This is a classic – professionals recommend that children who have poor core strength do wheelbarrows and planks as exercise but children can’t complete these activities unless they have good core strength. I feel dizzy trying to sort my way out of this so I suggest we all hop off the merry-go-round and find out what the core muscles are and how they work.
1. Our inner core muscles turn on first.
We now know that the inner core consists of 4 muscles (the respiratory diaphragm, the pelvic floor, the transversus abdominis and the multifidus). They function to give us a stable spine and pelvis before movement begins and they activate as a team in the same way before every movement that we do. During the process of development, the inner core muscles become active and efficient during the first 2 – 3 years of life. For our children with motor challenges, the inner core muscles do not become efficient due to neurological, sensory and alignment issues.
2. The timing of outer core muscles depends on the task.
Unlike the inner core muscles, outer core muscles activate differently depending on the task. Superficial abdominal muscles, hip and back muscles are all members of our outer core groups. The inner core muscles create an anchor at the center so the outer core muscles have something to stabilize on and this allows the outer core to work efficiently. We call this partnership of inner and outer core muscles the body’s “core strategy”. When the inner core muscles are not active, children over-recruit outer core muscles instead and this causes clumsy/uncoordinated movements and can also lead to pain. (This happens with adults too. Please go to www.juliewiebept.com for great information about core function in adults.)
3. The inner core muscles are easily overwhelmed.
The inner core muscles are easily overwhelmed by other muscles. A sure sign that the inner core is not active is breath holding to accomplish a challenging movement. Babies and toddlers do this naturally when accomplishing new skills but they move quickly through this as they develop. Children with motor challenges continue to use breath holding as their way of creating a stable center.
Now that we understand more about our core muscles, how do we apply it to help children with motor challenges?
1. Stop thinking about core exercise and start thinking about core strategy.
Core exercises (crunches, wheelbarrow, crab walk, planks, stability balls – the list is endless!) are something separate in a childs’ day but in reality core strategy is something that should be present throughout the day. Building alignment builds core strategy, which is critical for endurance and strength.
2. A is for alignment.
Our children need to experience better alignment. Many of our children tuck their bottom under (photo 1) and shift their rib cage back (photo 2) or pop their bellies out and shift their rib cage forward (photo 3) in an effort to keep their body balanced. Alignment of the rib cage over a neutral pelvis is needed to be able to activate the inner core muscles (photo 4). No amount of telling children to “sit up straight” will help; kids actually need to be able to breathe properly to activate the muscles and maintain the posture.
3. Everybody breathe.
When you are with a child, listen to their breathing. If they are breath holding prior to/during a task, remind them to breathe. Many of our kids also overuse their shoulders or belly during breathing (when you ask a child to take a deep breath, do they lift their shoulders or puff out their belly?). We need to retrain the respiratory diaphragm by encouraging a full breath with expansion of the lower rib cage; we call this an “umbrella breath”. Then the inner core team can provide that all-important central stability.
4. Movement should be fun.
Ultimately we want our kids to take their core with them wherever they go! They need it sitting, walking, running, playing hopscotch, skipping rope, hula hooping, rock climbing and rollerblading. If we train the inner core to come online first, then we can put that into play (and school and sports too!). In that way, every activity becomes a core activity. So in my practice you’ll find my clients working their core in everything they do – but the wheelbarrows stay in the garden and planks are just pieces of wood.
For more information on Dynamic Core for Kids or Physical Therapy for children with special needs, please visit Shelley’s website at www.heartspacept.com/blog. For continuing education workshops, visit www.heartspacept.com/workshops. You can also find Shelley on Twitter @heartspacept, Facebook at HeartSpacePT or Pinterest at heartspacept.