We keep cutting down on kids’ play time so they can do “more important” things. But this West Coast mom of four writes:
Dear kiyesdbfkk
Free-Range Kids:Today I took my son to the pediatrician for his annual physical. He’s 11. I mentioned the slight turn in of his ankles that I had noticed and wondered if that was cause for concern.
She told me his was slight and caused by weak hip flexor muscles.
She also told me that it’s a common issue and she’s seen some quite severe, and if you’ve ever seen kids who look like they’re walking on their arches, you have too.
Nutshell is that kids are being so inactive that they’re actually causing structural damage to their little frames!
This problem can lead to arthritis and knee issues down the road.
My son had gotten more sedentary going into middle school and becoming more interested in computer programming. He’s going to be sent outside a lot more. More jumping and squatting and running is the prescription to correct this.
We’ve kept our kids so under wraps, we’re causing warping of their frames. How messed up is that?!
Made me think of Free-Range.
Here’s a picture example. https:// rootcausemedicalclinic.com/wp- content/uploads/2016/04/ pronated-foot_optimized.jpg
Jessica
I wrote back to say I hope it’s reversible!
Yes, it’s reversible since it’s a new weakness but I guess it can become permanent.
Walking to school might help but she emphasized big movements, I’m assuming because it’s hips.
She said “power bursts” were what strengthen it. She suggested he play leap frog with his siblings.
So in kids, it really is all about play. As adults we go to the gym and do squats or whatever but kids should be doing this just through natural occurring play.
Has anyone else seen this particular issue? Doctors? Parents? I’m hoping it is rare, but I like the prescription. — L.
.
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44 Comments
My five year old cousin was recently diagnosed with juvenile rheumatoid arthritis. I have no evidence that one could cause the other, but he is ALWAYS (ALWAYS ALWAYS ALWAYS) indoors and playing on a tablet.
I think you may have your cause and effect mixed up, Angie. Juvenile rheumatoid arthritis in an auto-immune disorder. It’s not caused by inactivity. If anything, the inactivity is a result of the pain from the arthritis.
I would encourage her to look into MovNat. It’s a system of natural, functional movement. I wish I had been exposed to it as a child, it would have helped me enormously.
Eleven is a hard age–I remember that age as being the age when “naturally occurring play” kind of tapered off for me, because I was getting older, and moving away from childhood, and towards becoming a teenager. I still built forts in the woods with my brother, and biked/Rollerbladed around the neighbourhood when I was allowed, but I also remember it being a time of first bras, first school dances (although my first dance was actually at summer camp), sneaking peeks at teenage magazines that were too mature for me, and discovering popular culture in a bigger way than I had before. All of those activities were necessary for my development, but mostly pretty sedentary. Anyway, maybe it’s different for boys, but at that age, I chafed at being told to “go play outside,” because I hated being treated like a child. So, I’m going to go against the Free-Range grain here, and suggest getting input from Son as to what kind of physical activities he wants to do–maybe martial arts? Winter is coming, so skiing or snowboarding might be fun, or ice skating if there’s no place to ski nearby.
As for the comment about adults going to the gym and doing squats, et cetera, eleven might be a good age to start teaching Son how to use the gym. It might be a bit early for most chain gyms, but our YMCA here starts Youth Wellness at age ten. Kids pass two levels of the course (Level 1 to use the cardio equipment, and Level 2 for the weights machines, and some places even have a Level 3 for free weights, but we don’t). Anyway, after completing each level, the kids are given a coloured wristband to wear when working out, so the YMCA staff on duty know that they’re old enough to be using the adult workout equipment. The kids love it too; they see working out as a special, fun, adult privilege, which is why I used to love helping to teach Youth Wellness. Anyway, if Son is still too young to work out at the gym, there are tons of free workout videos on YouTube; some with male instructors. I love PopSugar Fitness and Yoga With Tim.
Kids shouldn’t need a gym that’s the whole point. They are supposed to get all they need from natural play. We have gone the other way around to now teach, natural, functional movement, because everything has to be “a class” now. Also, machines do not allow full development of all the muscles and only move the body through a very narrow, limited range of movement.
“She also told me that it’s a common issue and she’s seen some quite severe, and if you’ve ever seen kids who look like they’re walking on their arches, you have too.”
