stroller safety

Get into Pre-Baby Shape: Stroller Safety Edition

Celebrities make getting back into pre-baby shape look so easy! I’m sure you could too with your own team of nutritionist, nannies, personal trainers, and seamlessly infinite amounts of free time. Unfortunately, this is not the way of life for most people and those new moms who are looking to get in shape must utilize their time wisely. Often times this means dual-tasking: squats during trips back and forth to the laundry room, taking the stairs 2 at a time, jogging while pushing a stroller. So if you’re thinking about getting back in shape through some stroller jogging, here a few tips to optimize your workout and prevent injury.

Make the most of your stroller-based exercise with these safety tips:exercising stroller mom

  1. Good Posture – Good posture applies to more than static positions such as sitting and standing. When walking or jogging, it is important to remember to engage your core muscles to maintain an erect posture. This provides the base for all other muscles to work most effectively. When pushing a stroller, it is important to remember that you are pushing the stroller, not using it as a device to hold you up. A good rule of thumb is if you were to fall over if you let go of the stroller, you are leaning too heavily on it.
  2. Shoulder and Elbow Alignment – Once your core base is set, the next thing to look at is the angles at which forces are being relayed up to your shoulders and elbows. Ideally, your shoulders should be between 0 and 45 degrees of flexion and at neutral rotation. To find this position start with arms at your side. Bend your elbows to make 90 degree angles and point your thumbs to the sky. You have just now put your arms in 0 degrees of shoulder flexion and neutral rotation! Depending on preference, you can now raise your arms anywhere from at your sides to just below the nipple line for most people. This is the 0 to 45 degrees of shoulder flexion range.  When looking at elbow positions, the most important thing to remember is to keep those elbows bent! Once we lock out those elbows into full extension, we dramatically increase the joint compression force dealt to the shoulders, thereby decreasing the amount of overall arm muscle activation. This elbow extended position also tends to lead to leaning on the stroller. And as we previously talked about, this inhibits our ability to maintain a good posture. Ideally you should have between 90-135 degrees of elbow flexion.
  3. Scapular Stability – If you’re finding it difficult to keep your elbows bent and off your body, even though your posture is great, you may need to look to your shoulder blades to make sure they are providing the stable base needed for arm movement. The scapulae (shoulder blades) provide the bases for muscles further down the chain to work most effectively. Muscle fatigue in shoulders or arm muscles may be attributed to poor scapular strength. By working on scapular stability strength, you may be able to decrease shoulder pain and fatigue, and get more from your work out.

  Please seek medical attention if pain persists longer than 2 weeks or inhibits daily function.

Click here to learn more about what makes exercise so good for the body!



Alcoholism: A Disease that Affects the Family

Alcoholism is a family disease and therefore, the effects of this illness will inevitably impact all those within the family system. Not just the user is affected by the adverse implications that come along with addiction, the family suffers socio-emotional, financial, and physical burdens as well. Addiction is often times considered a secret and those who keep the secret are often deemed ill as well. In order to truly overcome this disease all family members, in addition to the abuser, must seek help to heal.Alcoholism

With that being said, how does one relinquish themselves from the throws of the horribly debilitating disease of alcoholism? To begin, it is critical to truly understand alcoholism and addiction for that matter. There are common misconceptions regarding “what an alcoholic looks like” or  “what an alcoholic does.” According to the National Council on Alcoholism and Drug Dependence, Inc.

Alcoholism, also known as alcohol dependence, includes the following four symptoms:

Craving- a strong need or urge to drink
Loss of Control- not being able to stop drinking once drinking has begun
Physical Dependence- withdrawal symptoms such as nausea, sweating, shakiness, and anxiety after stopping drinking, and
Tolerance- the need to drink greater amounts of alcohol to “get high.”

