High Muscle Tone Is Affecting My Baby's Movement
The short answer
High muscle tone (hypertonia) can make it harder for your baby to move freely, as stiff muscles resist stretching and limit range of motion. Physical therapy is very effective for managing hypertonia, helping to improve flexibility, range of motion, and functional movement. Early intervention leads to the best outcomes.
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By Age
What to expect by age
High tone in newborns may appear as stiff, rigid limbs that resist bending, difficulty with diaper changes, or arms and legs that stay in tight positions. Some increased tone is normal in newborns, but persistent stiffness should be evaluated.
If high tone is affecting your baby's ability to bring hands to midline, reach for toys, or develop age-appropriate movements, physical therapy can help. Stretching exercises and positioning strategies can improve range of motion.
High tone may affect sitting, crawling, and transitional movements. Your baby may have difficulty getting into and out of positions. Physical therapy focused on stretching, strengthening, and functional movement is important during this period.
If your child is walking with high tone, they may have stiff gait, toe walking, or scissoring. Ongoing physical therapy, and in some cases medication or botulinum toxin injections, can improve functional movement. An orthopedic evaluation may also be recommended.
What Should You Do?
When to take action
- Some stiffness that comes and goes with excitement or effort.
- Your baby can be positioned and moved comfortably with gentle handling.
- Stiffness is mild and not limiting motor milestones.
- Your baby was premature and tone is normalizing with age.
- Stiffness makes it difficult for your baby to move freely.
- High tone is interfering with motor milestones.
- Diaper changes and dressing are difficult due to stiff legs or arms.
- Your baby has scissoring or crossing of legs when held upright.
- Stiffness is increasing or new.
- Your baby seems to be in pain related to muscle stiffness.
- Your baby is losing motor skills alongside increasing tone.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Physical Concerns
My Baby Seems Too Stiff (Hypertonia)
Hypertonia means your baby's muscles feel unusually tight or stiff, making it hard to bend or move their limbs. While some stiffness can be normal during certain movements (like when a baby is startled or upset), persistent stiffness at rest warrants evaluation. Early identification and physical therapy can make a significant difference.
Signs of Spasticity vs Normal Stiffness in Babies
Spasticity is velocity-dependent stiffness, meaning muscles resist fast movement more than slow movement. Normal baby stiffness occurs briefly during excitement or startle and resolves quickly. Spasticity is persistent, may affect one or more limbs, and often worsens with growth. Your pediatrician can perform specific tests to distinguish between normal tone variation and spasticity.
My Baby Crosses Their Legs When Standing
Leg scissoring or crossing when a baby is held in a standing position can be a sign of increased muscle tone (hypertonia) in the leg muscles. While occasional leg crossing is not always concerning, persistent scissoring should be evaluated by your pediatrician, as it can indicate spasticity or other neuromuscular conditions that benefit from early therapy.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.