Muscle tension disorders

Muscle tension disorder is a condition in which there is abnormal tension in the muscles. It can be caused by a variety of factors, including neurological disorders, muscle damage, or metabolic problems. These disorders can manifest as excessive or insufficient muscle tension, which can lead to stiffness, muscle weakness, and problems with coordination and movement.

Muscle tension is the ability of muscles to counteract passive contractions to stretch. Maintaining posture or performing any activity requires maintaining a certain tonus (tension) in numerous muscles. Excessive or decreased muscle tone in adults are symptoms that are diagnosed quite often. Tension can be diagnosed as increased (hypertonia), decreased (hypotonia) or complete loss of muscle tone (atonia). At the Paley European Institute, we provide physiotherapy for people with congenital muscle flaccidity and other muscle tension-related conditions.

Muscle tension disorders hypotonia

Muscle hypotonia is reduced muscle tone in adults and children. It is defined as reduced resistance to passive joint movement, and impaired ability to maintain postural control and movement against the force of gravity.

Decreased muscle tone in children and adults, or lack of muscle tone, can result from damage to the central or peripheral nervous system, muscle disease or metabolic disorders. It is not a disease, but a symptom. Hypotonia is easy to spot, but the cause is more difficult to diagnose. It can be a symptom of many congenital or acquired diseases, including:

1. Down syndrome,
2. Guillain-Barre syndrome,
3. Prader-Willi syndrome,
4. achondroplasia,
5. Pateau team,
6. hypoxic-ischemic encephalopathy,
7. intracranial hemorrhage,
8. hypothyroidism,
9. polio disease,
10. myasthenia gravis,
11. meningitis,
12. Secondary elastopathy,
13. SMA - spinal muscular atrophy.

Symptoms vary depending on the etiology of the condition. They include, among others:

1. Muscle flaccidity, which leads to abnormal posture patterns, atypical movement mechanics and less control over one's own body,
2. breast sucking problems,
3. Delay in the child's psychomotor development,
4. A limp, "overflowing through the hands" baby,
5. Reduced repertoire of activities - the child does not grasp toys, does not play with his hands and does not lift his feet,
6. No lifting of the head while lying on the stomach,
7. speech problems,
8. The impact of reduced muscle tone on intellectual development,
9. In the so-called traction test, i.e. pulling on the hands to get the child to sit up from the supine position, he does not lift his head,
10. Doesn't turn, can't maintain a sit-up, or achievement of this activity is delayed,
11. may have trouble swallowing - whooping, choking,
12. In preschoolers and school-age children, rounded backs, a large, protuberant abdomen, overpronation in the peripheral joints, flat-legged feet, sitting in the so-called "W" sit are noticeable,
13. Older children exhibit rapid fatigue, postural defects, increased joint range of motion, difficulty and aversion to physical activities.

It is important to recognize muscle tone abnormalities in the child as soon as possible and to begin intervention, as well as to continue the recommended exercises at home. Often, the first signs of hypotonia can be recognized when assessing a newborn with the APGAR scale. Reduced muscle tone in children, however, does not have to be associated with any serious condition, and physiotherapy can quickly help deal with the problem. Always see a neurologist when hypotonia is suspected. Because of the possibility of dysfunction at very many levels of the nervous system, extensive diagnostics are used to help clarify the underlying cause of hypotonia. Often a transdiaphragmatic ultrasound, MRI, EMG - electromyography and muscle biopsy are performed.

Neurological physiotherapy uses motor improvement methods - the Voita, Bobath, MAES, or PNF methods. They are used to work with patients of all ages. Vibration platforms are an excellent complement to rehabilitation. If hypotonia occurs in the course of other diseases, orthopedic treatment and pharmacotherapy are necessary.

The effects of physiotherapy depend on the causes and severity of hypotonia. The more optimistic prognosis, in terms of compensating for motor deficits, is for mild reductions in muscle tone that are not due to obvious disease causes. However, when the cause of hypotonia is damage to neuromuscular structures or other serious diseases, physiotherapy results are more difficult to achieve and evaluate.

Muscle tension disorders hypertonia

Muscular hypertonia is increased muscle tension with characteristic symptoms that can develop at any age. It is influenced by the nerve centers of the hypothalamus through increased mental tension, activation of the endocrine and autonomic nervous systems. It can take the form of spasticity or rigidity. When the pyramidal pathways of the nervous system have been damaged, we are dealing with increased muscle tension of the spastic type. There is a noticeable gradual weakening of tension during movement testing. Increased muscle tension in adults, the symptoms of which are indicative of disorders in the extrapyramidal system, results in stiffness, which means keeping muscle resistance at a high level all the time.

The main causes of hypertonia include:

• Parkinson's disease,
• head/spinal cord injury accident,
• Tumors involving the nervous system,
• MS - multiple sclerosis,
• cerebral palsy,
• stroke,
• Poisoning by certain chemicals.

Increased muscle tension in older children and adults are symptoms such as:

• gait and balance disorders,
• Impaired motor coordination,
• Discomfort felt when moving around,
• muscle contractures,
• A constant feeling of stiffness, such as in the extremities,
• feeling muscle tension even when they are at rest,
• joint deformities (when hypertonia lasts for a long time),
• pain complaints,
• In young children: significant tension of the whole body, which occurs very often, even when the child seems calm; positional asymmetry; difficulty changing and dressing the child due to stiffness; problem grasping the breast or bottle during feeding; frequent positioning of the child in an unnatural position; unnatural bending of the head when lying on the tummy; constantly clenched fists.

If hypertonia is suspected, one should see a neurologist, who will examine muscle reflexes, order additional tests (e.g., CT, MRI, lumbar puncture) and refer for appropriate physiotherapy, which is the best method of treatment. Properly dosed movement guarantees that the patient's muscles will remain functional for as long as possible, and movement discomfort will be minimized. Sometimes it is necessary to introduce pharmacotherapy (muscle relaxants). The patient should not be immobilized, as this leads to permanent and negative changes in the body. Kinesitherapy, physical therapy, kinesiotaping and massages are effective, as well as the NDT-Bobath method (massaging and stroking the child and having the physiotherapist move his body appropriately to teach him the correct patterns) and the Vojta method (having the physiotherapist apply pressure to the appropriate areas on the child's body). Early recognition and treatment of hypertonia allows the child to develop properly. Noticing the problem too late can lead to painful, permanent muscle contractures, postural defects, concentration problems at a later age, or can make it difficult or even impossible to cure the disease causing the hypertonia.