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What does "low muscle tone" (Hypotonia) mean for Aspies?

Although it's not part of the official diagnostic criteria for Aspergers, low muscle tone is nevertheless an condition strongly associated with Aspergers.

Why is it so Confusing?
When most people hear about "low muscle tone" they assume that it has something to do with bodybuilding - I certainly did at first. This is particularly confusing since many newly diagnosed aspies are children and it's quite uncommon to see any child with a well-developed set of muscles. Most parents will either simply ignore the condition or assume that a bit of outdoor activity, eg: playing soccer, is required.

The other confusing thing is that there are adult aspies out there who regularly attend the gym and who have "better" muscles than many NT people. How do they fit the criteria?

I saw a great line on a web site discussing Hypotonia. "Your kid seems perfectly good with their muscles - they are strong, they run round with boundless energy, but they have trouble doing things. You have likely been given the standard explanation about your kid's muscles being floppy and you just cannot see it in your kid."

Defining Low Muscle Tone
Low muscle tone refers mainly to the distribution of muscles on the body, their initial state, speed and stamina. The affected muscles can be "trained" but that training won't come from sport or from and normal gym/weight training. It comes from some very specialized training - and it won't be 100% effective. In young children, the problems of low muscle tone will reduce in severity as they get older - up to about the age of 10, though aspies will likely continue to adjust and compensate for the rest of their lives.

Low muscle tone is often described as "floppiness". This is because the muscles are supposed to help support the skeleton and are supposed to prevent certain types of movement. Since the muscles aren't particularly tight, people with low muscle tone often experience "hypermobility", the ability to move limbs into awkward positions.

As children, aspies often find that they are able to easily perform feats which require flexibility but not strength or balance, such as splits, backbending and shoulder rotation. They may display unusual flexibility in other joints such as fingers.

The Bad News about Low Muscle Tone
Such flexibility comes with a price and aspies are usually quite uncoordinated and clumsy. In running, this contributes to the famed "unusual gait". It's easy to imagine that low muscle tone only affects the big muscles but this isn't the case, it affects all activities requiring muscles including most notably, speech, pencil grip and writing.

When sitting or standing for long periods, aspies tend to slump quite a bit. Sometimes, they will stand with their legs crossed in what appears to be an uncomfortable fashion. My mother was constantly trying to correct this stance and while I'm reasonably aware of it at work, I still find myself standing that way regularly. I'll point out now that although this looks uncomfortable, this is actually a very comfortable stance for aspies.

Aspies often sit with their head and shoulders rolled forward and will frequently lean on walls, furniture, door frames and desks. Parents of aspie children will probably be very familiar with being "leant on".

Low muscle tone does not prevent aspie children from enjoying themselves, they can run and play with other children without feeling any ill effects. The problem is that, they're a bit slower and they tire easily. This means that team sports, like soccer are often not well suited to aspies. In the case of my son, we turned to scouting as an alternative to soccer.

Dangers inherent in Low Muscle Tone
While the slumping and leaning behaviours aren't necessarily great posture, they're not particularly dangerous to the aspie unless the position is adopted for very long periods without proper breaks.

I have first-hand experience with this problem as I've had episodes of "overuse syndrome", a kind of RSI, with my hands, arms and shoulders from sitting at my computer for too long. It took quite a while for OH&S to work out that the issue wasn't with my hands, or even with my workspace. It was simply due to excessive time spent in an unsupported position.

Fixing the Problem
As I said earlier, the fix isn't normal weight training, it's physiotherapy and specialized muscle training. There is also a need for awareness and constant correction of one's position. In my case, the muscles most needing training were small ones high on my back. Correcting my keyboard "slump"moved my arms and shoulders back into less damaging positions. I have to be constantly aware of my position and correct it thoughout the day. I also do a bit of stretching and strengthening work on them at the gym.


macskadĂ©k said…
Wow. It seems like I have this. Though the hypermobility part is almost disappeared by now, but I caused some surprise at home when I was 8-9, doing pedicure with my teeth. Then my toenails grew harder and I never this this technique since then.
The more important part is start of movement is always very hard, e.g. when we have to do sit-ups in P.E. class, I tremble hard at the first 4-5, then the trembling gradually fades. It's like my muscles have to "learn" making continuous tension from the repeated small activation impulses first (as the nervous system sends little sparks instead of one long signal, of which it's not capable of [I remember this from bio 101 but surprisingly many people don't]). Also, I tire quite quickly when running, and I have been told many times that I sit, stand or walk "carelessly" or too loosely. I was told it's not "polite" - but I, being an Aspie, don't really get what exactly politeness means, anyway, so I thought it was not that important. And I always found handwriting very strenuous and thus my writing was always messy and hrd to read. But the really peculiar thing is that when I'm excited/happy, I don't have any of the "constantly tired" feeling what I usually do. Maybe the manic excitement creates a state that would be hyperactive in a person with a higher muscle tone, but in me it's just "normal" as perceived. (Though the bad balance and coordination stay there in this state as well, which can cause many "silly" accidents.)