To suffer from alcoholism doesn’t necessarily mean that an individual is drunk around the clock, chronically with a beer in hand, or missing work daily to feed the addiction although these things can happen. Alcoholism can take the shape of many forms including an individual who doesn’t drink everyday but when they do, their actions negatively impact those around them. When it comes time to talking to your kids about alcoholism, this article is mainly geared towards addressing how your child perceives the family environment, their overall notions of safety, and their understanding of the behaviors of their parent.

As an adult, you may be aware that you and/or your spouse has a problem with drinking. If you are attune to this, chances are your kids are as well. Regardless of their age, create an open forum for this child to disclose their thoughts, feelings, and experiences. Don’t overshare information about the “behind the scenes” struggles but use this opportunity to take a pulse on what your child’s interpretations are of the situation, debunk any misinformation, and impart knowledge to problem-solve future experiences. For example, if your child appears ambivalent to invite friends over to their house ask them why. If she share’s that it is because of “dad’s evening temper or silly moods,” dialogue with her about how she feels when dad acts that way and what she can do to feel safe and comfortable during times of unpredictability. Also, knowing that this normal childhood activity can be a stressor, work with your spouse to ensure one evening that he can either be out or abstain to provide the environment conducive for a playdate or sleepover.

Every family and every experience looks different with regards to alcoholism. Talk early and talk often about your child’s interpretation of the situation to help understand their needs and concerns. Seek mental health services to provide another outlet for the child to talk about their feelings in a private and nurturing setting to facilitate advocacy of thoughts and emotions, to enhance problem-solving skill sets, and cultivate a solid sense of self despite negative self-thoughts that may be derived from their relationship with their challenging parent (i.e. “daddy drinks because I’ve been bad).

If you, or someone you know needs support for alcohol addition, please contact the National Council on Alcoholism and Drug Dependence, Inc.


What is the FitnessGram and Why Are These Standards Used in Schools?




For more than 30 years, children from 5 to 18 years old have been tested using the FitnessGram Healthy Fitness Zone standards. Parents often wonder: What are these standards and how do the calculations reflect children’s health and fitness?

The most I remember from taking part in the FitnessGram back in the day was trying to reach for my toes and then getting pinched in the back of my arm. But the FitnessGram is more than just a measure of body fat and flexibility. The test items are used to determine body composition and aerobic capacity in children. They present a multi-dimensional view of children’s health. The test items reinforce health-related fitness research. The results serve to teach students and parents that just modest amounts of physical activity can improve their performance. The program helps children and parents better understand and appreciate a physically active lifestyle. The assessment does not compare one child to another and it tests fitness, not skill.

So what are the test items in the FitnessGram and what area of fitness do they measure?

To measure Aerobic Capacity (The ability to perform big muscle group high intensity exercises for a long period of time, such as running, jumping, and walking):

  • PACER test, Progressive Aerobic Cardiovascular Endurance Run, is a multi-stage endurance test, with twenty-one levels that increase in difficulty as children run 20 meter laps that gets faster and faster with each lap.
  • 1-Mile Run tests a child’s endurance and is a great indicator of fitness
  • Walk-test also helps to measure aerobic capacity, or the body’s ability to use oxygen efficiently.

To measure Muscle Strength (the ability of muscles to exert an external force) and Muscle Endurance (muscles’ ability to repeatedly exert an external force without fatigue):

  • Pull-ups are a measure of upper body strength and endurance
  • Push-ups are a measure of upper body and trunk strength and endurance
  • Curl-ups are a measure of abdominal strength and endurance
  • Trunk lift is a measure of back muscle strength and endurance

To measure Flexibility (the range of motion across a joint and the ability for muscles to stretch):

  • Sit and reach tests for flexibility of the trunk.
  • Shoulder stretch tests for the flexibility of one the shoulder, which is one of the most flexible joints in the body.