Not sure if it’s exactly the same thing, but it seems like I’ve noticed a lot of kids walking splay-legged since the turn of the century. I don’t remember that at all in my youth.
I’m not a fan of scare tactics, but I have no problem frightening my audiences with the fact that the first signs of arteriosclerosis are showing up at age 5. That 40% of children 5 to 8 show at least one heart disease risk factor, including obesity and hypertension. That 6- to 10-year-olds are dying of sudden cardiopulmonary arrest. That the CDC predicts that American children born in the year 2000 face a one-in-three chance of developing Type 2 diabetes — a disease that until fairly recently was called “adult-onset” because it was so rarely seen in children!
There’s more, but you get the gist. And much of this can be traced to children’s sedentary lifestyles. It’s a matter of priorities. Do we want to protect children from phantom fears, or do we want to protect them from very real risks to their health?
Hip flexor issues are no laughing matter. For people who sit all day (as in watching TV or playing video games), these important muscles weaken and can’t support kids’ (or adults’) frames. That’s an extreme case, but it speaks, as noted to the lack of physical activity.
As mammals we are not supposed to sit still all the time. This is why recess is so important in school. Aside from the chemical benefits of being active, the muscular and skeletal benefits are imperative. Fear of injury and lawsuits are compromising the safety and health of our kids. Go figure.
Kids NEED to be active and creative. I’m not suggesting seeing how far up the stairs you can jump from and then crashing into a bookcase, which causes the Hummel figure to fall off and shatter. That may just be from my brothers and me, but there’s probably other, normal, kid-directed activity that will keep kids a lot healthier.
I often say, “When was the last time you saw a kid in a cast because he or she played too hard?” Now, obviously, we’re not wishing injury on any child, but this is a great example of how over-caution and not letting children be naturally active, creative and push boundaries hurts them in more ways than one.
Actually, here in the 21st Century, see if you can combine the two. There are some fun bluetooth sensor kits out there (as well as the sensors in a phone). Tell him to make his own pedometer, speedometer, etc. Accelerometers are pretty neat things…
Back when I was 11, computers were kept in their own buildings. I would literally run from school to the computer center (a distance of about 2 miles) which was great exercise…
>>Kids shouldn’t need a gym that’s the whole point. They are supposed to get all they need from natural play. We have gone the other way around to now teach, natural, functional movement, because everything has to be “a class” now. Also, machines do not allow full development of all the muscles and only move the body through a very narrow, limited range of movement.<<
Stacey, I agree with you, but I think that, in this particular case, it'd be best to put "should" and "supposed to" aside for the sake of practicality, because this is about a child's health. An eleven-year-old boy isn't going to want to play leapfrog with his siblings. Saying "go play outside" isn't that helpful when there might not be any other kids to play with, and when "outside" is confined to the yard, because the parent is afraid of either child abduction, or busybodies calling the police or child protection because they see a school-aged child roaming independently, even if he's going to a specific place–which isn't even always possible, if the letter writer and her family live in the depths of suburbia, where there isn't much within walking/biking distance. Also, it's almost fall, and the days are getting shorter, and all too soon, it'll be winter, and it'll start getting dark around 4:30 p.m., so, that doesn't allow for much outside play after school, if the letter-writer doesn't want her son playing outside in the dark. So, with that in mind, I'd find an activity (or maybe a few different activities) for Son to do. Besides, some organized activities can spill into free play and "real life." For example, child who plays organized soccer or basketball, might start organizing "fun" games on the playground at recess. A child who takes gymnastics might go home and start doing cartwheels on the lawn. A child who takes dance, might start choreographing their own dances to music. A child who takes martial arts, will be able to defend him-or-herself in a dangerous situation. A young person who knows their way around a gym/health club is going to feel more comfortable going to places like that as an adult. My point is, I don't think all organized activities are bad, and if there's an underlying health condition that can be corrected with increased physical activity, I'd address that before going on a mission to try to "save" free play. Besides, there's a good chance that Son finds it painful to run around with pronated feet, and once that problem gets cleared up (even if it takes an organized activity to clear it up), he'll start becoming more active of his own accord.
I think it’s really sad that 11 yr olds “grow out of” playing outside, that’s far too young in my opionion. Also, we make kids do crappy things all the time school, homework, choes ect why don’t we simply make them go oit and play and be kids?
