Core Strengthening In Kids

This past summer my mama pride was nearly overwhelming at my 6-year-old Zoe’s triumphant first day as a surfer girl. It is enough of an accomplishment for anyone to get up on a surf board for the first time, but what made the event even more incredible was that Zoe has been in physical therapy since she was 3 because of a low tone trunk and balance issues. Low tone means Zoe has a weakness inherent in her muscle tissue, so she has to work a lot harder than most just to sit up straight for more than a few minutes. Even with strengthening, her muscles poop out more quickly and don’t retain the training the way normal muscle tissue would. Couple this with a glitch in her neurological system that makes it hard for her to tell where her body is in space, and you have a perfect storm of balance issues that has led to many falls. You can imagine that her physical therapist mom literally had to contain weeping for joy when her baby girl got up on that surf board.

Zoe got her official diagnosis while we were living in California, and began treatment. Not long after our family relocated to the Toronto area. We found Shelley Mannell, PT ( to continue Zoe’s care. Within a few sessions, Zoe made incredible progress. At the end of each visit, Shelley would explain how Zoe’s movement patterns were compensating for her deficits and what to work on until the next session. I was always fascinated by how similar many of Zoe’s homework assignments were to the types of activities I would give my mommy patients to help restore their Cores. Of course Zoe’s homework was way more fun! Pediatric PT’s, like Shelley give out games and toys; sports medicine PT’s, like me, give out reps.

As Shelley and I put our heads together, we both began to see Zoe’s physical needs from different perspectives. I realized that the way that Zoe’s body compensated for her central weakness was similar to the faulty movement and postural patterns common to the post partum women I treated. The similarity was so striking that it dawned on me that the impact of pregnancy on a mom’s central stability brought them back to developmental levels. This changed how I was able to bring my own skills to bear on Zoe’s needs, but it also started to change how I ordered Core exercise progressions for my patients.

Shelley realized that all along she had been doing Core work. She realized that integrating specific Core work with her techniques for the neurological and sensory systems was easily done. As Shelley began emphasizing this as a central component of her care, restoring the Core as a platform for the rest of the body to work from, the kids began making really amazing changes.

Shelley and I began to work together to create a core strengthening program that would address the needs of kids with big and small challenges (Autism, Cerebral Palsy, Aspergers, ADHD, Developmental Delays, Hypotonia). A true collaboration merged my background in Core restoration with her skills in pediatrics and voila, a new approach was born. We had the great privilege of sharing our ideas with a group of PT’s and OT’s in the form of a continuing education course this past Fall, which brought great reviews from the therapists who attended. Next we are headed to The Hospital for Sick Children, known for its innovation in pediatric care, here in Toronto on Jan 23, and 24 to share our approach with rehabilitation pros from across Ontario.

The professional opportunities that have come through our collaboration are exciting for sure. However, none of it has topped the excitement I felt watching Zoe, the first beneficiary of our collaboration, hop up on that board. She rocks!

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