So, do I fit the hypotonia dx? It would explain quite a few things.
Gavin Bollard said…
Thanks Meredith,

Your comments on this site are always very enlightening.

I don't think it is common for an aspie to not have hyptonia. It's not directly part of the diagnostic criteria but it is certainly indirectly there.
Anonymous said…
I originally started checking this site because of a friend who I suspect is an Aspie. But the more I read, I'm starting to wonder about myself. This topic really surprised me. I'm a competitive athlete (in an individual, NOT a team sport), yet my biggest challenge has been my balance - I have a tendency to lean over and overcompensate, and I joke at competitions about one way of judging if it was a good match was whether I managed not to fall.

The comment about standing with crossed legs hit home, and I've joked about having inherited lousy joints because of various instances of RSI.

Please keep this great site up.
Anonymous said…
Now I am grateful for 8 years of ballet lessons as a youth! My parents did a lot right even though the Aspie identifier was unknown at the time.
Anonymous said…
Gavin, reading your post on Hyptonia was amazing to me--as a 56-year-old guy recently self-diagniosed as Asperger's, I had not heard of this aspect. Yet it describes me exactly--I'm always leaning on things or otherwise supporting myself, and had never stopped to think that this might be unusual. But 50 years ago, I clearly recall my mother taking me to a doctor to find out why I was so clumsy, always falling down, etc., and he told her "he has poor muscle tone."

Another aspect of this is a kind of delay in getting muscles to fire. I used to notice it while riding a ski lift--after sitting for a few minutes it was very hard to get off of the chair, and once I missed the ramp completely! Even getting out of the car takes a mental effort. This is not from being unfit or overweight, just a weird kind of neurological delay.

I would be very intererested to know if anyone has done some actual research on this.

Thanks much, Fred in Utah, USA
Anonymous said…
I too have just found this site. I have an 8 year old with aspergers syndrome. This love muscle tone describes him to a "T" Meredith...what did you do about your handwriting? My son struggles with his handwriting -- if you have any pointers for a 2nd grader -- I'd love them.
Anonymous said…
Hi Gavin,

Really interested in your article and would especially like to know more detail re: appropriate physiotherapy and specialized muscle training. How does one go about getting this?
Gavin Bollard said…
Don't be confused about Muscle Tone and Muscle Strength. A Hypotonic individual may be able to exert the same strength as a normal person but may suffer from poorer stance, curvature or general "floppiness".

Have a look at this article: From a Cerebal Palsy Web Site.

Note the following in particular;

"There is currently no known treatment or cure for most (or perhaps all) causes of hypotonia, and objective manifestations can be life long. The outcome in any particular case of hypotonia depends largely on the nature of the underlying disease."

You may be able to change the size and strength of muscles but you can't change their position.

Still, you can visit a local physiotherapist and ask about hyptonia and you will be given some exercises which can reduce issues.

Just be careful. Weight training a person with Hyptonia can cause more damage because our arms can move into bad positions due to floppiness.
Wends said…
Hi, my son was diagnosed with low level aspergers last yr and he is 9, i was googling about physiotherapy with it because the seu at his school has sugested it and i wasnt really sure why. i found your post very interesting and now see why. i am definately bookmarking this site. thank you :-)
Anonymous said…
thx, i discovered that i fit into this description, i ll get a diagnostic for this it could change my life!

i was very flexible. ok i can still put my palm hand fully on the ground with my legs straight so im still quite flexible i guess (with no gym since 15 years)

funny that i was reading your comment about crossed legs while i had my legs confortably crossed :p

horrible handwriting which is more a support for above average long term memory than a real writing. but maybe it s related to left handedness since i write with right hand.

when im tired i can pronounce words with difficulty.

unusual way of walking,sandals in winter, toe walking when possible

i happen to have unusual burst strenghth for my body size. i have well developped upper body muscles with very little training.i also have very low physical activity and im very lazy.

