Search – Auckland Childrens Physio

04/Nov/2021

High Knees Exercise

High knees are a great warm-up exercise, they can be used as a cardio burst between resistance training exercises or as part of a high-intensity interval training workout.

What are the benefits of high knees?

High Knees help to build the correct running technique while also building the strength of hip muscles and shortening leg leavers (making them move faster). High Knees are an excellent full-body movement to increase your heart rate and warm the muscles in both your upper and lower body.

Before you start

While you do not need any special equipment to perform high knees, we find using hurdles makes the exercise more interesting and engaging. You can use running hurdles or even a pool noodle cut in half lengthwise and laid flat side down. To set up, lay the hurdles out in a straight line with just under a metre or a two-foot distance between them.

Getting started with High Knees:

Start by practicing lifting your knees high over the hurdles a few times in a row at walking speed. Keep your hips and tummy button pointing forward when lifting your knees up to step over the hurdle.

Tip: By placing your hands on your hips and keeping your elbows pointing to the side, can help to remind you not to twist your hips and tummy.

When you are happy to advance to running. Start with knees soft and feet slightly apart, bend your elbows so that your hands are resting at hip level and your hands are pointing forward. Run over each hurdle changing legs each time. Start off slow, working on quality (how well you run over the hurdles) before trying to go faster. A great starting point is running 10 laps in a row.

You can make the High Knees exercise more challenging by using higher hurdles (beginner hurdles are 15 cm height, advanced is 30 cm in height). You can also increase your knee height, your lap pace, your exercise time length, or the number of laps to increase the impact and intensity.

To find more exercises to help improve your child’s running ability check out our Running Skills for Children book.

Or if you really want to improve your child’s running, sign up for our six-module running program.

Louise Pearce

04/Nov/2021

Whether you’re looking to encourage your child to exercise more, wanting your child to build fitness for the sports they play or just wanting your kids to share your love of running, here are some great tips to get them started.

Start small. Short sprints are a great way to improve running fitness rather than starting with long slow runs.
Make it fun. Running games are an easy way to keep up motivation and work into the ‘tired’ muscle zone.
Don’t focus on miles or kilometers, aim for running duration. Build up from 5 minutes continuous running to 20 minutes. Most childhood sports do not require running for any longer than this time. Building up ‘distance running’ is not recommended until your child reaches pre-teen age. Running High mileage places detrimental stress and strain on children’s growing body’s.
Mix things up by finding some hills to run up and down. This builds up the leg muscles in different ways. You can make this harder by challenging how fast they can run, or how steep the hill is.
Don’t run straight after eating or drinking. Both hydration and nutrition are important for exercise and building muscles, however eating and drinking too close to running can lead to the ‘stitch’ or feeling sick. Wait 45 minutes to 60 minutes after a meal and 20 to 30 minutes after a drink before running. Small sips just prior to running is normally tolerated. Sports drinks are not recommended for children and should only be used for teenagers that are exercising at a high intensity for greater than 60 minutes. Although recent research has found milk is significantly more effective at rehydrating children following sport than water or sports drinks.

If you want information on the best exercises to help improve your child’s running ability check out our Running Skills for Children book.

Or if you really want to improve your child’s running, sign up for our six-module running program.

IMG_20200201_171419_1__2_exported_299_1636014817552-1200x1413.jpg

Louise Pearce

04/Nov/2021

Running is not easy for all kids. Some find it “tiring” or “feel clumsy” when running. But like all things, when we become better at something we begin to enjoy it more. To improve your child’s enjoyment of running, here are some tips to help them improve their running form.

Keep a tall running posture

It’s important to maintain a tall posture, with their head held high and eyes looking forward. Have them lean forward through their body (but not bending forward at the hips). While running they should aim to keep their head and trunk still, with no side to side or twisting movement in their arms and legs. Have them try to limit their bouncing which will enable them to maintain an efficient running style for longer.

