Starfish Therapies

January 29, 2017

Growth Spurts

When working with kids, growth spurts are always something we have to take into account.  I can remember as a child feeling like I had these arms and legs that weren’t connected to me making me even clumsier than I already was.  On top of that I think I was hungry all the time too.  Almost all kids go through growth spurts at various times during their developmental years so I just wanted to take a moment to point out some things to consider during these times.

For all kids, when they grow rapidly their bones change lengths, their muscles have to adjust and as a result their ability to sense where they are in space has to alter.  It doesn’t happen overnight (hence me feeling like my arms and legs weren’t attached) and during the time when their bodies are adjusting to these new proportions they may be a little on the clumsy side.  Just think for a second of your house and your daily routine.  I bet you know exactly where everything is and can almost go through your morning routine in your sleep.  Now imagine that someone came in during the night and moved everything around.  I bet it would throw you off for a few days while you adapted to the new layout.  That’s how kids have to adapt to their ‘new’ body.

When a child has low muscle tone or high muscle tone there are other things to consider.  For a child with low muscle tone, they are working hard to maintain strength and stability.  Their muscles get good at working at a certain length and they begin to progress their skills.  Now they grow suddenly and their muscles are longer and all of a sudden they aren’t as efficient and their endurance is decreased.  They will show some weakness and have a harder time with postural stability and overall functional skills.  This is their period of adaptation to their new size.  It just may take them a little longer, and they may look like they have regressed.  You may have to give them a little more help or a little more time for a short period, but the good news is, they get back to their previous abilities much faster than the first time around when they were just learning the skill.  That’s because their body already knows what to do, they just have to figure it out at this new size.

Hopefully this helps explain some of what you may see as your child is growing and they appear to change over night, don’t worry, its not permanent!


January 14, 2013

What does High Tone mean?

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I wrote a post a while back describing low tone so I thought I would try to do the same with high tone.  Tone is the resting state of your muscles.   When someone has high tone it means that their muscles are getting more input than is necessary, even when they are at rest.  Where kids with low tone tend to melt into you, these kids tend to be on the ‘stiffer’ side.  One thing I often hear from parents is that their child likes to stand all the time (even before standing is a milestone they should be hitting) and they don’t like to sit. (PS- for these kids it is not better to put them in an exersaucer alot because it doesn’t help them learn how to use their muscles differently)  This is because it is easier for their muscles to work all together.  When they are standing they are able to use extension all together, they can keep all of their muscles turned on at the same time.  When they are sitting they are asking their muscles to do different things.  They need to keep their trunk muscles turned on without turning on their gluts (tush muscles) at the same time.

Many people think that kids with higher tone are stronger because they are able to keep their muscles turned on.  This is a common misconception and these kiddos often have the same amount of weakness as kids with low tone.  The just look strong when they are able to do a task like standing when all their muscles are on.  If you ask them to sit or go onto hands and knees they often have a more challenging time because they have to isolate their muscles to have them do different things.  When a child goes onto hands and knees they need to keep their head, neck and trunk extensor muscles turned on but they need to relax their gluts/hip extensor muscles so that they can bend at the hips and again at the knees.  Often they will hold this position for a short period of time before they turn their gluts back on and come up into high kneeling.  This is because its easier for them to maintain head, neck and trunk extension with hip extension then it is to have hip flexion with their head, neck and trunk being extended.  Just like in sitting they need to keep their trunk upright while keeping their legs bent at their hips and knees.

Its important to remember that these kids need to strengthen individual muscles so that they become more efficient at isolating out movement and don’t need to rely on using all their muscles doing the same thing at the same time.  The earlier they start developing isolated muscle strength the easier it will be as they progress through their milestones where they need to be able to use each  muscle differently.  In addition, as they grow or have growth spurts you may see some ‘stiffness’ return because their muscles have just been stretched and need to adapt to the new length.  Maintaining isolated strengthening will help your child to move through these growth spurts with increased ease.

I know this is a hard topic to explain so I hope I made it a little more understandable for you.  Please don’t hesitate to ask any questions that this may have raised and I will do my best to answer.