2 days ago i moved a laundry machine, no problem to carry but my joints hurted after this.

on some occasions (maniac enthusiasm as meredith says) i displayed amazing strength, which i can not reach when in normal state.

also , despite lack of training and no taste for sports, i used to be above average in endurance running.

maybe hypotonia have also good side effects on performance while bad effect on normal daily muscle use?

like something that runs better than normal at full power but runs poorly at low power? (2 stroke engines for instance)

i have some idea that there are different muscle fibers.
a specialist of muscles physiology could probably answer to this.
Any Aspie around with a special interest in muscle physiology? :p
Denise said…
Thank you for your wonderful blog - and this post in particular. My 20 year old son (with Aspies) saw a new psychologist last week, who suggested low muscle tone to us - something we've never heard of before.

And lo and behold, it ticks SO many boxes, from his awkward gait as a child, difficulty handwriting and drawing, sleeping folded in half over crossed legs, to his hand tremor, and fatigue when just brushing his hair.

He's really been enjoying your blog, and keeps coming in to show me more posts, and saying "Yes, yes, I do that!" (stimming, memory problems, etc etc). Thank you again!!
Lindsay said…
Interesting post. I have wondered what hypotonia was ever since I learned it was commonly seen in Aspies/auties.

I am not sure if I have it, though. I have never tired easily, and have always enjoyed (and been fairly good at) sports. In high school and college, I did a lot of weightlifting, and am thus very strong, but inflexible. I was never hypermobile. But I do have poor handwriting, poor fine motor control, a hand tremor and general clumsiness. I also have awful balance, which I had previously attributed to inner-ear damage from childhood ear infections.

Also, your description of hypotonia as "floppiness" does not sound like me; I'm more rigid than floppy.
Damo said…
The other side of me shall come out. The gym trainer. I worked on body symmetry and body sculpting. I also focussed on correction of muscular imbalances or core strength.
Essentially what you are describing is a loose joint with hypermobility.
When I was little I used to suck my big toe. (I know its gross but I saw nothing wrong wth that.) Now that I have spent 16 years in the gym irony has set in. I can do 90% full front splits but as for sides I can only achieve 86 degrees at best. Ahhh the price you pay for doing too many squats. I tightened my hips sooo much that I now have to restretch them again.
And to validate Gavin, muscle strength and joint mobility are two completely different animals. My tool for this was the execution of slow controlled exercises in a fixed plane of motion using mainly bodyweight as opposed to normal reps with big weights. Tighten the bolts first and the crane doesn't fall over. The bolts are the joints. Good luck guys.
Anonymous said…
ive got the asperger thing and i had terrible muscle tone in my early years and i was extremely weak and skinny. i was also very uncoordinated and had no fine motor skill what so ever. i started up weight lifting when i was 13 and i did all kinds of things like running and bicycle riding. turns out i was an exercise addict, i couldnt sleep if i didnt expel that energy. i am now 20 years old and ive been an exercise addict for 7 years. its the best addiction anyone can have. i now have far better coordination, balance, hand/eye co., etc than a normal person. i have aslo gained an immense amount of knowledge about training and nutrition and everything in between(I also have the physique of a professional athlete). my advise to anyone with this thing is to take up vigorous physical activity and something you enjoy intensely that will correct your bodies clumsiness (mine was mountain biking). I never played any sports and i wasnt a fan of teamwork my point is that there is a way around anything if you work at it. and u may want to take up a martial art (not tae kwan doe or karate) more like judo or chinese boxing.
Anonymous said…
Wow. I am so glad I found this! After reading this Hypotonia describes many things about me. For example, I always used to get in trouble for resting my head on my hands, but I just had such a hard time keeping it up! My dad thought it was me being lazy, but I couldn't focus otherwise.

I also have balance problems if I stand straight up with my legs together. I usually stand on my right leg with my left leg off to the side and I cannot stand for more than a few seconds without something to lean on, and even that is just a few minutes. Most of the time I am out I always try to sit somewhere because my legs start to shake and my feet get hot and hurt. When I was little I thought I was just being lazy. Also, I will sometimes lean against something and stand on just one leg, or I will stand with my left leg crossing behind my right leg.

Another problem I have is with body awareness, though I don't know if this counts as part of hypotonia. The gymnastics I do requires a lot of body awareness, but when I am doing a move I don't always know what my limbs are doing unless I look. It's not like I'm not paying attention, but it is like I literally CAN'T FEEL THEM. Obviously I know my hands are still there, but I can't tell if my fingers are together and my hands are straight, which makes each move harder.