Use your arms

When running your arms provide you with rhythm, power and balance. When your child runs you want them to keep their elbows bent, with their arms moving backward and forward with their hands gliding past their hips. They should look to keep their shoulders relaxed throughout their running motion and avoid having their hands crossing their body at any point in the stride.

Run heel to toe

To minimise injury we recommend a running style that lands on the ground with the heel, followed by a push off with the toes and the ball of the feet. This will change for sprinting as we tend to land and push off through the ball of the feet. To encourage heel land, shoes that have a good heel cushion are beneficial to help absorb the load of impact.

Once your child has developed some good running form, it should be easier to begin to build their muscle strength, balance, coordination, breathing fitness (cardiovascular fitness), and power (strength with speed).

To find more starting exercises to safely improve your child’s running ability check out our Running Skills for Children book.

Or if you really want to improve your child’s running, find out more about our six-module running program.

kids-running-on-a-log-in-the-woods-RXQ73KY-1200x900.jpg

Louise Pearce

04/Nov/2021

Building balance is a significant component of child development and relies heavily on the growing internal balance centers (proprioception and vestibular center). Children need to learn to balance before they can progress to higher level gross motor skills like going up and down stairs, skipping or hopping. Having good balance is also important for building running strength as it prepares the leg in flight for landing, therefore enabling a better take-off again for the next step.

Here are some walking balance exercises to build up your child’s movement balance. To support these exercises you can use anything from a fallen log, a balance beam, a wooden plank, a concrete edge at a playground, a skipping rope laid out, or chalk line drawn on the ground. With all balancing exercises, you want your child to be challenged to the point of almost falling to make the most improvements.

Start by having your child practice walking forward along the line with a space between each foot. As their confidence and balance grow, begin to reduce the space between each placed heel and toe.

Once mastered, try these additional exercises to progress and challenge their internal balance centers:

Have your child turn their head slowly from side to side as they walk the line
Introduce catching a ball whilst they balance walk
Have them try walking along the line backward
Try placing toys or other objects like bean bags at a few points along the line. Have your child either reach down to pick them up or jump over them
Move super slow, imaging they are on the moon with no gravity

To find more exercises to help improve your child’s balance and running ability check out our Running Skills for Children book.

Or if you really want to improve your child’s running, sign up for our six-module running program.

Louise Pearce

04/Nov/2021

We often receive enquiries from concerned parents about their baby not rolling over at 6 months, and while we know that babies learn at slightly different speeds, there are key time points for when we’d expect to see them achieving certain developmental movement milestones.

When do baby’s roll over?

We expect most babies to be able to roll consistently from their tummy to their back at around 4 ½ months. By 6 months babies should have mastered tummy to back rolling and also the reverse movement of the back to tummy roll.

Rolling is an important skill for your child to learn as it allows them to experience moving on their own in a rotational plane. It requires your baby to develop the skill of turning ‘on and off’ their tummy and back muscles as well as coordinating their head, eye movements and weight shifts. It is important only to give your baby as much help as they need, however there are safe exercises that parents can do to encourage their baby to achieve these rolling movements.

Steps to teach your baby to roll over from their back to their tummy

Step 1:

With your baby lying on its back, start by introducing a toy to engage and draw your baby’s attention.

Step 2:

Move the toy across their body, so that they reach their arm across and arch their back following the toy. Maintaining your baby’s engagement with the toy, place it above their head and to the side, just out of their reach.

Step 3:

With your baby reaching for the toy, bring up their top leg up and slowly roll them over.

Top Tip: If their arm gets stuck underneath them while they’re rolling over, instead of pulling their arm out, teach them to lift their bottom to release their arm. You can encourage them to lift their bottom by gently pulling on their legs – which will help shift their weight off their tucked under arm.

If you have any questions or concerns about how your baby is rolling or moving, or you feel stuck on how to get them to the next step – let us help. We can help find the missing piece to the puzzle and teach your exercises to help boost them along.

Louise Pearce

30/Sep/2021

Crutches can be an important part of your child’s recovery following a leg or foot injury. They work by reducing the amount of weight placed on an injured leg while the child is mobile. By teaching your child to use their crutches correctly, they can be active while their injury heals quicker.

How to teach your child to walk with crutches

Standing Up

While sitting have your child hold both crutches firmly in one hand forming an ‘H’ shape with the crutch handles. Keep their non-affected (good) foot flat on the floor. Then have them lean forward and use their other hand to push up from the seat or armrest.

Sitting Down

Have your child back up close, feeling the back of the chair behind their good leg, followed by taking their hands out of the crutchers and hold with one hand. Using their other hand, have them reach back for the chair and lower themselves down.

Walking

Throughout the walking sequence your child wants to keep their crutches in a position that is neither too wide, nor too narrow.

Non-weight bearing

Lead with their crutches first, 2-3 feet in front of them. Have them lean forward to bring their weight over the crutches and then, pushing through their arms, hop-forward with their uninjured foot/leg. Try to only bring their good leg forward to an imaginary line between the two crutches.

Touch-weight bearing

Keeping their injured leg and crutches together, move the crutches forward 2-3 feet. Place the toes only on the ground (small amount of weight through their toes). Encourage them to imagine there is a strawberry or tomato under their foot that they do not want to squash. Follow by stepping through with their good leg.

Weight-bearing as tolerated

Keeping their injured leg and crutches together step forward and put as much weight through their injured leg as they feel comfortable. Push through the crutches to bring the good leg through to meet the crutches.

Turning Around

It’s important for your child not to just pivot on their good foot, rather they need to hop around to change direction. Start by having your child hold their crutches out at their sides and then get them to take small steps or hops around in the direction they want to turn – they want to keep a similar turning motion to that of the hands of a ticking clock.

Going Up Stairs

If it’s unsafe, it can just be easiest for your child to sit on the lowest step and shuffle up step by step on their bottom. If they are intending to walk up with their crutches, start by having them place their good foot and crutches close to the first step. Next, have them lean forward, bringing their weight over their crutches and have them step up (avoid hopping) to the first step with their good foot. From here have them continue the sequence while trying to keep their body leaning slightly forward. If you have one handrail, use this with one crutch. Use the crutch in the same sequence as if you had two. Hang the other crutch around your forearm or have a family member take the crutch up to the top of the stairs.

Going Down Stairs

Again if it’s unsafe have your child sit on the top step and down on their bottom. To walk downstairs with crutches start by having your child place their crutches carefully down to step below them. Place the crutches on the outer half of the step near the edge. Have them move their injured foot out in front of crutches and then lean slightly forward to bring weight through the crutches. Next, have them while pushing firmly through arms, step down on their good foot to the step below. Stop on each step to check their balance before continuing slowly down the stairs, repeating the sequence.

Additional safety tips for walking with crutches

Prevent slips or tripping by avoiding loose mats or rugs.
Avoid areas where there is surface water, uneven ground, grass or cracked sidewalk.
Make sure your child is wearing non-slip closed-back shoes and never let them walk with crutches while wearing socks – as they are too slippery.
To avoid tripping over them, try to keep your family pets contained as much as possible during their recovery.
Continue to review the ferrules (the rubber bits at the end of the crutches) for wear.
Use a backpack or your pockets to carry things so that their hands are kept free to use their crutches.

Louise Pearce

20/Jun/2021

When we look at how babies develop we know that they learn at slightly different speeds but there are key time points where we expect to see them achieving certain movements e.g. rolling by 5 months. Learning to move is a complex process, it relies on many systems working together. Some children may learn slower as they have been exposed to risk factors during pregnancy or in the first few months of life. Infants who are born premature (>36 weeks), having a low birth weight, their mother had an infection whilst pregnant (listeria or toxoplasmosis), there was reduced placenta health, can increase the risk of them having a neurological concern or cerebral palsy. However, we are lucky with current research and international collaboration of specialists within the area of child development as we now know what we should be looking out for. What are the red flags or movements that we see in the baby that means we should be taking a closer look?

