Courtney’s Corner: Articles

November 2020: Balance: why it’s tricky and how to master it!

From birth to adulthood, establishing balance is a fundamental skill set that allows us to sit, stand, walk, run, jump, climb and flip. Balance skills begin to develop early in childhood, when babies are learning to lift and turn their heads. It continues to progress through play activities and mobility practice. When fully refined, the body displays very mature balance reactions, which are coordinated muscle activations that keep the body upright. Muscles all throughout the body must work together: the trunk, the hips, the knees and ankles. The body also receives sensory feedback from many systems to support balance reactions. The visual system, the vestibular system (the inner ear), and proprioceptors (detecting position) all play a vital role in balance.

What does life look like if balance reactions have not fully developed? A child with decreased balance might need to hold onto a hand rail when climbing stairs. Sports, which include running, can be difficult due to the quick stops, starts and changes of direction. Climbing activities may induce fear due to difficulty of managing the body when not on a solid surface. Getting on and off moving objects, such as escalators, can be very hard. Consequently, living with decreased balance can truly limit participation in community, school, and peer activities.

What to do if your child is displaying difficulty with balance? Consider an evaluation with a physical therapist (PT). The PT should not only assess how good your child’s balance is (how long they can stand on two feet, on one foot, and with their eyes closed), but they should also look at how your child uses their visual, vestibular, and proprioceptive feedback to improve their balance. After discovering why your child has decreased balance, a PT will create home activities to specifically address the areas of concern.

Courtney M. Dunn, PT, DPT

August 2020: Outdoor Scavenger Hunt

Photo by Keran Yang on Unsplash

Sometimes looking at the world in a new way makes all the difference! During these uncertain times, many families have been spending more time participating in outdoor activities. A family walk is a beautiful way to incorporate a fun outdoor activity into your daily routine, especially one that encourages talking, sharing, and laughing. On your next walk, consider exploring the world through a scavenger hunt. Below you will find two different versions: a subdivision/city scavenger hunt and a nature walk scavenger hunt. Check off each item, or take a picture, and then share your hunt with us on our Facebook or Instagram pages! #NFCENTER

Download our sample Scavenger Hunt Charts for City/Subdivision or Rural/Nature.

Courtney M. Dunn, PT, DPT

May 2020: Bike Safety

Many families are enjoying the benefits of outdoor activities, including walking, running, biking, and using scooters and hoverboards. All of these activities provide extensive physical and mental health benefits; however, we want to take a moment to discuss safety.

As always, follow your local state/county social distancing guidelines.

The CDC reports wearing a helmet helps decrease the risk of traumatic brain injury by 80%. Consequently, a helmet is mandatory anytime children (and adults) are using anything with wheels – roller skates, inline skates, scooters, hoverboards, or bicycles. More children visit the emergency room with head injuries related to bicycle accidents than from any other sport.

As a general rule of thumb, “if your feet are using wheels, your head has a helmet.”

Twenty-one states have laws requiring children 16 and under to wear a helmet while riding bicycles. Although Missouri and Illinois do not have statewide helmet laws, many local communities do. A complete list of Missouri and Illinois areas that require helmets can be found at Please note all St. Louis County Parks require helmets for children.

When selecting a helmet, choose one appropriate for the activity, as bicycle helmets offer more protection than most skating helmets. Make sure your helmet meets standards set by the US Consumer Products Safety (CPSC) Division for bicycling. Helmets are labeled with either a CPSC sticker, an ASTM’s F1447 sticker, or Snell’s B-95 sticker.

Once you have found your proper helmet, it must fit snuggly on the head and always be fastened under the chin. Our colleagues at the St. Louis Children’s Hospital Safety Stop have created a short, simple video to walk you through fitting a helmet. They are also available for FaceTime support by calling 314-565-0369.

Courtney M. Dunn, PT, DPT