“Increased tension of the shoulder girdle.” When parents hear such a diagnosis, they often come to see me. They tend to be lost and confused, asking themselves, where does it come from and what can be done about it?
Let me explain this issue.
If you have ever tried to dress a newborn you know perfectly well that putting sleeves on those adorable, little arms is almost impossible. 😉
The baby usually keeps the arms so bent that straightening an elbow or pulling the arm up in order to put it through a sleeve is a real challenge. 😉
Oh well. What can you do…
It gets easier after a few months, although it does not mean that dressing your little one suddenly becomes less difficult. 😉 Your baby will most likely try rolling over by then. Forget about peacefully changing diapers on the changing table. 🙂 Not to mention the insanity of changing diapers practically on the run, which is going to happen sooner than you think.
OK, but let’s get back to the topic. 😊
It is natural for a newborn to hold bent arms close to the body. After all, that is how they were positioned in the womb. 😉 What’s more, the way that muscle tension is distributed throughout the newborn’s body is as follows:
The torso of a newborn is not very stable and their arms and legs are very tense. The child cannot move individual parts of the body independently. What it means is that the movement of the head, an arm, or a leg causes a reaction in the rest of the body.
Over time, this changes and the torso begins to provide a solid core for the head, arms, and legs to move independently of each other. As a result, the baby starts to look around and reach out for a toy using both hands.
This strengthening of the core happens most often around the 4th month of life.
Around this time, getting the top half of your baby’s body dressed (including sleeves!) should start getting easier. 😉
TENSE SHOULDERS – HOW TO TELL THERE’S A PROBLEM?
Having a hard time dressing your baby, even though your little one is getting older, is just one of many things that you might notice. You can spot that something is not quite right when you see that your baby’s shoulders are raised up. What I mean by this is that when you look at your little one from behind (when he or she is lying down, sitting, or even walking) you may notice that the shoulders are very close to the ears and it is difficult to see the baby’s neck. Other things that could alarm you are difficulties with reaching for a toy, ungraceful movements, difficulties keeping the arms under the shoulders during tummy time, clenched fists. The baby might also dislike having his or her shoulders touched or they may resist if you want to raise their arms over their head.
A tense shoulder girdle is often a result of difficulties associated with external rotation of the shoulders or difficulty with proper sliding of the shoulder blade…
Yeah, right… English please! How on earth am I supposed to notice that??
OK, I know it sounds complicated. However, most often you can notice these things when the baby sets the shoulders high up, and when lying on the tummy, after 3 months of age, their forearms are not moved forward, but are still tucked under the chest. Such children may, for example, get into the all fours position, but while crawling they will position their fingers inward. They may also have a hard time catching and holding a large beach ball with open hands. When holding a toy, their thumbs would be constantly pointing down.
WHY DOES THIS HAPPEN?
Of course, if you have any doubts, let your child’s pediatrician know so that he or she can guide you further if necessary. However, if a neurological examination did not show any abnormalities, then the cause is most likely less complicated than you think. 😊
A tense shoulder girdle is never a problem in itself, but rather has its cause somewhere else. So, for example, knowing that a stable torso is the basis for relaxed movements “around the periphery,” take a look at your baby in that regard.
Maybe tense shoulders are just one of the ways for your baby to control their posture, which in a sense compensates for the unstable torso? Or maybe your little one’s individual muscle groups do not cooperate with each other efficiently enough. For example, a baby at the end of 3 months of age still has difficulty lying on the tummy in an active way. Or maybe for some reason he or she does not like to be touched. Reflux can also be a reason – the receding food content irritates the mucous membrane of the esophagus causing pain and burning, and you may have an impression that your child is tensing up.
I could go on giving more examples. As you can see, it is necessary to look at the baby as a whole, and not focus only on one symptom.
