Perhaps you’ve seen your baby tensing up. In the middle of a great wail, he or she will kick their legs, curl their fingers into fists, bend their elbows, and flex their feet. It doesn’t seem like a big deal, but you notice your baby tenses up more often, has a hard time changing positions, and does not enjoy lying on the tummy. You decide to ask your doctor about it – just to be sure everything is fine.
During the visit, your pediatrician determines that your baby has increased muscle tension and recommends seeing a physical therapist. The physical therapist examines your baby, using a special scale, performs certain exercises, and then explains that your child has decreased muscle tension!
What!?! Who misdiagnosed your baby? Before you start pulling your hair out and looking for a third opinion, or surfing the internet only to end up with conflicting information, let me tell you a secret.
It is possible that both specialists are actually RIGHT!
How can that be?
Well, it’s actually quite simple. Both doctors referred to “muscle tension,” but they meant two completely different things. The pediatrician was referring to muscle tension “in the periphery,” meaning in the arms and legs; while the physiotherapist referred to central muscle tension, meaning in the torso.
I agree that it would be good to use consistent terminology. It would save everybody a lot of confusion – especially parents. It would eliminate the time doctors and therapists have to spend explaining themselves to both each other and the patient! Life would be much easier for everyone; but, for now, let me explain this apparent contradiction. 😉
Getting to the point:
How do these two “muscle tensions” relate to one another?
As you may already know, the first months of a baby’s life is focused on gaining stability of the torso. A stable torso gives your baby a solid core to develop independent and isolated movements of the arms and legs (the periphery). A strong torso is also crucial to achieve posture control.
One important “physio mantra” says:
If the torso is not stable, a baby will look for other ways to gain posture control, such as by tensing the arms and legs on the periphery.
Muscle tension in the periphery can be seen in many ways. We see this in babies lying on their backs with arms tensely stuck to the floor; or not managing tummy time too well. Or you may see this when you’re holding your baby and he or she arches the back, gets easily irritated, or has trouble sleeping. Sometimes it gets hard to even perform basic care when a baby has an unstable torso.
Of course, “muscle tension” is not just about its extent or distribution. It’s also about how muscle groups work together. But this is something for your physical therapist to get into. 😉
What are some red flags indicating muscle tension?
– Your baby doesn’t do the unconscious “reflex smile” in the first weeks of life. And, at six to eight weeks, your baby does not respond to a smile with a smile (social smile).
– At three months, your baby has trouble maintaining eye contact or does not fix their eyes on an object or the face of a person in front of them.
– Your baby stiffens up all the time, regardless of the situation.
– Your newborn has trouble sucking or swallowing food.
– You do not see progress in the development of your baby’s motor skills.
What can you do?
1) First of all, remember that your baby’s nervous system is still developing. A newborn is not a mini version of an adult. 😉 In the beginning, a baby naturally has primitive reflexes that gradually integrate – and are eventually replaced with conscious, planned, and fully controlled movements. But this takes time… Some children may need more time than others. This adaptation period is between months one through four, and is one of the most intense periods in a baby’s development.
2) Practice Baby-Friendly Care! As I mentioned before, the adaptation period is a crucial time because babies need to learn how to function outside the womb. During this time, babies need to be handled (picked up, held, put down) in a way that gives them support on the entire length of their spine. Limiting your baby’s base of support will cause your baby to reflexively stiffen. If this happens more often than not, your baby will learn that stiffening his or her body is a way to gain better control; and he or she will use that strategy again and again.
3) During playtime, choose a surface that will help your baby take advantage of his or her potential. By this, I mean a firm, flat surface which will motivate your baby to work. I avoid soft mattresses, recliners, or bouncers at LEAST until the child is able to join hands in the midline of the body and reach for a toy – usually at 4-5 months of age. (Read about how to tell if a baby bouncer is safe for your baby!)
4) Check to see if your child is in pain. Sometimes increased muscle tension occurs as a reaction to pain. If your baby has trouble with bowel movements, or has colic or reflux, then it is not uncommon for the child to tense up. If that’s the case, then the problem must be approached in a comprehensive way! (Read if spitting up affects development!)
5) Check to see if your environment stresses your baby. It can happen that the source of trouble with muscle tension comes from the parents. Babies often react to their parents’ emotions. If Mom’s not okay, I’m not okay! Check yourself. Are you okay? Also, we tend to unintentionally expose our babies to too many stimuli that they feel overwhelmed. As a result, they tense up. Are there too many noises, flashing lights, or bright colors in your home?
6) Get involved! Reading this article is a great way to start! If your child needs extra support, do your research, ask questions, see your pediatrician. Parents are the ones who spend most time with their babies. With supportive and involved parents, children heal and grow more rapidly. I can’t imagine going through therapy without the parents’ involvement! Proactive parents can be shown how, through play or proper care, they can support their child. (Examples of playtime activities can be found in my e-book about the best ways to play with your child).
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If you’re looking for fun game ideas – from birth to first steps – you can find them in this e-book: