Courtney's Corner Physical Therapy

Courtney’s Corner: Focus on Core Strength to Increase Participation in Activities

Many of the parents I speak with at the NF Clinical Program report similar struggles, “Participating in sports is really difficult for my child; why can’t my child keep up?”  Unfortunately, this question is not easily answered. In the last Courtney’s Corner, I introduced trends we have seen in children with NF1, including decreased strength and increased fatigue and pain.
In this month’s blog, I will address the first steps necessary to increase strength, and lessen the pain and fatigue many children with NF1 experience when completing sports and motor activities. Participating in community sports and activities involves the integration of many body systems to achieve a goal. So, to increase participation in activities, from family hikes to basketball teams, let’s try starting from the ground up. Or, more appropriately, from the core up!
Core strength includes the ability to hold your trunk in a good, neutral alignment while performing various activities. Children with decreased core strength tend to sit with a hunched back and stand with a “sway back.” You may also notice their shoulder blades seem to be positioned forward, out of alignment with their sternum and ribcage.
Why is core strength important? Having a weak core is synonymous to attempting to perform activities from an unstable surface. Think about how much easier it is to shoot a hockey puck while playing street hockey versus ice hockey. What is the difference? Street hockey gives you a stable surface on which to work, whereas ice is much less stable, requiring the work and coordination of more muscles in order to achieve the same shot.
This holds true for core strength. When the core is weak, fine motor skills, coordination and balance are all more difficult. Increasing core strength can be a frustrating challenge because the strengthening exercise movements are often slow and subtle. However, choosing exercises that strengthen  several muscles at once can enable you to make progress more quickly with less time commitment.
Here are some strengthening activities I recommend to start improving your core strength:

Planks:  Create a family competition! Start with a ten second hold the first day, and try adding ten additional seconds each day. See who can complete the most days in a row. Superman Holds:  Lie face-down and simultaneously raise and hold your arms and legs off the ground. For an added challenge, try to hold a ball in between hands and/or feet while holding them in the air. Jelly Bean Holds: A beginning step to sit-ups. Try holding a “jelly bean” position. The goal is to be able to hold this position one second for every year of age (e.g., six-year-olds should aim for six second holds).
Plank Superman JellyBean

Push-Ups:  Push-ups add arm strengthening to core strengthening, which means you get more bang for your buck!
Core strengthening throughout the day:  Consider having your child complete his/her homework while sitting on a large ball. This keeps the trunk muscles active while doing homework, with the added benefit that bouncing while trying to concentrate typically helps keeps kids on task.
Interested in more core strengthening activities? Check out this list of core strengthening exercises from The Inspired Treehouse!
Keep an eye out for the next Courtney’s Corner when we will explore foot, ankle, knee and hip strength!