Hypertonicity (increased muscle tone) can make movement feel stiff, effortful, and uncomfortable—affecting walking, hand function, posture, speech, and sometimes swallowing. 

At Palms Physiotherapy & Allied Health, we provide individualised, evidence-informed therapy to help you (or your child) improve comfort, mobility, and participation—working alongside your GP/specialist team where needed.

What is Hypertonicity?

Hypertonicity is an umbrella term for increased muscle tone—meaning muscles feel tighter and more resistant to movement than expected. It can occur in children and adults and is commonly associated with neurological or neuromuscular conditions, including:

• Cerebral palsy

• Stroke (CVA)

• Traumatic brain injury (TBI)

• Multiple sclerosis (MS)

• Spinal cord injury

• Other neurological conditions affecting movement control

Hypertonicity can contribute to stiffness, reduced range of motion, altered movement patterns, fatigue, pain, and difficulty with daily activities.

Hypertonicity vs Spasticity (and Other Tone Patterns)

People often use “hypertonicity” and “spasticity” interchangeably, but they’re not the same.

Spasticity

A velocity-dependent increase in tone (muscle “catches” more when moved quickly), often linked with exaggerated reflexes. Common after stroke, cerebral palsy, and spinal cord injury.

Rigidity

A more constant stiffness (not speed-dependent), sometimes seen in conditions affecting basal ganglia pathways (e.g., Parkinsonism).

Dystonia

Involuntary muscle contractions that can cause twisting movements or abnormal postures; tone may fluctuate.

A therapy plan is most effective when we understand what type(s) of tone pattern are present and how they’re impacting function.

Common Signs and Symptoms

Hypertonicity can present differently depending on the underlying condition and the body areas involved. Signs may include:

Movement and mobility

• Stiff or rigid muscles

• Reduced range of motion or “tight” joints

• Difficulty walking, climbing stairs, or changing positions

• Toe-walking, scissoring gait, or reduced balance (in some presentations)
  
  

Upper limb and hand function

• Difficulty opening the hand, reaching, grasping, or releasing objects

• Reduced dexterity (buttons, cutlery, handwriting)
  
  

Comfort and participation

• Muscle spasms or “tightness”

• Pain or discomfort, especially after activity or at end ranges

• Fatigue and increased effort with everyday tasks
  
  

Speech/swallowing (sometimes)

• Reduced coordination or control of oral muscles

• Changes in speech clarity or swallowing safety (needs assessment)

If symptoms are changing quickly, causing significant pain, or affecting swallowing/breathing, medical review is important.

How We Help Manage Hypertonicity at Palms

Our aim is to help clients move more efficiently and comfortably, reduce secondary complications (like contracture risk), and improve independence and participation.

Therapy may include:

• Assessment of tone, movement patterns, function, and goals

• A targeted plan for mobility, daily tasks, participation, and home carryover

• Collaboration with families/carers and (with consent) schools, support workers, and medical teams

Important: Therapy supports function and comfort, but it does not “cure” the underlying neurological cause. Progress depends on diagnosis, severity, overall health, and consistency of practice.

Physiotherapy for Hypertonicity

Physiotherapy focuses on movement quality, mobility, strength, and functional skills.

Physiotherapy may include:

• Range of motion and positioning strategies to maintain flexibility and joint health

• Strengthening and motor control training (building stability around affected joints)

• Gait and mobility retraining (walking pattern, stairs, transfers)

• Balance and coordination exercises

• Functional practice (getting up/down, floor skills, safe movement routines)

• Manual techniques when appropriate for symptom relief as part of an active plan
  
  

Occupational Therapy for Hypertonicity

Occupational Therapy focuses on independence in everyday activities (self-care, school/work participation, upper limb/hand function).

OT may include:

• Upper limb function training (reach, grasp, release, bilateral skills)

• Fine motor and daily living strategies (dressing, eating, grooming, writing)

• Task and environment modifications to reduce effort and improve success

• Splinting/bracing recommendations when clinically indicated (in line with best practice and medical considerations)

• Equipment and seating/postural supports where needed to improve participation and comfort
  
  

Exercise Physiology for Hypertonicity

Exercise physiology supports safe conditioning and capacity-building, particularly where fatigue and deconditioning are barriers.