One last question: could hypotonia explain why I can't build up strength in my arms and core?
Anonymous said…
I have just found this site as I believe I have Aspergers - I have been doing yoga and have been told I am hypermobile. I have always had a tendency to strains.

So I typed in 'aspergers and muscle tension' and I get this - I wasnt even sure there was a link!
Anonymous said…
Don't know if anyone will read this, but I'm grateful for these comments. My 3 year old has low tone muscle (via neurologist). Additionally, we have other mysterious issues that do not currently have an explanation or label, but the more I've read on aspergers, the more I see so many familiar issues. My 3 year old has trouble with remembering or saying people's names, with fine/gross motor skills, with sensory integration, anxiety, talking to peers, etc., etc. I guess when she's a little older and everything else in the world has been ruled out we might get a dianosis. I think it's aspergers. Thank you for sharing your stories.
eaucoin said…
Within our family, one of the issues the aspies have is with swimming. They can swim, but tire more easily. I used to think it was just the chemicals in the pool, but it's that way in natural bodies of water too. As my daughter describes it, something about her breathing makes it hard to swim even though she is in good physical condition.
Anonymous said…
Thank you SO much for this post! You could be describing my 10 y/o son. I've always known that he has Asperger's, despite never having him officially dx'd. I am an LCSW and work with children w/Asperger's and spectrum issues but I was totally unaware of the muscle tone connection. Your post has been most helpful! Thank you again!
moosemanlucknow said…
hi everybody
i am probably an asperger person , with low muscle tone and energy, is there any way around this or is there any way to improve the condition marginally
Sassy said…
I have my oldest son with aspergers, But he has very large muscle tone. But my 5 year old is waiting on an evaluation, and he has very low muscle tone to where he can hardly lift a five pound weight more than once or twice. I am not making him lift weights, he was copying his brother. I started to get concerned about that. And also I've noticed him fall a few times while running and it looks faked but I am not certain. Then I was reading low muscle tone is common in aspies. How can I help him? I am really watching him and it really hasn't been enough to take him to the dr yet. I read that carintine (sp) can help as well as co q-10. Also I'm putting him on a diet specifically for kids on the autism spectrum. I'm hoping all this helps. But I"m looking for any advice I can get.
Jennie said…
What an amazing blog!
I don't have any experience of Aspergers but we are considering adopting a child with a history of it and he suffers from low muscle tone. He is 2. He seems to have a really good emotional connection with people. Does it always affect your emotional connection with the world?
Gavin Bollard said…
Hi Jennie,

I'm yet to meet someone with Asperger's Sydnrome who doesn't have some kind of difficulty with the communication of their emotions to the outside world.

Aspergers doesn't affect your emotions themselves but it can make it harder for you to communicate them to others. This means that sometimes people can't read if your happy or sad in your face - and sometimes they can't read an expected response (empathy).

It doesn't mean that it isn't there.
Anonymous said…
Hi. My son is 14. He was dxd with Sensory Processing Disorder at 4. Then revised to Aspergers at 8. Because of early intervention he has excelled in the social and emotional area. He has continued to struggle with hypotonia and other medical issues related to Aspergers.

HOWEVER, we recently took him to a Podiatrist for basic insoles, thinking that would help his stability. Instead, the podiatrist pointed out that our son clearly has an underlying connective tissue disorder. Because he has Aspergers, the "autism" doctors have always passed off the "floppiness" and "hypotonia" as just another symptom of Aspergers. After the appointment, I began researching online and found tons of info on Connective Tissue Disorders, info that would have helped us greatly had we gotten it when he was 4 and we initially saw the geneticist. Now we're just catching up.

What is scary is this: Connective Tissue Disorders appear as "loose" or "floppy" limbs, scoliosis, etc. because the connective tissue is affected by an underlying cause (genetic, bacterial, or viral depending on a whole range of possible disorders or diseases). But Connective Tissue does not just hold your limbs in their sockets. They hold your organs together. "Loose" or "Floppy" limbs could indicate "loose" or "floppy" colon, stomach, lungs, heart, brain... (I'm being simplistic here, but you can explore further by googling "connective tissue disorders" on your own.) In my son's case, they are seriously looking at him for Marfans which affects different organs including the heart and colon. (He has had IBS and reflux since infancy and has had great relief on the GF/CF diet.)