They can always grow out of play and grow into some manual labor. 11 is old enough to begin helping around the house (if he isn’t already) – mowing the lawn, tending flower beds, helping with small repairs, etc.
If he gets too stubborn about going out try a Wii game . some involve movement. I met a physical therapist that use one to move his patients bodies so it can’t hurt much.
My almost 6-year-old has a pretty severe natural pronation and I know it’s not from lack of activity! Part of it could be genetics, because I was a dancer when I was young and had the same issue, and I still have it to a lesser degree, because when I’ve been fitted for running shoes, my fitter suggests shoes to make up for a slight pronation.My trainers and PT have recommended theraband exercises, which are easy to do, when I remember to do them!
I don’t fully understand how the hip flexors are the problem with ankle pronation. (Might the doctor have meant foot/ankle flexors?)Every anatomy book I’ve ever encountered (during my years as a dancer, my time as a runner, and studying to be a group fitness instructor as an adult) has indicated that strengthening the foot inverters and everters help with this. Supination and pronation have the same origination — muscular inbalance.
The problem with this imbalance in the lower legs is that it can have a deleterious effect on the knee and hip (problems with the feet almost always end up causing problems up the body.) I agree that he needs strengthening exercises, but there’s no real reason to blame an age-old problem on lack of fitness. We had foot pronation issues in ballet in the 70s so it’s not a new thing.
Primarily hanging around homeschoolers, I typically don’t see them growing out of “playing” until 12/13 or later – schools really do bring the pop culture social pressures (and sexuality) in much earlier than seems to be “naturally” occurring with most. I will say, though, that not all kids are naturally big players. Several of mine are much more interested in legos, games, reading, and dolls than leap frog and tag – and I’d imagine it has always been that way, at least to a certain extent.
I think we are a society of extremes. I understand that there are more kids with sports-related overuse injuries than ever before because they play league sports – hard – year round (and isn’t that in part because college has gotten so crazy expensive that parents are desperately hoping that their children will get sports scholarships?). And then there are the kids who aren’t doing ENOUGH movement to stay healthy!
Jennifer, my friends and I weren’t even homeschooled and this how it was. Oue 8th grade summer was sort of a “last hoorah” of being a kidif you will until pt jobs, driving ect. I thought this was the norm shocked to find out it’s not.
When will humans stop denying that we are animals.
Throughout the rest of the animal kingdom play is how the young learn and grow. Anyone that has seen puppies or kittens knows this. It is the overwhelming arrogance of the human species that has people believing we don’t need play.
My kid has ankle pronation and hip issues. We did physical therapy and he wears inserts in his shoes…don’t know if this is enough or why he has this problem in the first place. No one mentioned that it could be inactivity. He’s somewhat naturally athletic, but certainly doesn’t spend time running around the neighborhood–there’s no one to run with. This year we signed him up for a competitive swim team so he can burn some energy off, because it’s become clear that it’s not going to happen naturally. My other kid has different foot issues and hasn’t picked up the skills and stamina that he should have by age 10, so we took him out of public school (so sedentary) so he could have physical activity every day. I’ve accepted that for my kids the physical stuff isn’t going to just happen naturally, so we’re making time for it. Interestingly, they don’t have video games or phones, they just have other indoor interests.
I understand about having indoor interests, that’s fine we spent time indoors too. Interestingly enough the reason i’m so passionate about getting kids out and about and playing and playing for longer is necause I was born with a physical disability, i know how hard it is. Kids are just so lucky that they can get out and run and play, i just hate to see kids who don’t or abandon it way too early. It’s hard to watch kids doing things you wish you could.
Yes, but if it saves them from being sold on the sex slave market, it’s worth it! Arthritis and knee problems are nothing by comparison. Besides, people can get sued if we allow children to play.
Again, arthritis is not caused by inactivity. If anything, excessive activity can cause wear and tear that causes osteoarthritis. Other forms of arthritis are caused by genetics, viruses and auto-immune disorders.
“My five year old cousin was recently diagnosed with juvenile rheumatoid arthritis. I have no evidence that one could cause the other, but he is ALWAYS (ALWAYS ALWAYS ALWAYS) indoors and playing on a tablet.”