So what are these “early warning” signs?

Is your baby showing a hand preference before 1 year?
Are they older than 6 months and they cannot get their feet to their mouth or their legs feel stiff and are hard to bend?
Are they older than 4 months and keep their hands closed tightly (fisted/ clenched) most of the time?
Are they not able to hold their head in line with their body when pulled up to sitting (older than 4 months of age)?
Are they Can they sit by themselves

Louise Pearce

20/Jun/2021

Advice for new school parents

Your baby is all grown up and off to school. You most likely have a looong list of things that they need. A school bag would definitely be on the list. Your child might already have a back pack that they used for kindy or childcare but is it right for school? How they will use their school bag is likely to be different. We need to ask ourselves; is it the right size for their height? Is it big enough to carry what they need? Will they be wearing it for a long time e.g. walking to school, waiting to catch the bus? And is it comfy? It is important to consider these points and what the ‘tradeoffs’ are for each on the ‘health’ of your growing child’s back.

If you drive past a school take a minute to look at the kids walking to or going home with their heavy school bag. If they are wearing both straps these are often loose with the bag hanging below their back. Initially when they set off they may look ok, but with each step their posture is changing and their body is adapting to the load. Their chest muscles are shortening whilst their back and shoulder muscles are being lengthened, their spine is being stressed and they are changing the messages from their brain to their muscles which will reinforce the bad posture.

Changes to their posture

shoulders are rounded and pulled forward affecting the arm position in the shoulder joint
head is pulled forward in front of their body
spine alignment affected- neck curve is flatter and the mid-back curve has increased
smaller steps taken as body positioned forward- affecting the muscle in their hips, knees and ankles
natural arm and opposite leg swing is reduced which is important for cross patterning
decreased walking efficiency

If they are wearing only one strap- shortening of back and neck muscles on the same side and lengthening of the other.

Over the years there has been an increase in children having neck and back pain. This is down to a number of factors such as our kids being less active, poor posture sitting watching TV or looking at other handheld devices but also due to schools having fewer lockers or permeant desks and carrying more in their bag’s. Therefore adding a poorly fitted, poorly packed, thin strapped and too big a school bag to the mix isn’t going to help. As a result your child may experience back or neck pain or complain of ‘tingling’ or their arms feeling ‘funny’ from the pressure of the straps pressing on blood vessels and nerves that supply their arms.

There are numerous medical studies that have investigated back pain in children. The research shows that most children start to experience pain at around 11 years of age around the time they start to hit puberty. Other risk factors identified are being female, carrying a heavier weight, a bag that is too big (in proportion to the child) and increasing age. Interestingly they found that wearing one shoulder strap was the same as wearing two.

Unfortunately we can’t stop them growing up or change if they are a girl so we can only influence the bag’s Size and Weight. The curves in our spine are developed to enable us to carry greater weight than if it was straight. When we wear a heavy backpack it pulls our shoulders forward and we lose these natural curves and this is true for children, teenagers and adults although as adults we are less flexible in our joints and hopefully our muscles are stronger. This flattening of our spine puts uneven pressure on our vertebrae (bones) but also on our discs (cushions between our vertebrae) which long term uneven pressure can cause them to bulge and press on our spinal cord (called a herniated disc).

It is recommended that children carry no more than 10 % of their body weight. For most 5 year olds with an average weight of 20 Kgs this is 2 Kgs only.

How much is 2 Kgs?

2 Kgs = Lunch box (cheese sandwich (2 slices of bread), apple, yoghurt, banana, 2 biscuits), empty drink bottle (500 ml), pencil case, 2 x 1B4 exercise books, P.E shoes, jumper.

Tips when selecting a school bag

Choose a bag that is proportional in size – when the straps are fitted the bottom of the bag should sit at the level of the hips
Shoulder straps should be well padded and wide to help spread the weight and fitted to reduce excess movement
Teach your child how to adjust their shoulder straps and place heavy items close to their back
Encourage them to use their locker or their desk to leave things they won’t need for the rest of the day
Full their drink bottle at school and empty it before leaving (if they are old enough to do this)

Reducing the risk of your child developing back pain will help ensure your child goes into adulthood with a ‘healthy back’. ??