Amazingly, I found (just) one medical site that did list Connective Tissue Disorders as a comorbid condition associated with ASDs. It seems that statistically, people with Aspergers and ASDs are more likely to also have connective tissue disorders, tho no one disorder is particularly linked. Interestingly, people with many connective tissue disorders are often dxnd with Generalized Anxiety Disorder due to how connective tissue affects proprioception. (If you've been dxnd with Sensory Processing Disorder you know this term well.)

This is really disturbing to me. The more I search the various autism websites, the more I see these sypmtoms listed as benign "signs" of Aspergers. If you have a connective tissue disorder, you possibly might live a long life, but very possibly you will die of aortic problems or bowel perforations in your early to mid adulthood. You might also end up with severe arthritis due to joint "floppiness" and spend your golden years in severe pain. I didn't know this before the podiatrist began to talk to us about connective tissue disorders. I just assumed the "symptoms" were benign indications of his Aspergers. I've always tried to decide between treating or accepting my sons Asperger "symptoms" on a basis of whether the symptom is hurting him in some way. Since "floppy" limbs didn't seem to hurt him, I assumed wrong. Now we are going through a series of tests to find out just how much our child has been affected.

Just wanted to let you know. This is really something that should be explored further.
Nature Mom said…
We have seen good results with martial arts (taekwondo) -- better balance and overall muscle tone. I hope my 6 year old aspie will continue to be interested. In addition to the physical work outs, they teach "character training" (really like social skills therapy) and meditation.

I have always described certain behaviors of his as "noodlely" flopping around. We have seen improvements of the noodlely behavior with biomedical treatments (gfcf diet and supplements), listening therapy and sensory integration with an OT, and martial arts training. My son also needs the orthopedic inserts in his shoes, so I'll have to ask our wonderful doctor about connective tissue disorders. Thanks for that information.
PAULYA said…
This was very informing my son is 9 and he is just starting PT. I understand about the muscle thing because he had to train the muscles in his mouth. It took a while but he worked really hard and the therapy worked a miracle. I am hoping that the therapist will understand when I print out this article and ask if they could keep the suggestions in mind during sessions. Lol thanks again
Ray said…
I can tell you 100% I dont have hyptonia.So much disinformation about aspergers on the internet.
Gavin Bollard said…
@Ray "Although it's not part of the official diagnostic criteria for Aspergers, low muscle tone is nevertheless an condition strongly associated with Aspergers."

Strongly associated (as in very frequently a condition).

It doesn't say always.

Don't forget, if you've met one person with Asperger's Syndrome, you've met ONE person with Asperger's Syndrome.
KateGladstone said…
If it helps at this late date (I've just found this site) — I'm a fifty-year-old Aspie, with the muscle tone issues, who self-remediated for the handwriting issues at age 24 and became a handwriting remediation professional: web-site HandwritingThatWorks dot com, and you can e-mail me through there.
James said…
I've always wondered why I felt more tired or "floppy" at times. I always remember my legs feeling rubbery. Even now, when it's later in the day, my slow walk usually involves my legs sort of extending backwards so that the knee locks. It also reminds me of my late uncle (whom I strongly suspect was Aspie) being able to twist and bend his body around in ways that made him appear to have no joints (or bones, for that matter)! But I've always had poor posture, and found that even sitting up straight makes me feel tired. Very interesting post, I'll also check out the linked article...Thanks!
Tony said…
Interesting blog. I've never considered myself to have low muscle tone. I've never had hypermobility, though I could mange to suck my toes up until my late teens/early 20s with difficulty. I actually have issues sitting in any position that compresses the legs, which I always thought was simply due to the fact I have a lot of muscle mass around there.

As a kid, I had poor coordination and low strength, but a year of playing football at the age of 13 (Aussie Rules) started a lifelong transformation. I seemed to take particularly well to the training, and the more intense, the better I developed. A couple of years later, I accidentally found myself getting into gymnastics, which I ended up enjoying. This also brought a lot of coordination issues under control. Today, I use weight training, run and compete in some very intense team sports. At almost 45, I have the energy levels of someone much younger, and am still finding my peak potential, and I'm remarkably free of wear and tear type injuries (touch wood!).

One challenge and mystery that remains is despite having little natural endurance and extremely high power over a very wide range of speeds (which is a real asset in my sport, where I have to push heavy objects at speed), I hack the sprinting speed that I should have. I suspect this is a neuro-muscular issue, as on a bad day when I'm feeling particularly sluggish, any attempt to increase speed is likely to cause injury, and I'm wondering about ways to specifically train to consistently reach my full potential. I also have a slight delay in changing direction, and don't perform as well in agility test that one would otherwise expect, which definitely seems to be neurological in origin.

