A pediatric therapy company operating in San Francisco and the greater Bay Area. We provide physical, occupational, speech and aquatic therapy services in the most beneficial and convenient setting for you and your child, including our clinic, currently located in San Mateo, your home, school or daycare.
What the heck is core stability and does my child have it? Does my child really need it? Do I even have it?
Our abdominal and trunk muscles make up our core, the center of our entire body. Their strength and ability to work together to create stability is essential for all of our movement. It can help to use an analogy, so humor us and think about at tree… The trunk of the tree is the foundation for networks of branches which extend from this base. Now if the trunk wasn’t strong, what do you think would happen to the branches? With the blowing wind, they would move more easily with less control, they may lose height or even break. The health of the tree is largely dependent on the strength of its trunk. This is very similar to us, but may be less obvious. Lately we have noticed a group of kids with something in common, limited core stability. These kids are meeting their gross motor milestones on time and are enjoying exploration as we hope for all of our kids. But something else stands out too. They can’t stay still. We must acknowledge that constantly moving and exploring is developmentally appropriate especially for our toddlers, but the difference here is that stationary positions are being avoided. Examples of stationary positions and skills which take core strength and stability include sitting, kneeling, and standing. Movement can still predominate, but we hope for these positions to be intertwined with movement in order to build stability.
To make matters more confusing, moving through space also takes stability. Being able to walk up and down stairs or curbs requires co-contraction of core muscles so the limbs can more easily move. We have another analogy that can help here. Think about how it feels to hold your child when they are fast asleep versus when they are clinging to you. The more activation, the lighter your child feels and the easier it is to move them. That is the same when we move our bodies. If we are activated centrally moving our limbs and controlling where our bodies go is easier. Core stability is essential for all positions and movements, stationary and locomotor.
As I mentioned above, gross motor milestones can be reached even with some underlying weakness. So if milestones don’t always give you a clear picture of core strength, what other things can you look at?
A few signs of potential core weakness:
Avoiding stationary positions, always on the move: A child with less core strength may not sit or stand much in between bursts of movement to explore something more closely. They may lose interest in the item if it does require them to stay still.
W-sitting or other preferences for widening their base of support: W-sitting is named for the appearance of the legs once in it. A child’s lower legs will be on the side of their thighs and their feet will be pointing out. The amount of contact their lower body has with the ground increases which also increases the stability they get from outside of them. Another example of widening the base of support is sitting with legs opens and knees fully straight. Consistently sitting like this reduces the amount of work on the core muscles in order to maintain the position.
Poor posture: Sitting or standing with a rounded spine, dropping the head forward, or consistently leaning into external support are potentially signs of poor core strength.
Fear not, there are simple ways to challenge this. Present opportunities for your child to engage in something very interesting to them in a stationary position. For example, a seashell on the beach, an animal at the petting zoo, or light up/musical toy. Encourage them to sit in a criss-cross position with their legs, which is a reduced base of support in comparison to w-sitting or long sitting and requires more from the core. Elevate toys they play with in sitting or standing to be eye level so they must come up to engage with it. Simple changes like the ones we just mentioned are sometimes all that is needed. If you worry that is not enough or if you want more specific help and advice, come see us! We would love to help!