This is the problem. It can’t be proven that this was the cause. The results of an inactive lifestyle are difficult to measure. On the other hand, test scores are accessible. It’s easier to make a decision (more academics, less recess) if we have measurable facts to back them up.
Life is all about revolving your life around a potential future court case. If the kids suffer as a result of this, SO WHAT?
It’s safer to assume that kidnappers are on every corner and will pounce the moment that you take your eye off of your child. In the same way, it’s safer to assume that there’s a lawyer on every corner that will pounce on you at the drop of a hat.
Going barefoot would help as well. With many things. Most kids are overshod
I still played well into my teens. I know many 13, 15 and even 18 and 20 year olds NOW that play and are active. I despise seeing age as a cop out. You can grow up without becoming sedentary and without doing ‘adult’ type exercise. Kids are still kids. The only thing that has changed is how they’re marketed to and parents and the kids buying into it. Turn off the screens and get back to normal.
My daughters’ natural state is barefoot. My husband grew up on a ranch, so a lot of free play but with all of the ranch stuff like poop and nails one learned to wear shoes, so he is so insistent about shoes.
I’ve said it before here, but I take my girls to the playground and they show up kids twice their ages.
And really, why don’t we see kids with casts anymore? I’m a teacher. I rarely see a kid anymore wandering in one morning with a cast and a big grin and this crazy story to tell and his classmates tripping over themselves to sign said cast.
I also played later in life. Scout camp. Being a counselor at Scout camp. It’s what you did in the evenings and weekends. Our camp was on a mountain in the middle of nowhere. The nearest towns were all tourist towns with lakesy-woodsy things to do. You played. No matter how old you were.
Unfortunately, a boy this past summer at my own beloved camp was paralyzed after falling out of a tree we had all climbed before. Very sad, very tragic. But 50 years of this camp and this legendary tree and one accident? The news comments were horrible. “People shouldn’t climb trees!”
Rebelmom, great post! I couldn’t agree more.
Re: growing out of playing, I think it really depends on what you like(d when you were younger) and what there is to do in your area… If you never liked ball sports and all the playgrounds are meant for little kids and there are no climbable trees around, then it can be difficult to find something fun to do outside…
Also… When I was a kid, I honestly didn’t care one iota if my clothes got dirty or ripped, so I never hesitated climbing trees or whatever. When I was a teen, however, that changed :-/
I suppose it can ne a little more difficult as a kid gets older, depending on the kid. Maybe my opinion is simply nased on personal experience, but i didn’t find it very hard to be a kid (teen ) and play outside, i even grew up in a small town.
>>Re: growing out of playing, I think it really depends on what you like(d when you were younger) and what there is to do in your area… If you never liked ball sports and all the playgrounds are meant for little kids and there are no climbable trees around, then it can be difficult to find something fun to do outside…
Also… When I was a kid, I honestly didn’t care one iota if my clothes got dirty or ripped, so I never hesitated climbing trees or whatever. When I was a teen, however, that changed :-/<<
Yeah, that was me as a kid. I didn't like ball sports, tag, et cetera, playgrounds get boring after a while, and I liked ice skating as a kid, but my feet grew to be too high-arched for skates. As a result, voluntary physical activity for me was pretty much confined to swimming lessons (pretty much year-round), and downhill skiing with my dad and my brother (on weekends in the winter). I also liked kayaking at summer camp, but I was only there for a few weeks each summer–two weeks at first, and then it grew to four. Anyway, it's fairly easy for me to get my exercise now, as an adult, through non-competitive physical activities like yoga, Zumba and other dance fitness, strength training, Pilates, ballet fitness/cardio barre, and even more traditional things like walking or running outside, or swimming. I also get myself to most places I need to go, by foot or bicycle.
Now, when I was a kid, I didn't have a whole collection of free exercise videos on YouTube, and most exercise videos on VHS and DVD were aimed at adults. I couldn't independently get myself to and from the YMCA or the recreation centre to swim, until I was probably ten or eleven for the rec centre (walking distance), or twelve for the YMCA (had to bus there), and this was before Youth Wellness type courses, so I couldn't join in fitness classes or use the adult workout areas at the gym. I wasn't allowed to walk or bike around independently, weekly ski outings definitely required adult transportation as well. So, I didn't get as much exercise as I needed. Nowadays, fitting exercise into my daily routine is easy, but that's because I have a lot more options now. It's not even just that I have more resources to exercise independently, but nobody's going to gawk at a grown woman doing yoga (or whatever), because that's socially acceptable. An elementary-school-aged child who likes yoga (or whatever) might get made fun of for that.