On, and I've always had lousy handwriting. :)
Anonymous said…
I'm a 50 year old female Aspie and have had many issues and still do regarding lose muscle tone. I was very obese and have lost a lot of weight but because I find exercise even small amounts exhausting, I've got a lot of lose hanging skin. I've always had problems walking with my calves cramping up and so can only walk in flat shoes. I can only wear heels if it's a very short walk to and from where I have to go. So even walking for exercise is very hard due to the cramping up. I also slump a lot, lean on things for balance when standing but also find even just relaxing the lounge very hard. I usually sit at the table and lean on it while watching TV. On a more personal note, I find no matter how many pelvic floor exercises I do, it doesn't help to strengthen my vaginal muscles at all either. I've often wonder if other female aspies suffer from this as well regarding intimate muscle tone. I've never been able to do chin ups as I cannot support my body weight with my arms, no matter what my weight . I can't get one inch off the floor. I've also had lousy handwriting but I find also makeup, hair styling and any grooming involving me lifting my arms to do it very challenging. Even plucking my eyebrows is a real effort to the point now where I've become very adept at using a razor to do them instead. Strangely enough, one thing I can do very well is painting. I think it's because I can stretch and lean on the wall and put pressure on the roller while I am doing it. If there was a piece of exercise equiptment that was a big roller than u could roll up and down the wall to bend and stretch with, I'd be the first buyer as it would be my kind of exercise....There's heaps more I could say but i'm sure this post is long
Unknown said…
Wow, I just found this site. My girlfriend was googling low muscle tone, and she said Aspergers. I read all the posts, and was astonished! She always comments on why I slump forward in my chair, round shouldered, I even sometimes lean all the way forward and rest my head on my legs. She says lean back and be comfortable. But it is comfortable. I too stand with my legs crossed, or I have to lean on something, I can't just stand still. I am terribly clumsy, my legs buckle a lot, my arms tend to swing a little crazy when I walk, and I constantly bang my hands into shelves, walls, and doorways, and I lose my balence a lot, crashing into doorways and such. I tire so easily. I have Chronic fatigue syndrome and Fibromyalgia. So I'm not sure whats what, but I was tested for multiple sclerosis awhile back, negative. I am 50, but that doesn't mean anything as I don't go to Drs too much. Thanks so much for all these posts!
Greg Piazza said…
I have never seen sitting in a 'w' before as an aspect of ASD and was quite startled. I have always been commented on for sitting like that. I also tend to lean on walls with my legs crossed... As Aspergers goes, my wife notices a lot of the traits and has always been there to help out. I practice the social stuff, but she's always close by if I forget. :-)
Anonymous said…
Is Connective Tissue Disorder the same as Ehlers Danlos?
Gavin Bollard said…
Ehlers–Danlos syndrome (EDS) is an only one of a number of different types of connective tissue disorders.
Bambam said…
I'm really glad I've read this, it helped me understand Low Muscle Tone quite a lot. I have a few questions though, and would be very grateful if you were to answer them.

If I have the idea of low muscle tone right, then it means that there's not enough tension in the muscle as well as a lack of graded control right? Which means they have much more difficulty performing tasks that we have no problem with, as they require more energy to perform them, as well as the fact that they have difficulty remaining still independently (like without leaning on something) for long periods of time.

This was said to be curable but... How long would it take on average? And is it completely curable, or will they continue to have problems in the future? And for the hyperflexible joints, do they go away after (if) the low muscle tone "cures"?

Also, patients with low muscle tone can still form muscles, right? Like through exercise and such? Since its not really the muscle development itself that is affected... (or is it?)

Sorry if the questions are worded awkwardly or what not, I just wrote it as my brain thought and rewriting it just makes it sound more awkward. My brain's kinda dead, I guess.
Gavin Bollard said…

No it's not "curable". You can increase your muscle strength but you can't change how it is layered.

People with Hyptonia always have excessive muscular movement, even when better toned. It has its upsides and downsides.