To measure for Body Composition (the makeup of the body and the ratio of fat tissue to non-fat tissue such as muscle and bone):

  • Body Mass Index (BMI)
  • Skinfold Measurement
  • Bioelectric Impedance Analyzers

The results of the test classify children’s performance as Healthy Fitness Zone (HFZ) or Needs Improvement (NI) zone. Children who score in the Needs Improvement zone receive reports that let them and their parents know that their currently at risk for future health problems. Some children may even score in the Health Risk category of the Needs Improvement zone. If they continue to live a sedentary lifestyle, there will be clear and potential health problems. Overall, The FitnessGram has been widely accepted in schools as a great educational tool for parents, teachers, and coaches. It builds a strong healthy foundation in children as young as elementary school. The program teaches them, through a hands-on approach, that being physical active in childhood pays off later on in life.

Click here for more great fitness related posts!

Plowman, S.A. Muscular Strength, Endurance, and Flexibility Assessments. In S. A. Plowman & M.D. Meredith (Eds.), Fitnessgram/Activitygram Reference Guide (pp. Internet Resource). (2014) Dallas, TX: The Cooper Institute.
Plowman, S.A. & Meredith, M.D. (Eds.). Fitnessgram/Activitygram Reference Guide. (2014) Dallas, TX: The Cooper Institute.

Boy yelling

Top 10 Tips for Improving Vocal Health

Keeping our children healthy is something that every parent is concerned about, but many parents may not know that it is also important to keep our children’s voices healthy. To achieve voicing, our breath travels up to our vocal folds (vocal chords) which vibrate to make sound. We change the sound using our articulators (e.g., tongue, lips, teeth) to produce speech.

Most children engage in some level or vocal misuse or abuse, which can have long-lasting effects on vocal health. These behaviors can include excessive yelling, cheering or screaming; continuous throat clearing or coughing; or using harsh or hurtful sounds to communicate. Some health and environmental factors can also contribute to one’s vocal health, including pollution, smoking, infections, and reflux.


1)      Use “inside voice”: Modeling your own appropriate volume will help your child learn what is appropriate. Using an “inside voice” is safest to reduce any extra stress to the vocal system.

2)      Avoid whispering: Using a whisper voice can produce unnecessary strain to the vocal system and can result in damage to the vocal folds (chords).

3)      Boy yellingDon’t yell: Similar to whispering, yelling without adequate breath support can force the vocal folds together, resulting in strain or even vocal nodules (callouses).

4)      Try not to cough/clear throat: Excessive coughing or throat clearing also forces the vocal folds together, resulting in a harsh slamming of the muscles.

5)      Practice diaphragmatic breathing: Supplying the vocal system with adequate breath support is crucial to achieving healthy phonation (sound). Practicing diaphragmatic breathing, or “belly breathing,” can maximize breath support, allowing for longer and clearer sounds. Inadequate support can result in a hoarse/harsh vocal quality.

6)      Avoid talking over people/things: As with yelling, talking over people or television can result in using a louder or yelling voice.

7)      Talk in quiet environments: Avoiding noisy environments can help to maintain adequate volume and healthy voice. When in crowded restaurants or on playgrounds, children naturally raise their volume to be heard.

8)      Reduce pollutants/environmental stressors: Pollutants, allergies, and asthma can all contribute to vocal health. Keeping air irritants and allergies to a minimum are essential to promoting a healthy voice.

9)      Drink lots of water: Just like any other mechanism, our vocal system needs to stay lubricated. Drinking lots of water and staying hydrated can enhance vocal production; conversely, not drinking water can be harmful to our vocal system.

10)   Avoid caffeine: Most children don’t drink caffeine, but it is important to note that caffeine is very drying to the vocal folds and consequently can reduce vocal health.

push-ups child

Benefits of Strength Training With Kids

What exactly is strength training?

Strength training, or resistance training, is a way to increase muscular strength where levels of resistance are increased over time. It can be done with free weights, weight machines and resistance bands. Strength training can also be performed with activities like tug of war or climbing in the playground where resistance is provided by the child’s own body weight.

Is it safe?

According to the American Academy of Pediatrics strength training is safe for children when specific guidelines are followed. Strength training can
be unsafe for children when unsupervised. The US Consumer Product Safety Commission’s National Electronic Injury Surveillance System reports that most injuries related to strength training occur while children are at home unsupervised. Injury rates are much lower with supervision and knowledge of appropriate technique. Children should avoid body building, power lifting and maximal lifts, but that does not mean they cannot perform other strength training or weight lifting exercises.