EP may help with:

• Graded strengthening and endurance programs

• Low-impact conditioning (e.g., gym-based programs, hydro, adapted circuits)

• Movement confidence and tolerance-building

• Consistent routines that support long-term participation
  
  

Speech Pathology for Hypertonicity

Speech pathology may be helpful when increased tone impacts speech clarity, oral motor coordination, drooling management, or swallowing safety.

Speech pathology may include:

• Assessment of functional communication impact

• Strategies to support clearer speech (where relevant)

• Swallowing screening/assessment and safe-mealtime strategies (if indicated)

• Referral pathways for instrumental swallowing assessment (e.g., VFSS/FEES) where clinically required, via appropriate medical teams
  
  

Treatment Approaches We May Use

Management is tailored and may include:

Stretching and range of motion

• Structured flexibility work to reduce stiffness and maintain function

• Positioning advice to reduce prolonged “tight” postures
  
  

Strengthening and movement retraining

• Building strength in key muscle groups to improve control and function

• Retraining movement patterns to reduce compensations and improve efficiency
  
  

Positioning and daily routines

• Seating/postural guidance to support comfort and participation

• Routines to maintain mobility and reduce secondary problems
  
  

Splinting/bracing (when appropriate)

• Recommendations made carefully and individually (often alongside medical/orthotic input)
  
  

Shared care with medical teams

For some clients, medical management may be part of the broader plan (e.g., medication changes, botulinum toxin injections, orthopaedic review). We can coordinate and provide therapy input with consent.

NDIS and Hypertonicity

Palms supports self-managed and plan-managed NDIS participants. Whether therapy can be funded depends on the participant’s plan, stated goals, and NDIA requirements. We provide goal-aligned therapy and documentation where appropriate—final funding decisions remain with the NDIA.

Frequently Asked Questions

What’s the difference between hypertonicity and spasticity?

Hypertonicity is a broad term for increased muscle tone. Spasticity is a specific type of hypertonicity where tone increases more when muscles are moved quickly and reflexes may be exaggerated.

Can hypertonicity be treated?

Hypertonicity often can’t be “cured,” but it can frequently be managed. Therapy can improve comfort, movement efficiency, functional skills, and participation, and may reduce secondary complications.

Which conditions are commonly associated with hypertonicity?

Common causes include cerebral palsy, stroke, TBI, MS, spinal cord injury, and other neurological conditions that affect motor control.

Can children improve with therapy?

Many children make meaningful functional gains with early, consistent therapy and good carryover at home/school. Outcomes vary depending on diagnosis, severity, and supports.

Is hypertonicity therapy covered by the NDIS?

It may be, depending on the participant’s plan management type, goals, and NDIA requirements. We can help align therapy to functional goals and provide appropriate documentation.

Book Hypertonicity Support in Malaga or Noranda

If you’re seeking support for hypertonicity in Perth, our team can help with assessment and a practical therapy plan focused on movement, function, comfort, and participation.

Contact Palms Physiotherapy & Allied Health to book at Malaga or Noranda.

External Resources for Hypertonicity in Australia

1. Cerebral Palsy Alliance – Hypertonicity in Cerebral Palsy
   https://cerebralpalsy.org.au
   Information on how hypertonicity affects individuals with cerebral palsy and available treatments.

2. Better Health Channel – Muscle Spasticity and Hypertonia
   https://www.betterhealth.vic.gov.au
   Detailed information on muscle hypertonicity, spasticity, and management options.

3. NDIS (National Disability Insurance Scheme)
   https://www.ndis.gov.au
   Learn more about funding and support for individuals with hypertonicity through the NDIS.

4. Spinal Cord Injuries Australia
   https://scia.org.au
   Resources for individuals with spinal cord injuries, including support for managing hypertonicity and spasticity.

5. Royal Children's Hospital – Muscle Tone and Hypertonicity
   https://www.rch.org.au
   A helpful guide on understanding and managing abnormal muscle tone in children with neurological conditions.