The most obvious downside is that it's much easier to injure oneself if the limbs and move into positions that they shouldn't.
Anonymous said…
Honestly I'm an aspie but I'm not flexible. I'm one of the most unflexible people at my school. But I do tire out easily.
Solomon said…
I am father of 3 and 1/2 year son for me he looks ok he grab me well,he does not get tired even sometimes I force him to seat easily,but he has hard time to cache ball ,and now he is in KG ,his teacher is give me hard time,I assume she often took him to school clinic of course the clinic is operated by a nurse, every time they guess something and worry me a lot,of course I am concerned about my kid health I took him to neurologist he told us he is fine and his growth is average,sometimes I got confused ,angry and really sorry on the teachers at my son's school , and now I am planning to put him another school the thing is my son love the school I do not know what to do ?
ev said…
Well Im just realising at 44 that Im an aspie while self diagnosing my 8 year old son. I have always found it hard to hold my back up straight and always had my head on the table through school and wondered why. I couldnt handle flashing flouro lights or clocks ticking. I have always had a problem with flexibility and cannot seem to change it. Wow...I am on such an eye opening journey at the moment
seems every aspie has different handwriting was perfect and I was very coordinated
Anonymous said…
The first time I read this post I wasn't sure, as whilst I did self-diagnose Asperger's(pretty much took every test there is and I've sort of been reading about it non-stop ever since) I wasn't sure about hypotonia as I've become aware of how tight my shoulders usually are which to me didn't fit(although when I lower my shoulders I seem to need a lot of tension elsewhere to keep it up). However the whole flexibility thing does fit-I've always been "floppy" but when I started figure skating I decided I needed to be able to do the splits and even though I was already 12, I had no problem getting myself to do it. I also have a flexible back with very little core strength and can do a bridge from standing then often collapse when I try to get out of it!
My body posture always made me feel awkward, and as a kid I remember the other kids often said I walked weirdly, but I didn't get what they meant-after all, everyone walks differently, right? Now though it's annoying for me as a pianist, I've tried to sort out my posture before in figure skating lessons(my coach did ice dancing and decided to focus on my posture) and Alexander technique. All I have now though is that when I notice my posture's bad I try to correct it but don't seem to be able to maintain it without serious concentration, and Meredith I get what you said about usually feeling sore all over until you feel "hyper", it's annoying because that feeling's so inconsistent! One day I have the energy to go figure skating and do a lot of practice, the next three I'm sore all over! It never seemed to make sense...
Corinne said…
I know for a fact that I definitely have this. I have Asperger Syndrome and have been an avid swimmer all my life - I learned how to swim when I was still in diapers and joined a team in middle school. However, I've always been extremely slow no matter how much I train, and it isn't my technique. It wasn't until recently that my mother figured that it was because of poor muscle quality, which I've had since birth.
The "leaning" thing also makes so much sense. I always thought that I just I just got tired more easily because I tended to lean against things when I was standing up for a while. Up until recently, I worked at a job that required me to be on my feet all day, and my boss had to constantly remind me not to lean against the wall, chair, etc. because it looked bad in front of our clients. I feel like I want to slap myself in the face for not realizing this sooner!
Anonymous said…
I have Aspergers but don't believe I have hypotonia. My endurance was pretty good for an unfit child at school compared to folk who trained for soccer and other sports. I do get sore knees, a doctor at 14 said something bout shape of knees but prior to having lymphoma I never had an issue with sore knees but when I got it my knees where much sorer and are still sore if I run a lot of miles, hoping it partially improves as I here for any runner it does any way. I severly overprotonate which apparently my foot arch shape doesnt predict but the other features of my foot seem consistent with overprotonation such as narrow heal, longer ball length relative to foot size than men ( I am a man). But these things are hard to measure given companies overstate the extent of difference in proportiontiallty of male and female feet, we talk bout on average a few mm's which is difficult to measure without high tech equipment. Also also had sore back from exercising but the cancer and since has made that a lot harder I believe that too will improve as core strength improves but it will always be an issue getting in the way of actually letting your core muscles work to exhaustion as your back muscles/tendons and bones will give up the boat first though I do believe with training the gap will narrow, thats tended to be my experience when I was exercising without knowing I had cancer. I was more flexible than average for a guy but no issues with falling over or being able to absolutely incredible things I believe my muscle fibers themselves where just more flexible naturally unlike the "bad" flexibility of movable joints. I find I am actually stiff but flexible when fit...The person who says they struggle to feel what their body is doing, I am a bit like that, in that I don't know if my hips are doing things correct or not when doing bent over rows, and Icant do the pelvic type exercises women dancers do easily as it is more likely to look like a rude pelvic thrust than the sort of sassy thing women do but that could be due to being a guy as much as the hip utilization/awareness issue...It may be my knee pain is not due to hyptonia but my overprotonation and some sort of abnormal knee shape related to aspergers that is different from the knees bending like they are going backwards thing because I look at my knee and it just looks flat so it could actually be shape differences with normal joints rather than angle differences of hyptonia, id put money on shape rather than the problem of angle to be honest (beyond the problem of the angle of overprotonation on my feet which is a quite different thing).
Anonymous said…
does this mean you'll never be able to thighen your muscles?
Unknown said…
I havent been formally diagnosed with Aspergers. As there was no label for that in 1982 but when reading my detailed IEP from 1982 and reading about Aspergers it seems its all there. General observations from the examiner read: A pale completion appearance and dark circles under her eyes contribute to her waif-like appearance. She seems tired and frequently lays her head down on her arms as they are stretched across the table. Her low affect suggest a noticeable lack of energy and depressed emotional condition.

