June 2, 2014
A New Operating System
I have seen a plethora of “core stability” programs for kids published over the past few weeks and I’d like to make a couple of comments. First, I think it’s great that we are talking about kids’ need for core/central stability and also that we are finally beginning to talk about this with respect to children with motor and sensory challenges. Because, make no mistake about it, the research is clear that our clients have difficulty with postural control and central stability is a crucial piece of this foundation for every single motor skill.
Second, it is evident we still need to discuss what this program should look like. All too often, I see bridges, prone extension and abdominal crunches as examples of core exercise for kids. But because there is no mention of alignment or breathing or what muscles are being targeted, these programs don’t reflect the current evidence regarding what the core muscles are, how they function, or how they create central stability. And having a child perform an isolated exercise routine but ignoring their alignment in sitting and standing and recreational/sport activities is not going to address the issue for any child, let alone one who experiences motor and sensory challenges. We need a core strategy that carries over in all activities. So let’s revisit core function with some new information from the adult and the paediatric literature:
1. Central stability is created by the 4 inner core muscles:
The anticipatory core team is the respiratory diaphragm, pelvic floor, transversus abdominis and multifidus. They work as a team to maintain intra-abdominal pressure (IAP) throughout the respiratory cycle; this helps to stabilize the spine and pelvis through tonic muscle work. They also create phasic bursts of support BEFORE every single movement. Availability of these muscles is dependent on alignment of the rib cage and pelvis. Without proper alignment, adequate IAP is not generated and central stability suffers. Any activity that targets core muscles needs to be performed in an optimized alignment.
2. Breath holding is a compensation:
Children hold their breath as a means of creating central stability in the absence of adequate IAP. If a child holds their breath during an activity, they aren’t working a crucial group of core muscles.
3. Stability during movement is assisted by activation of outer core postural synergists:
Outer core muscles (= the reactive core teams) work in synergies during functional movement – that’s one of the ways the brain organizes fast and efficient movement. One example of a major synergist is the Posterior Oblique Synergist ( = contralateral latissimus dorsi and glute max.). We can use this knowledge to our advantage, targeting these muscle groups during our programs. We should be working reactive core muscle groups rather than individual muscles.
4. Recruitment order is inside-out:
The reactive core muscle groups have to be activated on top of a stable spine and pelvis or they don’t work in an efficient, coordinated manner.
Finally, none of our children can maintain sitting for hours with proper alignment. We have to help them to activate their core muscles in sitting by adapting their chairs to support the alignment of the rib cage and pelvis required to access the central stability system. This impacts everything from attention to handwriting to back pain. We also need to train them to access this alignment in standing as well as sporting and recreational activities so central stability is a part of every activity, every day.
Armed with this evidence regarding central stability, it’s time to change how we operate regarding core function for children. Core strategy integrates alignment, breathing, reactive core muscle synergies and an inside-out recruitment order to establish the neuromuscular program for postural control during sitting, standing, recreation and sports. That’s a 2014 approach to the core.
The full Dynamic Core for Kids course is now available on-demand! Check it out at www.heartspacept.com/onlinecourses.
For the next live Dynamic Core for Kids continuing education course, check out the course calendar at www.heartspacept.com/workshops.
photo credit colorfully.eu