Guidelines proposed by:

The Official Journal of the American Academy of Pediatrics, The American Orthopedic Society for Sports Medicine and The National Strength and Conditioning Association.

1. An evaluation should be performed by a pediatrician or family physician.

2. push-ups childSupervision is always required by an instructor with an approved strength-training certification with an instructor to student ratio of 1:10.

3. It is recommended that strength training should start after the child has postural control and good balance, usually around 7 or 8 years old.

4. A 10-15 minute warm up and cool down must be done before and after every session.

5. Always begin with low resistance until technique is perfected.

6. When 8-15 reps can be performed properly, weight should be added in 10% increments.

7. Include all muscle groups, and perform the exercise through full range of motion. Workouts should last 20-30 minutes, 2-3 times/week (more than 4 X/week can increase injury risk).

8. Remember to also include an aerobic component to any exercise routine. The Journal for the America Academy for Pediatrics also reports that children will benefit more from participating in sports than from strength training alone. For maximal health benefits, strength training should done along with an aerobic training program.

Some benefits from strength training include:

– Improved sports performance

– Increased bone mineral density

– Improved cardiovascular fitness

– Improved posture

– Improved body image

– Improved motor skills


Won’t strength training stunt my child’s growth? According to the American College of Sports Medicine, there is no evidence that supports stunted growth in kids who strength train in a safe and supervised environment. Strength training programs have no documented effects on growth. That does not include competitive weight lifting however, the American Academy of Pediatrics is more cautious when weight lifting is competitive and does not recommend power lifting, maximum lifts and body building for children.

Children are unable to increase muscle strength due to low testosterone levels. Children can still become stronger from strength training without the muscle hypertrophy that adults will have (bulkiness). Strength gains will still occur through an increase in motor neuron firing with each muscle contraction. In simpler terms, the brain will send more signals to use that muscle and therefore the muscle contraction will be stronger.

Father Consoling Child

Helping Kids Cope With Siblings’ Health Issues

Illness and injury of a child can impact an entire family, especially healthy siblings. Whether the changes include extra doctor visits, therapy visits, or hospitalizations, the healthy sibling’s life will be effected in some way.

Healthy siblings can display a wide range of feelings and emotions which may include:

Here are some ways to support these well siblings and help them through their feelings:

  • Be honest with them about what is happening.  Share your feelings so they know it is okay to share their feelings.
  • Give your time, not gifts.  Set up specific times to spend one-on-one with the healthy sibling. Try marking them down on a calendar so that younger children have a “visual” to remind them.
  • Continue daily routines.  Keeping (as much as possible) a normal schedule for mealtimes, school, homework, chores and bed time can help the child/teen stay focused and on task.  Work with the healthy sibling to design a calendar or schedule to keep posted so they know “what is when”.
  • Try to prepare for changes in the house.  If a parent will be absent from the home, a babysitter or family member may come in to help.  Let the sibling know this in advance and set up rules/guidelines so everyone is on the same page.
  • Keep teachers informed of changes.  This will help school understand if there are behavioral issues and will allow them to be sensitive and understanding to the situation.
  • Validate the feelings of the healthy sibling. Reassure them that they are not to blame and it is okay to feel the way they feel.

If you would like to seek out extra help, North Shore Pediatric Therapy has an experienced Social Work team that can help work through the various emotions and behaviors.

The Power of Yoga for Children

Yoga has become an increasingly popular form of exercise over the past few years. So much so that on every street corner there seems to be a new yoga studio advertising a variety of classes and programs. Yoga is practiced by people of all ages and skill level. The benefits of yoga, especially for children, are countless. Below are four of the reasons children should practice yoga.

