Alignment and Movement

Are You Helping a Child Move Before They are Ready? Thinking About Latency in the Context of Movement.

“Nate, stand up”. Nathan is five, has cerebral palsy and takes a while to prepare to move his body. Thirty seconds or more can pass between the request to move and getting a response. He is quiet, then there may be a quiver of movement. Sure enough, after some patience, up comes the leg and he rises to standing with only a little assistance. In the context of the classroom, this extra waiting time is surely difficult. Nathan either arrives late to an activity or his aide is lifting and initiating for him throughout the day and a behavioral expectation is set up.

Children with motor planning difficulty need extra time to initiate and carry out their movement. Many of us live in a world where time is scarce and we don’t feel that we have time to wait. On the other hand, starting with the end in mind is crucial and takes a lot of training, repetition and patience. What have you decided to do when faced with this dilemma?

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Nice Weight Through Your Heels, Little One

“Is my baby standing OK? It seems like he is up on his toes, and toe walking runs in my family”.

The answer to this question, of course, depends on how old the baby is and how long he or she has been on their feet. I teach in an infant mobility class every week and have the amazing opportunity to watch children pull to stand at the big drum in the middle of the room. How they love to pound on that drum! I love their joy and their success. However, as the class physical therapist, I’m also looking closely at how they are standing. Are they up on their tip toes and leaning into the drum, or are they standing with their hips a little behind their firmly planted feet? Continue reading “Nice Weight Through Your Heels, Little One”

Wall Activities for Scapulo-Humeral Dissociation

You are playing a game on a flat surface during a PT session and everything is going well, but have you thought about the benefits of playing it on the wall instead?

When we actively reach above shoulder level with hands on the wall, the scapular stabilizing muscles (lower trapezius and serratus anterior muscles) hold the scapula in place while other muscles work off that stable foundation to elevate the arm (humerus). Holding in this position dissociates the movement of the scapula from that of the humerus. Dissociation of this kind naturally evolves in babies at about 5-6 months as they are on their stomachs and beginning to bear weight on extended arms. Most children older than a year don’t enjoy a prone position any longer and will protest. Don’t worry, you can get some of the same movement by playing a game on the wall or other vertical surface instead. Check that you have optimal alignment in all other segments of the body: rib cage, low back, hips, knees and ankles.
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What Makes a Good Quality Squat?

The couch creaks and slides every time she sits down. “I have no control once I start to bend my legs!”, she says.

Controlled squatting allows babies to get down to the mattress after pulling to stand in their crib. It allows children to sit down in a chair with control. It is the ready position, allowing a low basketball dribble or ease while moving wet clothes from the washing machine into the dryer. If we don’t have the required alignment, strength and endurance, falls and crashes start to happen. Squat with good alignment and build the strength and endurance to squat and recover over and over again in daily life. Continue reading “What Makes a Good Quality Squat?”