Logan Steele
Muscle tone is the amount of tension a muscle has at rest, which helps the body move freely against gravity and is needed for overall posture. High muscle tone, or hypertonia, is an increased state of muscle contraction, even at rest, which can cause rigidity and resistance to movement. This can be treated with physiotherapy, which includes exercises to relax tight muscles, muscle stretching, hydrotherapy, and electrical stimulation. To inhibit muscle tone, techniques such as positioning, neutral warmth, and stretching can be used to reduce muscle activity and prevent contractures.
| Characteristics | Values |
|---|---|
| Muscle Tone | The amount of tension a muscle has at rest |
| Hypertonia | Increased tension in the muscles which makes it difficult for them to relax |
| Hypotonia | Low muscle tone |
| Treatment | Physiotherapy, hydrotherapy, exercises, electrical stimulation, muscle stretching, joint mobilisation, etc. |
| Neutral Warmth | Stimulating thermoreceptors and activating parasympathetic responses |
| Inhibiting Postural Tone | Prolonged use of ice |
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What You'll Learn
Neutral warmth
Other methods to inhibit muscle tone include light compression, which is thought to inhibit muscle spasticity, and heavy compression, which facilitates co-contraction at the joint. Slow stroking can also inhibit muscle tone, by gently pressing on the posterior rami slowly and firmly for 3 to 5 minutes, followed by allowing the patient to relax.
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Slow/prolonged stretching
Slow and prolonged stretching is an effective way to inhibit muscle tone and improve your range of motion. It is a common practice not only for athletes but also for older adults and rehabilitation patients.
Stretching generally focuses on increasing the length of a musculotendinous unit, thereby increasing the distance between a muscle's origin and insertion. This is achieved through passive muscle stretching, which activates Golgi tendon organs and inhibits the excitability of alpha motor neurons. This reduced motoneuronal excitability leads to an increase in the extensibility of soft tissues.
To perform a slow and prolonged passive stretch, start by standing a few feet away from a wall and stretching your arms until your palms are flat against it. Then, bend your elbows and bring your upper body toward the wall, feeling the stretch in your wrist muscles. Ensure that you do not feel any discomfort during this stretch.
Another example of a slow and prolonged stretch is the contract-relax method of pre-contraction stretching. This involves holding a muscle in a stretched position by a partner, who then contracts the muscle for a minimum of 4 seconds, followed by a short relaxation period of 2-3 seconds. The stretch is then pushed further than the initial stretch and held for a longer period, such as 10 seconds of stretching followed by 20 seconds of relaxation.
It is important to note that the duration of a stretch to effectively reduce spasticity and prevent contracture is still unclear and requires further research. However, combining stretching with calming, deep breathing exercises can be beneficial. For example, try exhaling for longer than you inhale, as this pattern has a calming effect on the central nervous system and can improve your stretch.
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Physiotherapy
Neutral warmth is a common method used to inhibit postural tone and muscle activity. This involves stimulating thermoreceptors and activating parasympathetic responses, usually by wrapping the body part with towels, hot packs, tepid baths or air splints. This typically takes 10-20 minutes to produce an effect.
Light compression, which involves applying normal body weight through the long axis of the bone, is another technique used to inhibit muscle spasticity. Muscle vibration has also been used to reduce muscle tone and spasticity in individuals with neurological conditions.
For those with low muscle tone, or hypotonia, deep tissue massage can be used to lower tone in the muscle.
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Hydrotherapy
In recent times, hydrotherapy has been studied as an evidence-based treatment for certain conditions and symptoms. It is considered an alternative or complementary treatment option, as it is not regulated by the U.S. Food and Drug Administration (FDA). While hydrotherapy has legitimate benefits, it is sometimes marketed as a cure-all, which can be misleading and unsafe. Therefore, it is important to consult a healthcare provider before incorporating hydrotherapy into your treatment plan.
The warmth of the water in hydrotherapy also plays a role in muscle relaxation. It reduces the sensitivity of sensory nerve endings and diminishes muscle tone by warming the muscles with blood flow. Additionally, warm water positively stimulates blood flow, which can contribute to pain relief by reducing peripheral edema and sympathetic nervous system activity. The reduced gravitational pull in water allows for smoother and more controlled movements, further enhancing muscle relaxation.
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Electrical stimulation
EMS uses a slightly stronger current than TENS to make muscles contract. The unit's electrodes, placed on the skin near the affected muscles, cause rhythmic contractions. This can improve muscle strength if the user attempts to contract the muscle simultaneously. EMS can be used at home with devices like a Powerdot, Compex, Tone-A-Matic, or MarcPro. EMS can also be used to help with weight loss and physical therapy. Research has shown that EMS can increase muscle mass and improve functioning.
Other forms of electrical stimulation include patterned electrical neuromuscular stimulation (PENS), TENS-LVPC motor stimulation to acupoints, and subthermal ultrasound over GTOs. These treatments may assist in tone reduction. Research supports the use of electrical stimulation as an adjunctive tool in the treatment of hypertonicity, which may facilitate an improved range of motion and mobility.
During a typical application of e-stim, your physical therapist will apply electrodes to the part of the body that needs treatment. These electrodes are connected through a wire to an e-stim machine. You will feel a slight tingling sensation that will be increased until it feels strong but comfortable. If the e-stim is used for muscle spasms or pain relief, you will relax during the treatment. If electricity is used to improve muscular strength or function, you may be required to squeeze or contract your muscle as the machine is working.
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Frequently asked questions
Muscle tone is 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.
High muscle tone, or hypertonia, is increased tension in the muscles which makes it difficult for them to relax and can lead to contractures and loss of independence with everyday tasks. It 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.
There are a variety of ways to inhibit high muscle tone, including:
- Physiotherapy — this may include exercises to relax tight muscles, muscle stretching to relieve tightness and ease pain, and strengthening exercises.
- Neutral warmth — stimulating thermoreceptors and activating parasympathetic responses.
- Slow, prolonged stretch — to maintain or prevent loss of range of motion.
- Fast/quick stretch — produces a short-lived contraction of the agonist's muscle and short-lived inhibition of the antagonist muscle.