1. Motor Planning

Yoga poses vary in complexity. While your child twists and turns their body to match the pose of the group, they are creating motor plans in their brain for these movement patterns. Creating and refining these plans are what help a child to improve their overall coordination. For children just learning the practice of yoga, try to practice poses where they hold the left and right sides of their body in the same position (down dog, cat, cobra). Once your child is able to efficiently assume these poses, try a few that require them to move the left side of their body differently than their right (triangle, tree, or warrior poses).

2. Strength and Endurance

Once your child has motor planned their way into a yoga pose, encourage them to freeze in that position for a predetermined duration of time without losing their balance or dramatically swaying from side to side. As their body endurance and balance improve, increase the duration they are required to sustain the position. Holding these static poses will help to improve your child’s muscle endurance.

3. Attention

Sustaining poses for predetermined durations can also help to improve your child’s attention. Holding the same pose with a steady and still body for even three seconds may prove to be a challenge. Try to choose a duration of time for your child to hold a pose that challenges their attention but that they also have a chance to be successful in completing. Once they master the ability to hold a pose for a shorter duration of time increase the challenge by a second or two to see if they can maintain a still and focused body.

4. Social Skills

Yoga can be a challenging form of exercise but it can also be a lot of fun. Working together with friends or classmates to practice and refine yoga skills offers vast opportunities for promoting social skills including flexibility of thought to participate group classes, active listening, turn-taking, imitating and replicating group dynamics, and identifying personal role in group activities.

In the coming weeks, especially while it’s still cold outside, look into kid-friendly yoga classes in your community. If you would rather, there are also some excellent videos and yoga cards that you can use in the comfort of your own home. “The Yoga Pretzel Cards” by Tara Guber and Leah Kalish are an excellent tool for practicing yoga with really colorful illustrations for kids to practice with. No matter the way or place you choose to do yoga, remember the cardinal rules for practice: breathe in, breathe out, and namaste.


How to Recognize Childhood Depression


How can you tell the difference between your child just having a rough day or week versus a more serious mood issue? We all have the occasional bad day, but when a child’s mood or behavior changes so significantly that it begins to interfere with their overall quality of life, depression may be present.

In addition to persistent feelings of sadness, key indicators of childhood depression are as follows:

  • Anger and irritability
  • Changes in sleep patterns (sleeps more or less than usual)
  • Changes in weight (gain or loss)
  • Difficulty focusing or concentrating
  • Social withdrawal or isolation
  • Guilty or worthless feelings
  • Feelings of hopelessness, helplessness
  • Loss of interest in previously enjoyed hobbies or activities
  • Low energy and fatigue
  • Heightened fear of being rejected
  • Crying and other vocal outbursts
  • Physical symptoms (i.e. stomach aches or headaches that are not responsive to other modes of treatment)
  • Thoughts of death or suicide

For example, if your child has previously loved school and valued completing homework and now has become resistant towards going to school and failing to complete assigned tasks, this would be a red flag that something deeper is going on with your child.  Your child does not need to meet every criteria listed above in order to meet depression diagnostic standards.  If depressive symptoms are present for at least 2 weeks, it is important to contact your medical and/or mental health care provider. Factors that may contribute to depression include family history of depression, interpersonal conflicts, or life event changes. The good news is that depression responds to mental health treatment. Cognitive-Behavioral therapy alters the ways in which a child views the world. Children and their therapists can address underlying messages and assumptions that the child has about him/herself and the world in order to re-create a more positive and realistic framework from which to function within. Depression is more than just feeling sad; it is a low-mood state that affects all aspects of daily life and functioning.

6 Health Benefits of Basketball for Children

Ever wonder which team sport keeps boys and girls busy no matter their age, skill level, or the season? I recently had the opportunity to watch one of my clients play basketball with his middle school team, and it was so rewarding to see him transfer skills we worked on during physical therapy to the court.  Basketball is a high-intensity, high-agility activity that teaches children coordination, concentration, and cooperation.