It’s worth remembering that a red lamp should light up only when the child stiffens the shoulders at all times. If, on the other hand, you sense that your baby is tense when crying or when cold or, for example, makes the first attempts to maintain a new position, then it’s a completely healthy symptom. 😊 Who wouldn’t tighten up a bit when trying something new and not that easy? 😉
TENSE SHOULDERS – WHAT CAN IT INTERFERE WITH?
Tense shoulders can negatively affect basically every activity of the baby. Even those you probably wouldn’t associate directly with the shoulder girdle in the first place. For example: walking. Very often, the adventure with walking begins with the work of the shoulders.
WHAT SHOULD YOU WATCH OUT FOR?
Of course, there is no universal “set of exercises” that would solve the problem of tense shoulders. Every child may need something different, and this can only be assessed during an individual visit at a physical therapist’s office. However, there are a few things to keep an eye on:
- First of all, pay attention to how you care for your baby – that is how you carry, lift, and roll over your little one. Why? Because these activities take up most of your baby’s everyday life. Babies learn through experience and as a result you as a parent might sometimes unwittingly cause your little one to tense up.
A simple example – lifting your baby.
If you lift your baby from the crib by putting one hand under their head and the other under the baby’s bottom, you suddenly take away a large base of support from underneath his or her body. It’s a known fact that support plane means stability. When you take stability away, the child looks for other forms of postural control and, for example, begins to tighten the shoulders.
If it happens once or twice, then it’s OK. However, if it occurs constantly, the baby might consolidate such a pattern.
If, on the other hand, when lifting the child, you roll him or her to the side and make sure that the support plane is still big enough, the baby won’t probably even notice the his or her position has changed. 😉
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- Now, take a look at how you carry your baby. Does your child have to flex his or her shoulders in order to maintain the position in which you carry him or her? Or does the position allow your little one to join his or her hands in the center of their body and put them in their mouth? When babies play with their hands in front of their chests and look at them while doing so, they work very hard on integration of the muscles. 😉
- Another important issue is making sure that your little one has enough opportunity to activate the torso. The muscles of the torso engage more when the baby is lying on a relatively hard surface. A soft mattress or prolonged stays in a bouncer that “envelops” the torso may contribute to the fact that the deep muscles do not sufficiently stabilize the child’s body posture and he or she will need an additional form of control. Of course, the child needs a variety of experiences and the parent’s chest or lap are also great places to encourage development, but it is good if playing on the mat is also on the list of daily activities. 😉
- Pay attention to what playtime activities you do with your child. For a 4-5-month-old baby it is crucial to reach for a toy and bring his or her eyes down. Knowing that, show your little one a large ball at the level of the navel in order to motivate your baby to look at it and embrace it with their hands. Pay attention to whether your child starts to express interest in his or her knees, legs, and feet. Keep in mind that for a child at this age it is important to be able to PUSH their hands into the floor. So when planning playtime with your baby, pay attention to whether pulling movements do not dominate. PUSHING INTO THE FLOOR.
This is just the beginning. 😉
OTHER PLAY IDEAS?
You can try to roll your baby, to get their body weight onto the shoulders. Some other good ideas include: clapping hands, reaching for the feet, embracing the baby’s torso with your hands and raising the arms by sliding them on the floor on both sides of baby’s torso while the child is on the back. Later, the hands should come back down in such a way that the baby brushes his or her face with the palms of their hands. Of course, none of this can be forced. If the child starts to fuss you should stop what you’re doing.
REMEMBER, HOWEVER: it is always worth looking for the cause of increased muscle tension within the shoulder girdle, because only then you will be working most effectively. Obviously, the best exercises are those that are tailored to the needs of an individual child. Also, do not be surprised if you go to the therapist who, instead of focusing on the shoulder girdle, will, for example, work a lot with the torso. Actually, that would be a good sign that shows a comprehensive approach to the problem. 😉
Having a baby is challenging and FUN! You can make the best of it by having a GREAT TIME with valuable PLAYTIME IDEAS for every day! 😊
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