And then there is this:
http://www.cnn.com/2017/09/11/health/sitting-increases-risk-of-death-study/index.html
Seriously, we as a society sit way too much, and kids sit more now than ever. My 13-year-old son sits glued to his computer or tablet as long as he can get away with it, and yes I know it’s my fault, but now when I try to get him to get up and move, he gives me this look. I think you know the one if you have teenagers.
We joined the YMCA so he could exercise more, but I’d rather see him get out and move and get some sunshine, too. But I keep getting that look whenever I suggest anything as horrific as getting off the computer for a few minutes every half hour or so.
Corrected link https://rootcausemedicalclinic.com/wp-content/uploads/2016/04/pronated-foot_optimized.jpg
Tbh, I started growing out of playing when I was around 11-12 also, and this was in 1983, when the electronic/indoor entertainment options were much fewer. I remember still occasionally riding my bike that year, but by the time I started middle school in the fall, I just wasn’t interested anymore. My middle school had a daily P.E. class and I was on the cross-country team, so I was still getting plenty of exercise, but there was no way I would have gone outside at home and played hopscotch or leapfrog like a little kid (there’s obviously nothing wrong with that, but 11-year-old me wouldn’t have thought so). I think there’s a middle ground between hitting the gym like an adult and playing games that seem childish to a preteen–maybe something like indoor rock climbing or laser tag?
Sometime last year I read on a major news site that children of today do not have the strength or endurance their parents had at their age. I attribute most of that to the cyber generation. Computer and video games. I also attribute some of that to crazy school policies that demonize parents for allowing their kids to walk to school and the elimination or minimization of physical education classes in many schools.
BUT finally when a very physically fit child who exercises, be it gymnastics or weightlifting or triathlon training, etc., is featured on the news or on YouTube, it really pees me off when people scream “child abuse.” Really? Where is their logic? Is every truly positive thing children do nowadays considered “child abuse”? Goodness, we have a generation of overweight and sedentary children and not to mention, a larger number of children with type 2 diabetes than we had years ago which is projected to impose a huge burden on the health care system years from now when these same children become adults. But finally when we see an active kid with healthy exercise habits, people scream “child abuse”? Now do they say that about parents who take their kids to McDonald or KFC 3 times a week? No or rarely.
So we very illogically assume that a child with above average strength and above average endurance for their age is worse off than an overweight child with type 2 diabetes. People just blow my mind. While we put out these grim statistics on the physical fitness of today’s children, at the same time, we discourage children from being physically fit.
Vanessa, there is obviously a middle ground and if you were that kind of kid that’s cool, everyone is different, but I wasn’t implying older kids go out and do “babyish” things. When we were out as older it certainly
wasn’t leapfrog or playing house or something like that.
@Vanessa–I agree. I think “Free-Range” is more nuanced than just sending kids outside to play. If they say they’ve outgrown “playing outside” for its own sake, but they’d like to bicycle to the library, or walk to a friend’s house, or join the cross-country team at school, like you did, or something like that, I think that’s valid. I wanted to do those things, but my parents just told me it was too dangerous, or that I was too young, too irresponsible, et cetera (and I wasn’t a “bad” kid). However, they did encourage me to play outside, in the yard, or ride my bike or Rollerblade, in the driveway, and the thing was, I’d enjoyed those things when I was younger, but by the age of eleven (or even ten, or nine), I was sort of “past” that stage, and ready to move on to something else. I think your suggestions of indoor rock climbing and laser tag are good ones. 🙂
@John–I think kids should be encouraged to be active, but at a certain point, it definitely crosses the line into child abuse. Were you alluding to this particular news story, of young teenaged girls being forced into splits at cheerleading camp? https://www.youtube.com/watch?v=kN02LUftyNY I think that counts as child abuse, because forcing someone into the splits (or any other position that their body isn’t ready for) can cause lasting physical damage. There are stretches that can be done to gradually (and SAFELY) develop the flexibility needed for a split, and routines can be re-choreographed so that those who aren’t able to do splits, do something else instead, and it’s so much easier to do that, than to repair a torn ligament. Even independent of physical injuries, the psychological trauma of being forced into a painful position by a “trusted” adult in authority, could put those girls off of physical activity in adulthood, whereas if they build happy memories of participating in sports in their youth, then they’ll be more likely to remain active throughout their lives.
