Continuing my focus on increasing strength and endurance to enable your child with NF1 to participate in sports and other activities, this month I will be taking things from the core down to the ground. If the core is solid, the next place for strengthening to improve balance and agility are the legs. The legs can be broken down into three key areas: ankle/foot, knee and hip. Each of these critical joints benefits from specific exercises to progress motor skills.
The foot consists of 26 bones, all held together with ligaments. When foot muscles are weak, balance is decreased and the risk of pain and injury is increased. Despite the intricate inner workings of the foot and ankle, strengthening exercises for this area may actually be the easiest to sneak in throughout the day.
Try out the following foot and ankle strengthening exercises with your child:
- Switch from walking on tip toes to strengthen the back of the ankle to walking on heels to strengthen the front of the ankle.
- Strengthen the small muscles within the foot by standing on unsteady surfaces (such as a core yoga disk or memory foam pillow) while brushing teeth or doing dishes.
Next, we have the knee, which can be a problem spot for children with NF1. Many of the children I treat experience a great deal of “end range” weakness at the knee, which means they experience difficulty in getting the knee totally straight and holding that position. Leg lifts (with really straight knees) can help alleviate this weakness. Also, a variety of fun, daily activities like riding a bike and jumping rope will strengthen and stabilize the knee.
Finally, we have the hip, which connects the leg to the core. The hips do get some benefit from core strengthening activities (detailed in the June Courtney’s Corner blog), but specific hip strengthening exercises are more beneficial to improve overall strength. Perform the following exercises with your child to improve hip strength:
- Squats
- Lunges
- Jumping
If you believe leg weakness and pain are preventing your child from engaging in daily activities, completion of a brief burst of physical therapy may help. In as little as four weeks of therapy, we can identify which muscles are weak and create a specific strengthening program for your child. Increasing strength to improve your child’s ability to participate in sports and other activities not only has a big impact on motor skills, but also aids in further development of cognitive and social skills.
-Courtney Dunn, PT, DPT