As a pediatric PT I spend the majority of my time with kids working on developing the appropriate core strength and dynamic control they need as a foundation for many other skills. This blog goes over core muscles, why core strength is even important, how it is interwoven into so many of your child’s daily activities, play, and development, and gives some ideas for working on core strength at home!
The Plague of the 6-Pack
Diagram of Core Muscles.
Image from Harvard Health Publishing.
When I talk about developing a child’s core I am NOT talking about getting them a 6-pack. A common misconception is that the “core” is only the muscles on the front of the trunk. But a child’s core strength actually comes from an interplay of anterior (front) trunk muscles, posterior (back) trunk muscles, and hip muscles. Much like a puzzle, a child’s core isn’t complete unless you work on all the pieces. Below is a non-exhaustive list of important core muscles.
Anterior Superficial Muscles:
Rectus Abdominus
External Obliques
Internal Obliques
Transverse Abdominus
Anterior Deep Muscles:
Quadratus Lumborum
Psoas and Illiacus
Posterior Muscles:
Erector Spinae
Multifuidus (not depicted)
Latissamus Dorsi (not depicted)
Hip Muscles:
Gluteus Maximus
Gluteus Medius
Gluteus Medius
Piriformis (and all his very small friends; not depicted)
In kiddo’s with low tone these muscles tend to lack strength to function to help with stability during movements. In kiddo’s with high tone, these muscles tend to lack synergy and the ability to dynamically integrate with one another to allow for fluid and controlled movements.
Kid’s Cores are their FOUNDATION
Ok cool, cool…so lots of muscles but who cares? Without getting extremely technical, kid’s need their core for everything from developing their gross motor skills, to learning to eat, developing cognitive skills, and even language.
Every house needs a stable foundation in order to stand!
Gross Motor Development:
Think of core strength as the foundation of your house. Without that the house would surely fall over- there is nothing stable to build walls or a roof on. Without core strength, their is nothing stable to build new skills on. Head control only comes with the development of cervical core strength—>this leads to stability through the trunk for sitting—>dynamic control then leads to crawling and then walking—>eventually core strength determines a kiddo’s ability to balance on one foot, jump, and run with their peers on the playground.
Eating and Language Development:
So obviously core strength is needed for gross motor skills! But what about other skills? Imagine being a bobble head doll… imagine trying to learn how to speak or to eat if you couldn’t control your head at all? With a lack of core strength this is what kiddos face! Heads are darn heavy! If core muscles aren’t developed then they will have difficulty stabilizing their head to swallow…they won’t have the breath support to be able to vocalize sounds…or a stable center for their tongue to develop its fine motor control needed for speech.
Fine Motor Development:
If you imagine the trunk as a “yoke”: something that stabilizes extremities in order to affect the external world. Alright now lets place your yoke on something very unstable- a weeble. Do you think your yoke is going to effectively interact with the external world? There is no stability- you have no idea which way that weeble is going to wobble and good luck grabbing that small block to play with or a pencil to write with. Basically the same idea applies to kiddos without trunk control. Their shoulders/arms are “yoked” into their trunk. If their trunk is unstable they have no way to refine and develop graded movement and reaching patterns for objects in their external environment. And you can but say goodbye to fine enough control to manipulate those objects in a functional way. Examples are writing legibly or feeding oneself.
Cognitive Development:
Alright you probably think now that I am stretching this core strength thing… I promise I am not! This time imagine you are driving a car for the very first time. You can ONLY concentrate on the road and driving—> no way in hell you are going to reach for the stereo button or attempt dual task in anyway not until you’ve mastered the skill anyways! Alright now let apply this to a kid- they can’t control their trunk and head very well—> they are in sitting and sitting is HARD. All their mental faculties are concentrating 100% on sitting and staying upright. This leaves no room for cognitive development and environmental exploration needed to continue that trend in development. (see wasn’t that much of a stretch!)
Does my child have core weakness?
There are some hallmark signs for core weakness- most of which make sense.
Global delays in development- including gross motor and fine motor skills.
Lack of variety of movement patterns (think- sitting the exact same way every time they sit)
Difficulty sustaining postures for long periods
Would prefer laying down to play
Sitting in “W-Sit” or in a rounded posture
Open mouth/excessive drooling presentation
Flat feet/in-toeing
A physical therapist can easily evaluate your child for core weakness if you suspect there is an issue resulting in decreased participation and functional abilities.
5 easy ways to work on your child’s core strength at home!
PT’s give exercise prescription and just like medication, if not “taken” in the proper way it will have no effectiveness on increasing core strength and activation. I recommend working with your kid at least 3x/week for at least 30 minutes/day to make any true changes in strength. It doesn’t have to be 30 consecutive minutes but accrued throughout the day will also work.
Balance games
This includes balancing on one leg or in a half kneeling posture. Trying playing catch in this position to make it fun! Another fun way to challenge balance is to pick up marbles with toes and place them in a bucket. <- This might be a fun way to challenge your kid to help with cleaning up their toys!
2. Homework/reading positions
Think sitting on a ball while doing homework or playing video games! This will challenge their core without taking any time away from your already busy schedule! Other positions might be in half kneeling or standing on an unstable surface.
3. Yoga
I LOVE YOGA FOR KIDS. Find a youtube video (Cosmic Kids) or do Yoga Pretzels together to work on core. Challenge your kiddo to hold for longer or try a new, harder pose.
4. Animal walks
As listed in a previous blog animal walks work on SO MANY THINGS. One of which is core strength. Be creative! Make animal walk dice. Have your kid roll and see which animal they have to be while completing a puzzle or other small object game.
5. Obstacle courses
These are the best when it is nice outside (depending on your opinion of leaping on furniture!) Your imagination is your only barrier when it comes to obstacle courses. Add balance beams, ladders, tunnels, jumping over things/on things, moving from “island to island”…stick a section of animal walks in the middle of it! You can literally create anything and give your kids hours of fun doing it! Pinterest is full of extremely awesome and easily set up versions to try in your own home!