As you surely know, propping and the ability to PUSH UP are important skills for proper child development.
Symmetrical propping on the forearms, shifting body weight from side to side, and pushing up from the floor are developmental milestones that not only strengthen the shoulders, but also help to improve control of the torso — and a stable core is essential for little children who eventually march off into the world on their own little feet.
In typical child development, at around six months, the baby will prop up on straightened arms. Within a short time afterwards, the baby will get up on all fours, push off the ground, and sit.
However, pushing off the floor doesn’t come easily to every child. Overcoming the force of gravity and lifting up, not only the head, but also the upper torso and the tummy, can be problematic for some children.
Quite often, these babies are not very happy when placed on their tummy.
Even after the 3rd month of life, when propping on the forearms shouldn’t cause any “technical” problems, they can easily get impatient and then… well… the whole neighborhood knows just how much the baby doesn’t like being on the tummy. 🙂
If you watched such a baby closely, you would likely notice the child avoiding activity involving shoulder work and having difficulty propping on straightened arms. At the age of 6 months, this baby can prop up only for a short amount of time, or worse, not at all.
WHY DO WEAK SHOULDERS MATTER?
Some time ago (actually, not that long ago ;)), it was normal to pay little attention to the QUALITY of child development.
The rules were simple: If the child didn’t sit by 6 months, they were put between pillows to hold them in place and made to sit. If the baby didn’t walk at one year, the parents would help them walk by holding their hands or… they would put them in a baby walker.
And of course — a neurologically healthy child would acquire all these skills sooner or later, so then the problem was considered ticked off. ✅
So, why should we complicate our lives and invent all sorts of problems? Wouldn’t it be better to leave things as they are and take what life gives us in stride?
Considering all that we now know… I don’t think so.
If I am aware of unhealthy compensation mechanisms, resulting from reduced postural tension, often causing future postural defects… how could I not do something about it and minimize the risk to my child?
I don’t believe in undergoing physiotherapy when it’s NOT needed, but when it’s justified, it’s definitely worth it!
OK, BUT LET’S GET BACK TO THE TOPIC.
WHY CHILDREN WITH WEAK SHOULDERS MAY NOT LIKE LYING ON THE TUMMY
As I’ve mentioned earlier, children whose shoulders are relatively weak will most likely avoid any activities forcing them to work. If this is the case, lying on the tummy can be quite a challenge.
Why?
Because the movement patterns of such babies are usually not standard ones (they lack the right quality) and instead, such children use compensations. At first glance, these compensations seem to do the job, but in the long run, require much more effort. So keeping a compensated tummy position for a longer time becomes really hard, mainly because it’s uncomfortable.
Let’s look at an example:
You have just learned how to swim. You can stay afloat, but it still involves a lot of effort. As of now, doing even one lap in the pool will be a challenge for you.
But, if you improve your technique and eliminate unnecessary movements, you will feel like a fish in water and then… even several laps won’t be a problem for you.
The same goes for babies lying on the tummy. If they engage the right muscles and arrange their arms in a way that makes holding a tummy position easy, they probably won’t rebel against it.
If, on the other hand, instead of actively propping on the forearms, the child tenses up the back muscles to hold this position — with using the arms — there is a chance that he or she will get discouraged very quickly.
Remember — for a given activity to come effortlessly, it has to be done CORRECTLY.
ALRIGHT, BUT WHAT DOES IMPROVED SHOULDER CONTROL LOOK LIKE — STEP BY STEP?
- One of the first things that you should see at the end of the 3rd month of life, is that the baby assumes so-called symmetrical active support (propping) on the forearms.
While on the tummy, babies prop up in such a way that their elbows are under their shoulders, their legs are relaxed and straightened, and the hips are down. In this position, their line of sight runs parallel to the floor. (Check out how to make your baby enjoy tummy time!)
When lying on their backs, babies will start to look at their hands and reach them out in front of their chest.
- In the 4th month of life, babies start to feel more and more confident on the tummy — they shift their body weight from one side to the other and, although this is not exactly the “right way” of doing it, the increased pressure put interchangeably on both shoulders helps to stabilize the shoulder girdle area. The shoulder girdle (or pectoral girdle) is the set of bones that connect the arms to each side of the body (the clavicle and scapula).
When lying on their backs, babies extend their arms in front of their chest and focus on them for longer periods of time.
- In the 5th month of life, while lying on the tummy, babies shift their body weight to the sides more and more confidently, and can also reach the “unweighted” hand out towards a toy.
Babies push off the ground more confidently when actively straightening their elbows. As a result, the body weight shifts towards the hips and control of the shoulders is further improved.
When lying on their bellies, babies at this stage can lift up their heads and the upper part of the chest. They also begin to lift the lower chest and belly off the floor.
- In the 6th month of life, babies not only straighten their arms, but also shift their body weight from side to side during tummy time. Although when reaching for a toy, they often go back to leaning on the elbows, propping up higher happens more and more frequently.
