A Belly ‘n’ a Butt: Pediatric Core Strengthening

“Core strength” = A functional balance between the flexor & extensor muscle groups, so that one is not more powerful, or active, than the other.

Tummy Time: the first developmental position that is key to recruiting core muscles  

• Strengthens necks and upper back muscles to allow head lift and look in all directions

Sitting: Core muscles are used to hold head up and look in all directions, reach, and maintain upright posture 

• W-sitting can be an indicator of core weakness, chosen by the child to achieve a wider base of support and a lower center of gravity, providing more stability when the core muscles aren’t able to.
  • The W-sitting posture promotes decreased muscle activity.

Walking: requires balance, coordination, hip control, and leg strength 

• Begins with core stability in order to have your extremities move in space 
• Basis for walking is previous development of crawling and sitting

How does my child build strength?… by open ended, unstructured, spontaneous play! 

• Diverse and varied play better achieves comprehensive and dynamic strength skills
  • For children younger than 18 months, AVOID use of screen media other than video-chatting.
  • Organized sports are NOT the same as unstructured play – this is repetitious and sport specific
• To develop core strength regular exposure to climbing, lifting, rolling, pushing, pulling is important

Signs of Core Weakness

1. Poor posture     2. Fidgeting     3. Leaning on furniture or adult support

No core to anchor leads to…

i. Inability to use hands efficiently for fine motor tasks like picking up/playing with small objects, writing letters and numbers with control and accuracy, and cutting on a line with scissors

ii. Difficulty with transitional movement such as rolling, crawling, moving from lying down to sitting, and moving from sitting to standing

iii. Poor balance – unstable during balance challenges & unsupported sitting, inability to put on shoes/socks in sitting, inability to kick a ball  

Daily strengthening of antigravity musculature needed for trunk and hip control!

Core Activities

• Train the child to bring the center of mass backwards and to load the heels
  • Play with an object overhead – Child holds a hoop or toy overhead with both hands or plays balloon toss to activate abdominals, gluteals, and back extensors.
  • MODIFIED: Sitting on a bench in front of wall with pelvis vertical, feet supported and weight in heels, reach forward to pick up beach ball with both hands and return to upright. Use chest pass throw to perturb COM backwards. How many times can they pass the ball without their back touching the wall?
• Modified Basketball – laying on back with knees bent and feet on the floor, child puts the ball in the basket, and lies back down slowly. The child lifts head, reaches to get the ball out of the basket, and lies back down slowly.
  • Make it harder by: moving the basket farther away or play catch. Place basket on diagonals.   
• Ball Handling Using the Legs – Ball between knees, lift legs to touch the ball to arms without dropping it
  • Make it harder by: Hold ball between ankles or changing the direction of the basket to diagonals.
• Park the Car – On hands and knees with toy car & a parking area
  • Rock forward & back keeping elbows extended and belly up with flat spine and reach to park the car
  • Make it harder by: Changing the parking area on diagonals, raise the parking area higher 
• Standing activities
  • Ball play with weighted objects
  • Holding onto big parachute with grab handles
  • Rocket Zoomer – inflated pump with tube to the launcher – shift to offload the foot and stomp
  • Monster clompers – like easy stilts with rope handles, big feet
  • Zig zag balance beam
• Strategies to improve heel loading in standing and walking
  • Partial squat with feet apart, tibias vertical having child reach between legs for a small toy. Have the child stand with heels on a pressure activated music mat to know they are putting weight over heels.
    • Make it harder by: Stand on an incline surface. Reach and throw overhead for dynamic control. 
    • Walking up and down inclines while carrying an oversized, light-weight object (beach ball, basket of small toys) at chest height. Progress to carrying objects overhead.
    • Walking with a weighted backpack, 10% of the child’s weight
    • Stand with back a few inches from a wall, bounce a ball forward without touching the wall
    • Crab walk forward, backward, sideways, or hold the pose while crossing midline moving objects
    • Hold a beach ball attached to a stick with a string and have the child hit it in different positions – starting on belly → hands and knees → tall kneel → 1/2 kneel → standing
      • They can hit it one handed, two handed or alternating hands – crossing midline or same side.
      • Wheelbarrow walking 
• Yoga – promotes good posture, balance, coordination, strength and flexibility
  • Cosmic Kids Yoga – https://www.youtube.com/user/CosmicKidsYoga 
• Hands and Knees activities
  • Raise one arm out in front and extend the opposite leg back simultaneously. Alternating sides.
  • Crawl over bean bag or cushions, through an obstacle course or tunnel
  • Animal walks – https://pathways.org/help-your-childs-gross-motor-skills-with-these-animal-walks/ 

Thanks for reading!