory input 
  • Heavy Work: pushing or pulling a weighted laundry basket or miscellaneous bin that’s been sitting on a shelf 
  • Bridge exercises: laying on their back, knees bent, pushing their hips up towards the ceiling. Up the challenge by seeing how many toys can pass under the “bridge” or how many can you stack on their bellies while they hold the bridge. 

Additional Resources:

About the Author 

Kristen Maranan is a pediatric physical therapist at NAPA Center. She is an LA native who couldn’t imagine not being able to drive to the beach, mountains, Disneyland or grab some good grub, all in the same day. 

About NAPA Center

At NAPA Center, we offer intensive and traditional pediatric therapies to help children achieve their full potential. We have four US clinics, located in Los Angeles, Boston, Austin, and Denver. We also have two Australia clinics, located in Sydney and Melbourne. We take an individualized approach to therapy because we understand that each child is unique with very specific needs. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. If you’re interested in learning more, send us a contact form and our team will be in touch shortly!


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