It may happen that when the child pushes off the ground, their body moves backwards. This stage often precedes crawling forward and is excellent training, not only for the shoulders.
Of course, if we looked at child development in more detail, we could list a whole bunch of activities in which the shoulders have the opportunity to improve their stability (rocking on all fours, playing in a side position, pushing off the floor and moving to a sitting position, pulling up to stand, a bear position of peaking through the legs, pushing objects, etc.), but… that’s not the point here.
The most important thing is that we remember that shoulder stability happens GRADUALLY and that each stage of child development is extremely important, so it’s not good to rush anything.
WHAT SHOULD RAISE A RED FLAG?
Children with a weak shoulder girdle may:
- Have difficulty propping up (they can get impatient when lying on the tummy and reluctantly push themselves off the floor to the position of active support on straightened arms, usually only for a moment).
- Show signs of increased activity in the back muscles. If the shoulder girdle is weak and the child is unable to lean on it, you will see increased activity of the back muscles — the child pulls back the elbows, raises the head high, and lifts the hips up, instead of keeping them down.
- Avoid anything involving shoulder work — they are reluctant to push themselves to the position of active support on straightened arms, and when they lie on the back, keeping their hands up against the force of gravity for a longer time may be quite problematic as well.
- Have difficulties with shifting and holding the body weight to one side.
- Make rushed, messy, uncontrolled movements.
- Have other postural issues. This is due to the fact that weak shoulder girdles are rarely isolated problems. They are usually connected with limited control of the torso, shown when the child stabilizes the body position by moving the shoulder blades towards each other (it looks as if he or she was straightening the back by spreading the arms to the sides).
HOW TO HELP YOUR BABY?
If you suspect that your baby’s shoulders are not stable and it really causes concern, the best solution is to visit a physiotherapist who, if necessary, will prescribe a set of exercises appropriate to the needs and abilities of your baby.
However, as parents, you don’t have to remain passive in such situations. First and foremost, it’s worth keeping a cool head — such things happen and they don’t have to mean that your child will be undergoing physical therapy for months.
As it often turns out, even if additional visits to a physiotherapist are needed, they usually can be more good fun than strenuous training.
And… what to pay special attention to at home?
Certainly, the things to focus on are as follows:
- Encourage your baby to extend the arms in front of the chest. In the 4th month of life, while the child lies on the tummy, it’s good to show them a toy at the chest level and encourage them to reach for it.
- Encourage your baby to push off the floor. Try to make them enjoy lying on the tummy GRADUALLY! First, by laying the baby across your lap so that their bum is slightly lower than the shoulders; then by putting the child on your chest or placing a small rolled-up towel under their armpits.
- Pay attention to the QUALITY of the tummy position. The baby shouldn’t raise the head too high while pushing off the floor.
- Implement the rules of baby-friendly care and give the child various opportunities to increase stability of the shoulder girdle on their own.
- Play with shifting the baby’s body weight to the sides, pushing off the floor, in a side position, or carrying slightly heavier objects.
- Do not rush any activity — everything that is done slowly requires greater control…
CAN A WEAK SHOULDER GIRDLE SHOW UP LATER IN LIFE?
Definitely! As you know… THERE IS NO MOBILITY WITHOUT STABILITY, therefore, if the shoulders are not sufficiently stable, even hand movements can be affected by it.
This means that a child with a weak shoulder girdle can get tired very quickly while writing, drawing, cutting, or doing any other activity that requires precision.
That is why, if you suspect any kind of instability in your baby’s shoulders, it is advisable to deal with it as soon as possible.
Interesting facts:
- Stability of the shoulders is also significant when it comes to eating solid foods. The shoulder girdle, after all, is the base for the head, jaw, and tongue…
- If the shoulder girdle is weak and the child avoids propping up, the experience with “weighting it down” is small. This leads to lack of necessary feedback and then the whole sense of the body scheme is disturbed.
- The reluctance to lie on the tummy or the lack of propping on straightened arms may have causes other than a weak shoulder girdle. Difficulty with overcoming the force of gravity may be associated with reduced muscle tension or hypermobility. If this is the case, the child focuses not only on active support, but also on improving distribution of muscle tension, trunk stability, or on strengthening the muscles… So, it’s definitely worth looking at the bigger picture!
You may also be interested in:
Being a part of your baby’s proper development is an incredible adventure! Check out my e-book on fun playtime ideas to see how you can actively support your little one in their journey!
Sources:
- Bly, Lois (2011). “Components of Typical and Atypical Motor Development. Neuro-Developmental Treatment Association,” Laguna Beach: 2011.
- Matyja, M., Gogol, A. (2007). “Forecasting the Postural Development in Children Based on the Analysis of the Quality of Postural Tension in Infancy:” Child Neurology PL, Vol. 1 6/2007: pg. 32.
- Bly, Lois (1995). “Motor Skills Acquisition in the First Year:” Therapy Skill Builders.
