Body Positions for Therapeutic Benefits!

Sit up, don't slouch!

Why are you lying on the floor?

You don't need to hold up your head. 

Postural instability is a common reason we see children slouched, or propping themselves up or falling over.  There may be other reasons too but today let's talk about postural stability...

We talk about core muscle strength as being "the sturdy central link in the chain connecting your upper and lower body".    Core muscles describe both the muscles which assist with stability as well as those which enable trunk movement. 

In order for our children (and us) to use our limbs (arms and legs) we also need those joints connecting to the trunk (ie. the shoulder for arms and the hips/pelvis for legs) to be strong.  We need stability for mobility.

We need to be able to use our arms and legs separately and together. Individually as well as cooperatively.  This involves bilateral coordination as well as a established trunk rotation and crossing the midline  A separation of the upper body from the lower body is needed too.

We need to move and sustain our movements against gravity. In self care, our arms need to be raised so that we put on a jumper.  Our legs need be raised individually to put on or take off pants.  These actions work against gravity whilst keeping the body stable. 

Balance and coordination also come into play with postural stability. Mature balance and equilibrium responses also minimize the need for primitive reflexes.

Controlled movements of our arms and legs then develop into controlled movements of our hands and feet.  We then look at the stability and strength from our elbow and wrists for fine finger movements.  We look at stability from the knees and ankles for our feet and toes.

We also gradually reduce the base of the support (eg. legs wide apart to shoulder width apart).  This helps a child to reduce the need for abduction and external rotation at the hips and shoulders.  In turn, this helps with controlled movements. 

To SUM up... to achieve postural stability and strength, we need to be placing our body in different positions whilst we play or work! 

Yoga is highly valued for mindfulness as well as gentle stretching to work on stability and mobility. It is an excellent way to incorporate a change of body positions throughout the day. 

 We can also intentionally try a variety of positions that can have therapeutic benefits! Here is a list below. 

Body Positions!
When choosing a body position, also consider your placement of toys or activities.  You may place toys or items on the floor, a low height table, a high table or on a vertical surface.  Perhaps you have items placed on two different surfaces to allow for movement between boday positions. 

Also take caution that these positions are not recommended for babies under 12 months old. Older toddlers should also be supervised.  These recommendations are for preschool and school aged children. 

Single leg or Tall Kneeling. 

• This position encourages an elongation of the back and trunk, activating core muscles.
• This position stretches the pelvis into a neutral position. 
• This position encourages use of the upper limbs with a stable base. 

​Adults have long used kneeling chairs to work with at a desk. Some find this position more comfortable than sitting or standing. 

Four Point Kneeling.

• This is the "get ready for crawling" or quadruped position. 
• Crawling is a wonderful way to build bilateral coordination whilst developing strength, however if we stay in the four-point kneeling position for activities, there are also many benefits. 
• In this position the weight can be distributed between the arms and lower body with hands and knees planted on the ground.  Rocking forward and backwards can also be calming as weight is transferred. 
• In this position the core muscles are activated to maintain your back straight against gravity (back not too arched and tummy not too rounded). 
• In this position the knees are aligned under the pelvis (and not too wide apart). 
• In this position the shoulder and neck muscles are activated with stability and strength. 
• In this position the head and neck can turn from side to side, up and down; working against gravity.
• As your child gains stability in the position, you can increase the difficulty with one hand and the one leg lifting from the ground.  You can try the opposite arm and leg (eg. right arm and left leg). This will challenge stability and strength. 

Long sitting.

• Long sitting allows for a wide base of support with legs extended during sitting. 
• Gradually bring the legs from spread far apart closer together, reducing the base of support and developing balance skills. 
• Encourage use of the arms and hands whilst sitting in the position. 
• Encourage midline play and trunk rotation to reach objects. 
• Avoid leaning back on one arm. Rather lean forward to align the head over the trunk. 

Side sitting.

• Side sitting is an alternative body position that does require good balance and trunk control. 
• The position places the body in asymmetry (not symmetrical) which encourages more upper body movement. 
• Encourage use of the arms and hands whilst sitting in this position. 

Squat to stand

• Maintaining a squat position can be difficult to encourage a squat to stand by positioning items at different heights.
• Squatting can help to develop bone density.
• Squatting can relieve the pressure on knees and ankles, whilst building leg and hip strength. 
• Encourage an upright head and chest. 
• Discourage leaning forward and avoid the knees going over the toes.
• Modify this position by doing a squat against a wall (wall sit). 

Standing

• Standing engages the back, core and leg muscles and can improve posture. 
• Standing encourages placement of activities on a vertical surface which can build shoulder and arm stability. 
• Standing can encourage crossing the midline with trunk rotation. Discourage shuffling of feet or leaning to one side. 
• Encourage a small base of support with feet shoulder width apart.  

Prone 

• Prone or the "tummy time" position will strengthen neck, shoulder, arm and trunk (front and back) muscles.
• This position encourages reaching and pivoting skills.
• The elbows are can be points of contact for stability, freeing the hands for play. 
• This position can be achieved with the use of equipment such as a scooter board, gym ball or even a rolled up towel. 

You may have heard that children should avoid "W sitting"! 

This position is often used with very young children to gain a wide base of support. It is not problematic if they also move into other positions voluntarily. 

However, if the "W sitting" extends beyong toddler years, there can be associated difficulties.  They continue to need this wide base of support to compensate for weakness in joints, mucles and bones.  Read more about "W sitting" with this excellent infographic by North Shore Pediatric Therapy. 

How?? 

• Start with short time periods with a preferred activity. 
• Try the position together! Lead by example.
• Try multiple positions in one day (or during one therapy session). 
• Incoporate the position into a natural choice. 

Which positions are you going to try today? 

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
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