Louise Pearce

17/Jun/2021

With winter sports well underway, it is important to remember children do get injuries that we can help prevent. ACC has been instrumental in leading the change with their ACC SportSmart program development. In collaboration with Netball NZ, Rugby NZ, Touch NZ, Football NZ and League NZ they each developed specific frameworks with focuses on warm-up, training and conditioning, and wellbeing resources that can be found through the following organizations.

Hopefully, as parent coaches, you are implementing these in your training and warm-up sessions. If you are watching from the sideline and are not sure if your child coach is aware of these you can help spread the word or start some of these exercises with your child at home. Although most of these frameworks are developed for the 10 + age group but the knowledge and exercises can be easily adapted for the younger children. For example; lunge exercises. They may not be able to lunge low but they can start to learn the exercise, build strength and challenges their balance.

Check out links for these specific programs;

RugbySmart https://www.rugbysmart.co.nz/

NetballSmart https://netballsmart.co.nz/

Fit4Football http://Fit4Football.co.nz

TouchFit360 http://touchnz.co.nz

LeagueSmart http://NZRL.co.nz/get-involved/leaguesmart

Advice on sport for school-age children

For younger children, they have collaborated with researchers to define key recommendations to protect their growing bodies from injury (growing number of serious injuries such as ACL tears), prevent burnout from sport and continue to develop a passion for healthy cultures with exercise and sport.

Key recommendations

Participate in a number of different sports (codes)
Avoid specialisation in one sport till the child is at least 10 to 12 years
Hours of training and games per week should be less than the child’s age
Kids should have twice as long free play time (e.g. kicking a footy with friends in the backyard) as they have in structured play (training and game of footy).
4 months off training each year for each single sport
Fun and friendship is the primary goal for kids and teens in sport

Remember the key for children in sport is FUN, FUN, FUN. We want to encourage a lifelong love of sports and fitness.

Louise Pearce

11/Jun/2021

Babies have been swaddled or wrapped for thousands of years and it is enmeshed in many cultures around the world. It is designed to provide containment and mimic being in the womb. More recently in New Zealand swaddling was promoted with the introduction of the back-to-sleep campaign. Back sleeping is not an instinctive position for babies, but this combined approach helped them go to sleep and made an incredible difference to sudden infant death syndrome rates. However recently in some regions in New Zealand, there has been a move away from teaching new mothers how to swaddle. This intrigued me, so I went on a search to find the scientific evidence for the change in practice.

What does the research say?

Key findings: Tight, full-body, heavy fabric swaddling can cause significant issues

Swaddling that is tight with arms bound to their side (elbows straight) has been found to increase chest (respiratory) infections compared to non-swaddled babies
Tight swaddling around the hips and legs has been linked to hip development problems (hip dysplasia)
Heavy synthetic fabrics have been found to raise an infant’s body temperatures beyond the normally accepted temperature.

However there is nothing about how it might be beneficial for infants or parents if done correctly (hands up near their faces, loose around their hips, or not include their hips with a breathable light cotton fabric).

