High Muscle Tone

Table of Contents

Athletes with high tone benefit from regular physical activity to keep muscles flexible and build strength.

What is high muscle tone

High muscle tone is sometimes called hypertonia, increased tone or spasticity. Athletes with high tone may also have ataxia or athetosis.

Muscle tone and muscle strength are different things.

Tone

Tone is the amount of tension a muscle has at rest.
Tone allows us to hold our body up against gravity and move our limbs.

Strength

Strength is what your muscles do when they are moving.
Strength is the muscle’s ability to move the limb against resistance (equipment, the ground and gravity).

Athletes with high tone

Muscles are stiff and tight even at rest.
Muscles act like a tight spring.
It is difficult for the muscle to completely relax.
Will affect posture, sitting, walking and limb movements.
May affect speech and swallowing.
Will often create discomfort, pain, muscle cramps and spasms.
Tone increases with activity or excitement.
Tone increases when tired.
High tone muscles have decreased strength.

This may look like

Running or walking on toes.
“Bouncy” walking or running.
Knees and hips staying bent with exercises ie running with legs bent.
Shorter running strides due to tight muscles or reduced range of motion of joints.
Elbow and wrist and fingers bent – might start relaxed by the side but as the event progresses, the arm muscles bend in to body.
Strong startle response to the starters gun (this looks like an involuntary jump with the loud noise).

Athletes with ataxia

Movements are not coordinated.
May have a “wobbly” walking pattern.
May have a tremor in hands.
May have slurred speech.

Athletes with athetosis

Have extra movements out of their control.
Movements are usually slow and writhing.
Movements worse when balancing or trying to be controlled.

Causes of high muscle tone

It is caused by damage to the part of the brain which controls movement. 

How to support athletes with high tone using the TREE framework

T – Teaching/coaching style

R – Rules and regulations at the Centre

E - Environment

E – Equipment

Teaching/Coaching style

How the volunteer, parent or coach organises the events, encourages skill development and communicates information to athletes.

Include a light stretch pre-event. Stretches need to be slow and held for at least 30 seconds (no bouncing). Prioritise any tight muscles.
Be aware of different movement patterns and which muscles are affected by tone.
Athletes with high tone may need support for balance and coordination and use Assistive Technology such as a frame runner or race wheelchair.
Moving a body with high tone takes a lot more effort than for athletes with typical tone. Look out for signs of fatigue such as - shaky limbs, wobbly legs, reduced balance, reduced coordination, difficulty concentrating or remembering the tasks.

Rules and regulations at the Centre

Can be modified at the Centre so athletes can participate. Please note that specific rules may apply to higher level competition.

You can modify the event.
You can modify for safety when using equipment.
- Staggered starts or rolling starts (athletes starting at set intervals).
- Extra lane between competitors.

Environment

Changes you can make to the physical space to be inclusive.

To provide a space that everyone can access and use, it is important that the parking lot, entry to field, field, track, viewing area, and amenities can be used by everyone.

Prepare the environment by organising seats/benches in the waiting areas.
Think about lane allocations
- Encourage the athlete to use the lane with the smoothest surface to reduce risk of injury due to reduced balance and body awareness.
  - Sometimes the inside lane has a lip on the track which can be a tripping hazard.
  - The outside lane has a gentler curve which is helpful if using equipment or the athlete needs help from a volunteer.

Equipment

Modify athletics equipment or use disability related Assistive Technology so the athlete can participate. We have more information on Assistive Technology suppliers.

Athletes with high tone will likely need a seat while waiting at and between events.
Offer lighter or smaller throwing equipment.
- Alternatives include bean bag, softballs, quoits, turbojavs.
- The rules might be different between school and home sport.
Assistive Technology (equipment) is used to support high tone so the athlete can compete. You can allow the athlete to use their everyday equipment. This is Assistive Technology that they use in their everyday life, not for a short-term injury.
- Crutches.
- Walking frame.
- Wheelchair.
- Orthotics.
- Prosthetics.
Specialised Assistive Technology for athletics can be used.
- Frame Runner.
- Race Wheelchair.
- Throwing frame.
Athletes may need a helper adult (eg parent or support worker or therapist) to use the equipment safely and effectively, especially when learning – ask the athlete what they need.
Come and try days are an opportunity for athletes with disability to try Assistive Technology which might help them in athletics. Athletes without disability can try the equipment too to gain an understanding of how complex they are to use.
Don’t touch or move an athlete’s Assistive Technology without their permission. If an athlete using Assistive Technology looks like they need help, ask first before assisting.

Sources

Australasian Academy of Cerebral Palsy and Developmental Medicine  

Cerebral Palsy Alliance 

Assistive Technology and Adaptive Equipment for Children with Cerebral Palsy | Cerebral Palsy Guidance 

Health direct - Cerebral Palsy 

RaceRunning Australia

TREE framework developed by the Australian Sports Commission