Although I have overcome many challenges that I had when I was 9. I have bad knees, tendonitis in both elbows which has been a booger to treat and had it since winter last year, back issues and I am always leaning on something if I have to stand for long periods of time. I am very active and exercise regularly but its so difficult sometimes as I have no energy. In boot camp groups Im always lagging behind, and its so embarrassing when the old folks pass me. I feel like its gotten worse, and no matter how much I train and work on isolated muscle groups I cant seem to strengthen those muscles. I just keep plugging away the best that I can though. Maybe if I ever get formally diagnosed I can look into focus muscle training which will help me in the long run.
LionKinghorn said…
This has been a very informational post. I have Asperger's but wasn't diagnosed until age 21 (now 30) even though I had all the symptoms since childhood. Thanks to this article I did a little research on hypotonia and heard it called floppy baby syndrome. I was in fact floppy when born and had to be intubated. I was very flexible when I was younger, able to twist like a pretzel. My body mechanics are peculiar, e.g. my left elbow hyperextends effortlessly, my hips are always rotated out, feet pronate, etc. I was always smaller than kids my chronological age and quite frail having many broken bones and other such injuries.

This is great information that needs to be in the hands of doctors (children and adult), therapists, counselors, etc. There is research concluding a deficit of motor coordination in ASD but even this study steers it back towards behavior and socialization. When will professionals learn to look deeper than outward behavior and instead focus on the neurological, cognitive, sensory, and biomechanical aspects?!

P.S. You misspelled hypotonia in the title, writing hyptonia forgetting the "o"
Unknown said…
I have found this very interesting. At 5 years old, my now 8 year old, went to a physical therapist for toe walking. She noticed he had a hard time standing up from the floor and could not do a sit up for nothing. So she looked me dead in the eyes and said your son has Muscular Dystrophy. The family Dr. Did not agree and didn't feel it was worth the torture to put him through a muscle biopsy. So we found a physical therapist this past year who has done wonders for him. He then started seeing a occupational therapist who has determined sensory processing disorder. His muscles seem to get stronger, yet he does not. He struggles going up stairs and getting up off the floor. He runs slow and his legs buckle as well causing a lot of falls. His blood work always comes back normal, but he is getting frustrated with the amount of things he has trouble with. He is embarrassed by the way he does things and does not want to go to school ever. Does any of this sound familiar?
Gavin Bollard said…
Crystal; The question I have is whether this is a matter of strength or balance. Is your son falling because of wrong-footedness or because he is tired?

Tiredness could be lots of things including chemical imbalance and diet -- or it could be hypotonia which would indicate poorly layered muscles and hyper-flexible joints. If his joints are too flexible, this could cause his legs to collapse under him.

Doing Physio is the right answer but keep a watch on diet as well. If nothing is showing up in the blood work, it suggests, for the moment, that the problem is physical.

Unknown said…
My 16 yr old son has aspergers but he is also dx with ehlers danlos syndrome..type lll....which is what the hypermobile part is about. He also has slightly low musle tone. May look into eds as a dx for flawed collagen issues.
betty said…
Oh my Lord, you have helped me so much! I have ALWAYS had hypotonia, even as a tiny child. I was always last at everything physical, and along with my personality quirks, this made for a difficult childhood! I’m 60 years old now. Of course, when I was a kid there were no names and no information available, so I have slowly discovered who (and how) I am over many years. This was the final thing that never made sense in my life. I SO wish I had known when I was younger why I was “different”. It might have saved me from years of depression and self-loathing. The more I learn about Asperger’s the more I understand myself. Thank you all so much for this bit of enlightenment. I can’t thank you enough! Betty

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