Q Are there any kinds of specific mistakes we parents make with our kids in regards to their bone, joint, and muscle health?  I know diet is huge, but what about general wear and tear on their bodies?  Should I be purchasing good quality shoes for my 7 year old daughter (who is not involved in organized sports, but she goes to P.E. and plays outside a lot)? Should my kids have inserts in their shoes?  Should I tell them to stop popping their knuckles, shoulder blades, and necks all of the time? I suppose what I’m asking you is whether or not you ever encounter injuries in adults (acute or not) which could have been prevented if they had made different choices in their younger years while their bodies were still growing. -George

A.  Thanks for your question, George!  This is a large topic to cover, but an important one.  As a parent, I want to insure that I do everything I can to help my child live a long, rewarding, and healthy life.  For the first time in history, today’s youth are expected to have lower life spans and more health problems than their parents.  This is primarily due to the rise in childhood obesity and diabetes.  It is projected that nearly one third of American youth will be diabetic in the coming years.  Worse than that: after only five years of diabetes, a person of any age will start to experience negative, and typically non-reversible changes to his/her health, including damage to nerves and the vascular system.  This problem is now at epidemic proportions for America’s youth.

As parents, we CAN make a difference!  The following recommendations can help to optimize your child’s body and health without excessive wear and tear.  (As for popping knuckles and other body parts, research is inconclusive about whether or not it’s harmful.  Don’t encourage it, and hopefully, over time it will become less habitual.)

• Encourage Daily Activity: My advice to parents is to encourage as many different kinds of activities as possible. This can be through organized sports or just for fun! Variety and fun is the key. Also, don’t have a child specialize too early. Contrary to popular culture to push kids to be professional athletes, realistically, the majority of kids will not become professional athletes someday. Let’s insure that they grow up to be healthy and fit. Our bodies need lots of different stimulus to develop. This is particularly true at a very young age, but it is also relevant even in later teen years. If your child likes soccer, great! Let your child play, but also try to encourage other movement based activities, too, such as bike riding or martial arts. For younger kids, time at the playground or just playing tag is wonderful. Think of it as cross training. We need it at an early age just like we do later in life!

• Have an Off Season: Many parents pack their children’s itineraries with year round sports and activities with one sport season to the next. This never allows the body to rest and recover. Not even professional athletes can compete year round. We all need an off season to recover, rest, and cross train. Use this time to have fun! Participating in volleyball to basketball to soccer to track, without any break for recovery, is a good way to over train which will likely lead to injury. It also tends to lead to burn out, which is the last thing we want as parents. Think long term when it comes to a healthy lifestyle and activity level. Keep it fun!
• Wear Appropriate Equipment: Make sure your child wears the appropriate safety equipment, particularly in sports which require head gear or helmets such as skiing, skateboarding, bike riding, and baseball. Most safety equipment offers fashionable designs. It is never worth risking injury to appear cool. Be safe!
• Wear Appropriate Clothing: Some children will outgrow their clothes before they wear them out. This can especially happen in the case of shoes. Make sure their shoes appropriately fit. In general, brands do not matter as long as the shoes fit. This includes wearing the right shoe for the right sport. If the child participates in track, take him/her to a local running store to be fitted for proper running shoes. (I would not go to Walmart or another local retailer expecting a similar quality of shoe.) If your child participates in soccer or football, buy an appropriate set of shoes for the sport as improper fitting shoes can lead to injury. If your child just likes to run around and be active, but isn’t involved in any particular sport, then a well-fitting pair of general athletic shoes from a department store would likely be fine. Inserts for shoes are probably unnecessary, but please seek advice from either a physical therapist or podiatrist if your child is experiencing foot pain or you’re uncertain if he/she needs inserts.
• Go Barefoot: Spending time barefoot allows the foot muscles to develop and encourages development of the nervous system as it relates to movement and balance. Make sure your child spends time barefoot, and not just indoors, but outside, too. Grass and sand are the best environments when barefoot.
• Stop Sitting and Start Squatting: We push our kids to sit in chairs way too early! Not only does poor posture occur, but sitting can affect many developmental growth stages, including hip development. Encourage your kids to get out of their chairs. Squat, bend, and move! Yoga for children is great for this as well. Children often go through bony growth spurts, which leads to muscle and tendon tightness and can temporarily limit mobility. Squatting helps insure proper muscle length in the lower extremities and assists with bone development and strength. (I will be addressing the importance of squatting in an upcoming blog post.) Yoga teaches the child great motor control, strength, and mobility. It can also be a time of peaceful mobility and reflection in our hypercharge world and can be a great cross training opportunity.
• Encourage Body Weight Exercises and Moderate Weightlifting: This may be controversial, but I’m not suggesting Olympic power lifting. This is an opportunity to set your child on a path of fitness and health for the long term. For a child, the goal should be to learn fundamental exercise and lifting techniques to use throughout his/her life. It is also critical for cross training, and these days, the options are limitless. Many schools offer before or after school weight lifting classes. There are CrossFit classes for kids and other exercise programs which teach body weight training (such as push-ups, pull-ups, squats, and TRX). As parents, we need to be diligent about getting our kids involved in this type of activity as they tend to play less due to cuts in physical education programs and spend less time on the playground. Lifting weights is appropriate for children of both genders when it is supervised by trained coaches, and the emphasis is on technique, not weight. The right age to start these activities will vary depending on the child’s physical and emotional development and desire to participate.
• Encourage Proper Nutrition: Variety is critical. Don’t eat the same food all of the time. To optimize your child’s health, vary his/her diet by eating real food (and when possible, organic). Better yet, grow your own in a garden! If the food comes in a box or has words I can’t pronounce or my grandmother wouldn’t recognize, then I don’t eat much of it. Review this great article to see what the food Pyramid should look like! http://www.bengreenfieldfitness.com/2012/01/why-the-food-pyramid-is-wrong/

Your child’s path toward a healthy lifestyle started before he/she was born.  What mom did when the baby was still developing in the womb continues as the child ages.  What we teach and demonstrate to our children is likely what they will do as they grow into adulthood.  Start by modeling the behavior that you want your kids to use in order to thrive.  It is never too late to implement new and healthier behaviors!  The earlier we start, the better it is for the child.  Encourage movement, activity, and be mindful not to project any negative body insecurities (particularly with girls).  The main goal should always be health and fitness and never a focus on appearance.

Thank you, George, so much for this question!  As parents, we CAN make a difference!

If you have a question that you would like featured in an upcoming blog post, please email contact@thephysicaltherapyadvisor.com.