April 4, 2010

Growth Spurt

Since Spring is a time of growing I thought I’d talk a little bit about kids and growth spurts.  Many of you may remember your adolescent years when all of a sudden you seemed to be all arms and legs and were tripping over your own feet.  Well that was because your body grew a lot in a short amount of time and it hadn’t caught up to where everything was again.  We take in information all the time that tells us where our body is so that we can move through the world.  Three ways we take in information is through our vision, our vestibular system and proprioception.  The quick version of vestibular is our inner ear that keeps track of where our head is and sends messages to the brain.  When you go on spinning rides or spin yourself around until you are dizzy that is the system that you are sending information to.  Proprioception is information that comes through our joints and muscle attachments that tell about where parts of your body are at any given time.

When a child grows they need to adapt to their new size and this involves recalibrating the information receptors that are passing signals on to the brain.  Generally this happens in a fairly short amount of time and doesn’t cause too many problems.  For kids who are already having challenges moving it  is important to keep them moving and practicing skills (even if they already know how to do them) so that their body can begin to make the adaptions to their new size.  Without practice they run the risk of regressing and having difficulty with a skill (such as walking) that they may have already mastered.

In addition to having trouble with proprioceptive information you may see some more tight muscles.  When they grow the muscles stretch and if they have a tendency to be tight or had been tight in the past then they may get tight again.  Although stretching is important all the time it can become even more critical during periods of growth so that they don’t lose range of motion.  You may want to consider talking to your physical or occupational therapist about ways to help maintain range of motion during these times of growth so that you aren’t spending your whole day stretching.  Maybe its using a stander or getting creative with sitting options so that your child doesn’t even realize they are being stretched!

Lastly, for kids who have underlying weakness or who have to work to maintain strength, its critical to work with them during their growth spurts because they will appear weaker due to the new length of their muscles and they bodies.  For kids who are working and ‘strengthening’ on a regular basis they can generally prevent major losses in strength or get the strength back much quicker than kids who have not been receiving active therapy or doing a regular home exercise program.

Basically, the take away is to pay attention to if your child is growing because you may see some changes in their abilities to perform skills and movements that you thought they had already achieved!

July 27, 2009

Tight Muscles and The Importance of Stretching

baby yoga

As adults I know most of us have experienced tight muscles because we don’t stretch as often as we should, or there are those that just tend to have tighter muscles than most.  For example, one of my friends on the soccer team had the tightest hamstrings regardless of how much she stretched.  Well, believe it or not kids, even babies, can have tight muscles as well.

Now all babies actually have some muscle tightness when they are born, the reason being that they’ve been cramped up in the womb for several months.  With a few techniques, they don’t even realize they are doing, this problem easily resolves as they grow.  For instance, Tummy Time helps to stretch out their hip flexors (i.e. the front of their hip).  Making sure your baby spends time on their belly, and not always in a car seat, bouncy or swing, will make sure they have adequately stretched hip flexors.  When they start to put their feet in their mouth, this is their way of stretching out their hamstrings.  Encouraging your child to do this is a good thing.  Not only does it stretch out their hamstrings, it also helps them with body awareness and exploration.

For some infants and children, they have abnormal muscle tone, meaning they are too stiff (hypertonia) or they are too floppy (hypotonia).  Tight muscles is generally associated with hypertonia because the muscles are already stiffer, however children with hypotonia are at just as much risk for developing tight muscles.   Tight muscles can limit your child’s ability to do the things they want to do.

Areas to look out for muscle tightness in a child with hypotonia are their hamstrings, low back, the outside of their hips (due to the tendency of their legs to turn out while lying on their back), and their trunk rotators.  Its a common misconception that because children with low tone are floppy that tightness will not be an issue.  The reality is that they have a harder time holding themselves in a proper alignment and over time their muscles get tight.

When a child has tight hamstrings it is harder for them to sit cross legged.  You may notice that they want to kneel more often, this just encourages the tight hamstrings.  Also they have a hard time sitting with their feet out in front of them.  They either need to bend their knees or lean back on their arms.  It can also make it hard to climb ladders or really high steps which could delay their independence on the playground.

Tight calf muscles can make it challenging for your child to squat down while playing with toys.  It will also make it harder for them to go up and down stairs, although they will find ways to compensate, usually by turning their feet out to the side, or their feet could develop increased pronation (see ‘Does your child need the perfect shoe?‘).

The reality is that tight muscles do happen, as I said, most adults have probably experienced them at some point in their life, however, why start your child off with tight muscles?  Tight muscles just lead to limitations in mobility, changes in posture (or abnormal posture) and potential for injury as we get older.  By keeping a watch out early you can prevent tight muscles down the line!  While your child is growing and learning new skills, lets not make it harder for them!

Check back next week for some Stretching Strategies.

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