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Hypotonia is the medical term for low muscle tone or muscle weakness.

Hypotonia may be detected shortly after birth or as a child gets older. It can be a condition on its own (infantile axial hypotonia) or, more commonly, it can be a symptom of an underlying condition such as cerebral palsy and others listed below.


Hypotonia can be caused by a variety of conditions, including genetic disorders and muscle disorders. Some common causes can include but are not limited to:

Specific treatments and services may vary by location. Please contact a specific location for more information.


Below are common symptoms of hypotonia, though symptoms vary depending on each individual child.

  • Muscles feel soft and floppy
  • Feeling limp or like a ‘rag doll’ when being held
  • Ability to extend joint beyond its normal limit
  • Inability to meet developmental milestones (such as holding head up without support, rolling over, sitting up without falling over)
  • Problems with feeding
  • Shallow breathing or difficulty with speech
  • Mouth hangs open with tongue protruding (under-active gag reflex)

Diagnosing Hypotonia

An accurate diagnosis is important in order to provide the most effective care for children experiencing hypotonia. This is especially important because hypotonia can indicate that another disorder is occurring (such as cerebral palsy). Our physicians may ask the family if the condition has been worsening or if it has been consistent and stable. They may also ask about family history, their pregnancy and delivery, and whether any problems have occurred since birth.


Treatment is individualized to help improve functions such as daily activities, mobility and speech. In these cases, treatment may involve physical therapy, occupational therapy, and speech therapy. In some cases your doctor will recommend bracing or supportive equipment. On some occasions children benefit from surgery.

We absolutely love Shriners Children's. From the front greeters to the therapists, everyone makes you feel so welcome and comfortable to ask any questions.
Angela, Portland
therapist working with female patient during physical therapy session

Physical Therapy

Rehabilitation services provided at Shriners Children's are a combination of clinical excellence and evidence-based research to provide the best care for children.

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Physical Therapy

Physical therapy at Shriners Children's helps children build confidence and strength, focusing on what is important to them and what they love to do in their daily lives.

Occupational Therapy

Occupational therapists at Shriners Children's help kids be as independent as possible, focusing on what is important to them and what they love to do in their daily lives.

Speech Therapy

The speech therapy services available to patients at Shriners Children’s benefit children from birth through adolescence who have difficulties with communication and swallowing.

Orthopedic Surgery

With their expertise in treating children from toddlers to teens, the pediatric orthopedic surgeons at Shriners Children’s understand the challenges of planning ahead for growing bones and bodies.


Shriners Children's multidisciplinary team includes orthotists who create braces to meet the individual need of each child – whether to treat a complex condition or common injury.

Next Steps

Request an Appointment

Families and caregivers seeking treatment should start by contacting us for an appointment.

Log in to the Patient Portal

Parents and guardians of existing patients can email, request records, schedule appointments and more.

Refer a Patient

Physicians and healthcare providers can request appointments, start transfers or contact us with questions.