If you recall your antenatal ultrasound scans, you may have seen your baby’s hands up by their face or busily sucking on their thumb or fingers. Developmental swaddling which encourages their hands up by their face can help maintain this familiar and comforting position.
In neonatal units, supportive positioning is common practice as they are born with low muscle tone. Containment swaddling or nesting helps prevent over-stretching of chest muscles from the effects of gravity, provides good alignment of shoulder blades, and improves the baby’s energy expenditure. As a developmental therapist, there are noticeable differences in arm and body posture in non-swaddled term babies too. They tend to have tighter shoulder blade muscles and longer chest muscles making bringing their hands together and reaching up harder. It is visible when they are learning to roll and in sitting
Containment can help babies learn self-regulation, their ability to self-settle in the first few months after birth. If you are a new parent, you would be familiar with this period called the fourth trimester. During this time, parents are encouraged to support their babies to learn this skill which helps them go to sleep and return to sleep if woken after a sleep cycle.
I have heard the rumor babies who have not been swaddled lose their startle reflexes faster. In my experience, this is not the result of swaddling but the baby’s ability to control their arms. This voluntary control of their arms and legs is learned at around the age of two to three months. If we are comparing babies who are swaddled all the time during their awake periods then yes but I am recommending developmental swaddling for sleep only.
Good sleep is important to both parents and babies. For infants, good quality REM sleep is when they lay down their new learning for the day (motor learning) and this will help them learn the voluntary control discussed earlier as well as promote weight gain, growth, and stabilization of hormones compared to overtired upset babies.

When should I stop swaddling?

When your child starts showing signs of rolling from their back to their tummy is a good time to stop. For most babies, they learn to roll consistently at 4 to 5 months of age. Some babies roll earlier than this. If they have accidentally rolled over they might have demonstrated this skill once or twice then stop for a few weeks this is normal at 2 to 3 months of age.

I would recommend weaning the swaddling off. Start with no swaddling for day sleeps then progress to no swaddling for night sleeps after a few days of practice. The Love to dream range has a progression suit that allows you to zip off the arm covers to help them slowly get used to the change in sleep support.

Steps to Developmentally Swaddle

Hands up by their shoulders
keep it loose around hips and legs
use lightweight fabrics and do not overdress your baby

lay wrap with a point at one end – like a diamond
fold the top corner down around 1/3 of the wrap
lay baby on the wrap with fold line at the level of their ear lobes
tuck one hand into the “pocket” created from folding down the corner, pull the end across to the opposite side of their body, and tuck under
repeat with their other hand as in step 5
fold up the bottom of the wrap loosely fitting around their waist.

Watch the video to learn how to developmentally swaddle your baby. Check out the link here https://youtu.be/_BAikYKQylk

I don’t want to developmentally swaddle my baby.

I would recommend providing opportunities to counter the muscle imbalance changes through play if you do decide to not use developmental swaddling. Encouraging more side-lying play, using body slings, and supporting their arms together during cuddles and feeds will help.

Thank you for taking the time to learn more about developmental swaddling.

Hopefully, this has answered a few of your questions and also allowed you to work out what is best for you and your baby when it comes to swaddling. If you stick to the developmental method of swaddling with breathable light fabrics it can be a great way to ensure a successful night’s sleep. But if you find it stressful or challenging then swaddling may not be for you.

References:

Patricia Franco, Nicole Seret, Jean-Noël Van Hees, Sonia Scaillet, José Groswasser, André Kahn. Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants, Pediatrics May 2005, 115 (5) 1307-1311; DOI: 10.1542/peds.2004-1460
Bregje E. van Sleuwen, Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse Kuis, Tom W.J. Schulpen and Monique P. L’Hoir. Swaddling: A Systematic Review, Pediatrics October 2007, 120 (4) e1097-e1106; DOI: https://doi.org/10.1542/peds.2006-2083
Nelson, Antonia M. RNC-MNN, PhD, CNE, IBCLC Risks and Benefits of Swaddling Healthy Infants, MCN, The American Journal of Maternal/Child Nursing: July/August 2017 – Volume 42 – Issue 4 – p 216-225 doi: 10.1097/NMC.0000000000000344

Older Posts

CLASSIC LIST

Running exercises for beginners – High Knees

Running tips for kids

Tips to improve running technique in children

Exercises to improve balance and stability

How to teach your baby to roll over

How to use crutches correctly

Are you worried about your baby’s movements?

Is your five year-old off to school? Is their school bag right for them?

Parent coaches- are you helping to keep your player’s injury free?

Should I swaddle my baby?

Running exercises for beginners - High Knees

Running tips for kids

Tips to improve running technique in children

Recent Posts

Running exercises for beginners - High Knees

Running tips for kids