Connected Paediatrics Weekly: Core Thinking

Hi Reader

Dad Joke: Why did the tomato turn red at the gym? It saw the salad dressing, and realized it needed to work on its core.

Song of the Week: Johnny Clegg (With Nelson Mandela) - Asimbonanga (after spending some time in my home country South Africa this feels like the right song for this week.)

Picture a core workout…

I bet most of us have in mind a scene at the gym with yoga balls, reformer machines and lots and lots of lycra. But how many people do you think would picture a baby rolling or moving from sit to crawl position?

By 3 months of age babies need to be able to hold themselves in the sagittal plane, by 4.5 months they need to be able to maintain that stability whilst engaging in task specific, goal orientated reaching and leg lifting activities. And that only happens if the core is activating.

Don’t get me wrong…It’s not about getting them baby “abs of steel “(although that would be cool) it’s about them developing the neuromuscular ability to stabilize the trunk to prepare for movement. And core stability, like most other things in life, is learnt. Babies need access to as many varied opportunities to reach, roll, grab and move as much as possible.

However, the ability of the core to kick in can be impeded by many factors. Poor afferentation from hyper or hypomobile joints can affect the sensory input leading to poor motor output. Tension through the fascial and dural planes can have a similar affect. Neurology can also be behind poor activation with children who display developmental coordination disorders showing anticipatory trunk postural adjustment impairment.

So how do I apply this thinking in practice? Well, I see adjusting as less of a force event and more of a sensory one. By adjusting children, the primary effect is to change quality, timing and salience of sensory input. This then reshapes the motor output. In effect I am UPDATING THE MAP. As we said hypo/hypermobile joints create noisy, reduced, delayed or biased input followed by protective or inefficient motor patterns.

Once that signal is sorted out, guiding babies and parents through the correct motor patterning then sets up the correct core stability to allow children to progress in their development instead of compensate their way through the first few years.

Core workout is not all about yoga balls and pilates machinery…

And not babies with 6 packs…

However cool that may sound.

Chat Soon

Mike

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