6 Health Benefits of Basketball:

  1. Endurance: As with any high intensity sport, there are many cardiovascular benefits of basketball.  Between bouts of running, jumping, dribbling, and bouts of rests, kids are participating in total body interval training without even realizing it. Interval training boosts aerobic capacity, energy levels, and metabolism, which in turn helps kids concentrate more in school.
  2. Motor Control: The ability to control our limbs in space may come naturally, but being able to pass and shoot with precision during a basketball game takes special training and repetitive practice.  Performing drills on and off the court with a basketball enables children to grade their muscle forces, control the position of their bodies in response to an opponent or a pass, and plan out successful movement sequences.
  3. Ankle Stability: All the agility training, cutting back and forth, multidirectional running, pivoting, and turning within a basketball game are great ways to challenge our lower body muscles and joints, especially the structures surrounding our ankles.  Organized basketball teaches kids safe and successful ways to block, pass, steal, jump, and run without hurting themselves or others.  Ball sports such as basketball are great for reinforcing kids’ balance reactions and balance strategies and prevent future injury.
  4. Balance/Coordination: As with most team sports, basketball requires upper body coordination, total body coordination, and hand-eye coordination. Dribbling, catching, passing, and making baskets require planning, precision, and quick reactions. Walking backwards, turning, or running while dribbling a ball and at the same time paying attention to other players is a challenging but interesting exercise for coordination and body awareness.
  5. Agility: Basketball is a fast paced sport where athletes have to think fast on their feet and respond quickly to plays that could change momentum and direction at any minute.  Young athletes are working on mental drills in addition to physical techniques. Basketball enhances children’s agility due to the swiftness needed to dodge other players and make aggressive plays.
  6. Social Skills: The great thing about team sports is the level of discipline and communication needed for success at the games. Young athletes learn from an early age how to work in a team atmosphere, pay attention to others, and respond accordingly. An athlete needs discipline to attend practices and pay attention to the rules of any game.  Team sports prepare children for necessary social interactions later in life.  Through these sports, children understand shared responsibility, team work, how to deal with triumph and defeat, all of which are applicable throughout life.

Click here to read about the health benefits of another fun winter sport: hockey!

Recipe of the Month: Nutrition Powerhouse Smoothies for Parents and Kids

Smoothies are a great way to pack a lot of nutrition into something that tastes like a treat. They can be part of a meal or a post-workout snack. These recipes include four of the five components of The Healthy Plate Model:  protein (yogurt), calcium (yogurt), fruits, and vegetables. All of these smoothies promote healthy digestion since they contain fiber (fruits and spinach) and probiotics (yogurt). Kids love drinking something that is colorful and comes with a straw. Plus these are so tasty, they won’t believe how healthy they are! Smoothies are also a healthy option to eat while on the go. Hope you enjoy these!

Berry Blast

1 cup frozen mixed berries
½ banana
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow berries to sit at room temperature for 20 minutes for easier blending.

Recipe makes 1 serving. Provides approx 245 calories, 8 grams protein, 6 grams fiber, 277 mg calcium.

Green Monster

1 cup frozen mangoes
½ banana
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow mangoes to sit at room temperature for 20 minutes for easier blending. This smoothie will be green, and giving it a fun name like “Green Monster Smoothie” makes kids more likely to want to try it (it worked with my kid!).

Recipe makes 1 serving. Provides approx 285 calories, 8 grams protein, 4.7 grams fiber, 277 mg calcium.

Immune Booster Digestive Aid

1 cup frozen pineapple chunks
1 clementine orange, broken into individual pieces
¾ cup plain, organic, whole milk yogurt
1 cup loose baby spinach leaves

Put all ingredients in a blender and blend until smooth. If desired, allow pineapple chunks to sit at room temperature for 20 minutes for easier blending. Pineapples and oranges both provide vitamin C. Pineapple also contains a natural enzyme called bromelain that aids in digestion.

Recipe makes 1 serving. Provides approx 242 calories, 9 grams protein, 4.7 grams fiber, 274 mg calcium, 116 mg vitamin C.

Click here for healthy twists on your child’s favorite foods.