Kids on the coast

Bearing the weight

Professor and physiotherapist Dr Carolyn Richardson, who’s spent 20 years researching musculoskeletal health and four years devising a core workout program, says musculoskeletal health for children is a “huge problem”. She says by the age of six, children should have a well-developed strong healthy spine. “I fear it is all downhill from there, with lack of emphasis on good posture and lack of antigravity exercise, plus lack of cardio exercise too,” Carolyn says. “It’s far better to start young with antigravity exercise for the core muscles.”

Once you have a ‘gravity related medical condition’ Carolyn says it is far more difficult to reduce the pain then rehabilitate the core. “Prevention is far better than cure!” she says.

Children can look after their musculoskeletal health by stretching tall, spending time in bare feet on sandy or grass surfaces and playing games that include weight bearing like wheelbarrow races.

Freeing the spine

Many experts agree most back trouble can be avoided with preventative care.

Pain is the most common kids’ back problem chiropractor Dr Scott Baker sees at his practice. Most of the back pain results from minor trauma like a fall, repetitive poor posture or habits like sleeping on the stomach, slouching on a chair or playing computer games. “Just observe children sitting or playing a Nintendo DS and poor posture is obvious,” Scott says.

Chiropractic treatment for children involves checking all areas of the spine are moving freely and muscles are working in balance. This is followed up with postural exercises and Scott advises sleeping on a good pillow (on the back or side), limiting time on computers and wearing a backpack correctly.

Like anything over time, poor posture can become permanent and Scott says kids with poor posture may complain of headaches, neck pain or back pain. This is because poor spinal posture results in excessive weight-bearing loads to the spine and surrounding muscles. These spinal muscles tighten in response to abnormal forces and spinal joints become fixated.

As an example, Scott says 12-year-old Josh’s parents noticed him becoming easily irritated at home and school. His posture was deteriorating and he’d had ongoing back pain. Scott’s analysis of Josh’s posture revealed he had a high right shoulder and ear, a high left pelvis with forward head-carriage and a stooped posture. After four visits and some home postural advice Scott says, Josh’s pain had gone. “His parents said he not only looked straighter, he was more confident with his posture, was sleeping better and his concentration had improved,” Scott explains.

Another common reason parents bring their child to Scott is bedwetting. You might not think the back relates to such issues, but Scott explains misalignment in the lower spine (chiropractic subluxations) can affect the function of sacral nerves supplying the bowel and bladder. Research has shown that the weight of a five cent coin on a nerve can effect up to 60% of its function. Correcting these misalignments allows the nerves to these areas to function optimally, which in turn improve the functioning of the organs they supply (like the bowel and bladder).

School bag-sense

Chiropractors Association of Australia spokesperson Dr Patrick Sim warns lugging an overloaded bag to school places stress on growing spines and can lead to acute and long-term back problems. “Why treat our kids as pack horses when most of the information they need at school or for homework could be contained on a tiny memory stick?” he says. “Lifting a bag that is too heavy causes immediate strain on the spine and the longer a child carries that load, the more severe the damage.”

A wheeled bag with an extendable handle may seem a good solution for a heavy load but students may have to pull a bag over rough ground or grassy areas as well as lift it up stairs and on and off public transport. Dr Sim says all of these actions impact normal posture and could prove problematic in the long run.

• Backpacks should be no heavier than 10% of a student’s weight when packed
• Backpacks should be sturdy and appropriately sized – no wider than the student’s chest
• Put comfort and fit at the top of the priority list, not good looks
• Choose a backpack with broad, padded shoulder straps
• Use both shoulder straps – never sling the pack over one shoulder
• Use waist straps – they are there for a good reason
• Don’t wear the backpack any lower than the hollow of the lower back
• Don’t overload the backpack – use school lockers and plan homework well in advance
• Place all heavy items at the base of the pack, close to the spine, for a better distribution of the weight

Source: Chiropractors Association of Australia (CAA)

A lion’s share of health

Posture doesn’t just relate to the back: feet are often at fault too. Podiatrist Trent Johnston says grandparent’s innate ability to readthe signs is often how many children’s ‘foot faults’ come to light. “Spending every minute with a child makes it tricky to see changes, so it’s not unusual for parents to be blind to the signs of something amiss with their child’s feet,” Trent says. “The critical aspects of the development of posture occur in the first eight years.”

But natural variations to the posture of the legs may be hard to read, so how do we know what’s normal? We can look out for signs like really flat feet, excessive tripping, complaints of tired (or sore) legs, wanting to be carried all the time, or not walking by the age of 18 months. “Back your instincts, if you think that there is something wrong with your child’s feet then it’s likely there is!” he says.

A Podiatrist can assess whether the feet are ‘normal’ or are contributing to other problems. Some children will be required to do exercises to improve their posture, balance and foot function. “The beauty of young children is that the foot, and their whole body, is so pliable and responsive to treatment,” Trent says.

Often it’s simply giving correct-shoe advice. “You can waste a lot of money on shoes that actually can make things worse, so this is where professional advice is very important,” he says.

And what about going barefoot? Yes, kids should have some barefoot time because it allows their feet to develop and strengthen, Trent explains. But it should be balanced out with the use of footwear, particularly for sporting and ballistic activities like trampolining. Prevention comes back to posture. “It’s important to encourage children to change sitting positions,” Trent says. “Young girls often sit in a ‘W’ position, which can encourage knock knees, while boys tend to sit cross legged.

“Sitting in the same way all the time can have significant negative effects on the posture and the back.”

Trent once had a little boy ask him why he had to have ‘bird feet’. “He’d been told he was pidgeon-toed and had taken it literally!” Trent says. “He wanted to know when he grew up would these develop into ‘lion feet’.”

“After his treatment his feet had straightened up and he was a very proud lion.”

Tips to prevent back problems

Posture:

• Sit straight with the shoulders pulled back and the head raised (pretend a balloon is lifting your head to the sky)
• Stand against the wall with your heels, buttocks, shoulders and head touching the wall. Count to 20 and repeat daily

Stretches:

• Stand in the corner of a wall with the arms in a T position (stretching the chest muscles). Hold for 20 seconds and repeat daily
• Have your desk and computer set up ergonomically so you are looking straight and not slumping

Exercise:

• Walk a minimum of 30 minutes per day to facilitate natural spinal movement •

For more information:

Dr Carolyn Richardson: Visit www.gravityfit.com Her e-book Beyond the Core to Whole Body is available on this website.
Physiotherapy Association of Australia: www.physiotherapy.asn.au 
In Touch Physio: Phone: 5442 2255 or visit: www.intouchphysiotherapy.com.au
Children’s Sunshine Chiropractic – Dr Scott Baker: Phone: 5491 7743 or visit: www.naturaltherapypages.com.au
Wellness for Life Chiropractic: Phone: 5443 8888 or visit: www.wellnessforlife.com.au
Family Wellness Chiropractic: Phone: 5444 0711 or visit: www.familywellness.com.au
Chiropractors’ Association of Australia: www.chiropractors.asn.au