Esmond-White has several series of functional stretches that correct a lot of skeletal problems even better than chiropractors and physical therapists did–for me. He websites use the words Classical Stretch, and she also has Aging Backward.
@Emily:
No, I wasn’t referring to that story and yes it can venture into child abuse. The problem is, we’ve over reacted to the point where ANY kid with above average strength and above average endurance from doing exercise MUST have been abused. So now, kids huffing and puffing and sweating is considered “child abuse”. Goodness, what a bunch of horse-plop! If there is a positive outcome, how was he being abused?? Now obviously that gym teacher was going waaaaay overboard in conditioning his students for splits to the point where he was making matters worse and physically hurting the kid. That’s where the line needs to be drawn. But the problem is, because of that case, now ANY gym teacher who pushes his students even a little bit will be accused of “child abuse”. So in typical American fashion, we over react because kids were involved. The truth is, kids do need SOME pushing if they want to improve their flexibility and physical fitness. That’s why they have coaches!
Just saw this today. I have inflected ankles, where my feet stick out to the sides. It escalated into a massive problem with pain while I was in college studying geology, which was when a physical therapy student found what was going on. I distinctly remember him pointing out wear on the outsides of my shoes from the way my feet twisted. It subsided after I stopped hiking rough terrain, but I still wonder if it will cripple me some day. I don’t think lack of exercise was a part of my problem, since I always have walked regularly. I suspect once it did set in, more exercise mostly made it worse.
Had it all my life. Was very active kids. Suffer every day as an adult . Buy you kid good shoes and teach them gait conciousness. There maybe hope but playing outside is not a sure fix.
“Kids shouldn’t need a gym that’s the whole point. They are supposed to get all they need from natural play.”
I must say that when I played outside (in the field or the forest), I used mostly my legs and hands muscles. Running, sitting, walking, bending, looking for bugs etc. I climbed a bit on some rocks or fences, and sometimes trees, but not often, and not that much. Didn’t work much my upper body. In playscapes (which are not that natural), it’s easier to develop upper body strength (monkey bars, the firemen pole, climbing up ladders with the aid of your arms) etc. I always had weak arms, I was able to carry stuff, but that’s mostly back strength. My arms became stronger when I had a baby, and had to carry her everywhere, but it was also limited. So everyday activity (for kids and for adults, including outdoor play) doesn’t necessarily work all muscles.
Still, I cringe at the idea of kids going to a gym. Heck, I cringe at the idea of adults going to a gym, it never looks like a welcoming place for me. It seems such a bad place to be in, no fresh air, bad TV, bad music, machines that look like a torture dungeon (it’s not that I think that working them is so much of a torture, they just look this way). Not to mention all the negative emotions that come up: boredom, shame, constant comparison, judging or feeling judged, feeling like you’re on a meat market (as a buyer or seller, or feeling that there is a meat market, but you’re not even invited to participate). Plus the possibility of bad body smell and sweat. I know it’s personal, and many people feel inspired and motivated in such a setting, but I really get turned off any workout just by looking at how it looks…
I was born with my hip bones turning in, causing my feet to turn in when I walked (right was worse than the left).
In my case it was something that happened in the womb due to awkward positioning. It can also happen during the birthing process due to wee baby bones being soft.
I recently read doctors are seeing an increase in this again due to more parents wearing their babies like accessories. It makes sense. I see nothing wrong with putting your baby in a sling (I forget what the carriers are called) from time to time but some do seem to be using them too often or for extended periods.
It makes sense that lack of activity of too much time in one position could cause problems.
The little guy should be able to correct it. At 4 years old I was given the option of Forest Gump shoes or a year in a body cast after surgery. I picked ballet. You can only tell my feet turned in when I’m laying down now. The right foot still leans in when relaxed.