Faith@Work

Journey Article smallTiffany Higginbotham, MS PT, OCS owner of Body Logic Physical Therapy was featured in the March 2018 River Region’s Journey magazine article titled, Faith@Work.  Body Logic PT was honored to be a part of this.  Thank you so much Journey magazine.

 

The Power of Play

One thing that I am always trying to convince parents, teachers/educators is the importance of children moving and moving often. We tend to think of learning only occurring in our brain, and don’t really understand how critical movement is to that process. All learning utterly takes place in the brain, but it is through movement that learning really occurs. All of us are born with a set of primitive reflexes in our brains that make us neurologically normal. These reflexes make our bodies physically do things automatically until our cortex (high brain) is mature enough to accomplish this on its own. These reflexes are what make us go through normal developmental sequence, what we refer to as motor milestones. This is why we all sit up and crawl and walk at approximately the same time in our lives.  When a child goes through normal developmental sequence, and spends adequate amounts of time playing on their tummy, they establish the necessary skills to move on to the next developmental level.  They then begin to creep on their bellies and finally come up onto all fours and crawl. Crawling up on all fours, where the right arm and the left leg advance forward at the same time, is what we call a normal cross-crawl pattern. This pattern is the first real coordinated movement that we do as humans, where we are coordinating the left and right sides of our bodies simultaneously. When we use both sides of our bodies at the same time, it begins to connect the two sides of our brain hemispheres, thus better organizing our brain. Crawling also allows these reflexes that we mentioned earlier to “go to sleep” in our brain and allows our postural reflexes (which we have for life) to emerge. A child really needs to spend approximately 4-6 months crawling up on all fours to accomplish this. We always say “crawling is critical” and it is the foundation on which reading, writing, and attention are built. It begins to organize our brain in a way that facilitates all future learning and processing.

Another area of concern for me as a physical therapist, is the total change in play behavior over the last several years. Children just do not play the same anymore. We have changed from having to beg our children to come inside, to having to force them to go outside. Even as little as 15 years ago, you would have never seen a child who could not swing, skip or do a forward roll. It is now almost an epidemic.  Just like crawling is critical for your brain and learning, normal play is equally critical. A child needs torun and jump and spin to develop sensory systems that are absolutely essential to learning. Two of these systems are our vestibular and proprioceptive systems.

Our vestibular system is basically our inner ear. Anyone who has suffered from a bout of vertigo definitely understands the important role of this system. It is basically our sense of balance and ability to “feel righted”. We develop this through running, jumping, bouncing, rolling, spinning, hanging, swinging…PLAYING. A child needs to be doing all of these things regularly in order for their vestibular system to give their brain normal feedback. Believe it or not, the highest form of balance is the ability to sit perfectly still. If we allow a child to move a lot early, we give their bodies and brain the skill to be able to sit still later. Otherwise we might be in a scenario of, “I can sit still or I can listen, but my brain just won’t let me do both.” So the next time your grandchild is driving you crazy, spinning around in circles trying to make themselves dizzy, remember that they are developing their vestibular system.

The proprioceptive system is very similar and works very closely with the vestibular system. This is truly our sixth sense and it is our only sense that is active 100% of the time. Our proprioceptive system is housed in our muscles that run along both sides of our spine as well as in all of our tendons and ligaments in and around our joints. The pull of gravity on this system allows us to know where we are in space relative to me and relative to my surroundings. We know that when an astronaut goes into space and leaves the earth’s gravitational pull, they lose all sense of where they are. They cannot discern what is up, down, front, back, etc. If I don’t know where I am in space, then all spatial relationships begin to break down from that point forward. I would literally be living with no point of reference. A child with an under developed proprioceptive system would never be able to tell you, “I feel like I just don’t know where I am in space,” but that is exactly what their little brains might be feeling. We predominantly begin to develop this system, initially through tummy time, preparing and strengthening those muscles along our spine, and then through rough and tumble play. A child’s body needs to feel the sensation of activities such as: pushing, pulling, landing, falling, etc. If we over parent and alter their environment so much as to try and insure that they will never fall down and get hurt, their little sensory systems will suffer greatly. I am a physical therapist and have certainly seen tons of nasty injuries from careless, unwise activity, so I am certainly not endorsing that. However, we need to let our children be children and to play normally. We need to let them push their limits ever so slightly and be willing to let them fall down a bit. The amount of sensory input back to a child’s brain when they do what we call “climb and crash” behavior is absolutely necessary. This is how a child actually learns what their limits are in the first place. A child needs to jump off something just a tad too high and think “Uh, that was a little too high,” This helps develop their propriocecptive system which then gives them that critical reference point that they desperately need.

Most therapists and educators will tell you that we have all seen an increase in processing and sensory issues in children over the last several years. There are numerous theories as to why this might be, but I feel that it has been a bit of a perfect storm rising. Let’s say baby boy Jack did not spend adequate time on his tummy and was placed in too much “baby equipment”. Maybe Jack did not crawl long enough or in a normal pattern. Jack then becomes a preschooler and is in an environment where he is predominantly sitting rather than playing. He spends the majority of time at home in front of various screens (TV, IPAD, XBOX, IPHONE, etc.). Jack then becomes school age and the cycle continues of more emphasis on early reading requirements with cut backs made to both recess and physical education. Jack is left with a body that is uncoordinated, has poor core strength and balance, and a vestibular and proprioceptive system that did not mature through normal development and play. Jack might be smart enough to compensate for all of these deficiencies, but some kids are not. Jack’s cortex (high brain) should be completely freed up to just learn and store information in the right places. However, his high brain continuously gets diverted to help his low brain do things like sit still in his chair, hold himself upright, hold his pencil, track his eyes…things that Jack’s high brain should never really have to do. It is a constant scenario of “robbing Peter to pay Paul” and it catches up with most kids eventually.

There is a huge correlation between physical and cognitive readiness to learn. When I watch a child move, it gives me a little window into the organization of their brain. When our bodies work better, so do our brains. So a child who is uncoordinated, exhibiting fine and gross motor delays, poor posture and balance, may be telling us that they have an immature central nervous system that may not be ready to learn. In the past we relied on children “developing their bodies” through normal play at home. With the emergence of technology constantly at our children’s fingertips, this is just not the case anymore.

So, what do we do?! What is the answer? Obviously more research needs to be done to support the case for purposeful movement and its effect on our brains. I and Dr. Erin Reilly, AUM Kinesiology professor, conducted a six week study at a local school’s aftercare program. We had children ranging from 4-12 years of age that spent approximately 20 minutes, 4 x a week, for 6 weeks performing group exercise. The movements were all “purposeful”. We combined typical therapeutic concepts that address the systems mentioned above, as well as normal motor skills that you might see in physical education. We saw an 11 month increase in the children’s mental age in just six weeks. Even the children that had no physical deficits upon initial screening increased their mental age. Based on this research we developed an exercise class called Brain Pump™, which we regularly run at Metro Fitness.  We play fun music and games that specifically target all of their sensory systems as well as elevate their heart rate to a level that research shows the brain is most stimulated. It is in an enriched environment with other children and seems a lot more like playing than exercising.

So what does this tell us? Children need to move and they need to move a lot. We need to put our babies down on the floor and let them creep and crawl and we need to send our older children outside to play. Parents and grandparents should limit the use of technology and baby equipment. I don’t think that gaming systems or baby equipment are inherently bad for our children, but what is your child or baby NOT doing when they are playing video games or sitting in that exersaucer? There is no judgement here. I am the first to admit that there have certainly been numerous days that I have over utilized baby equipment and technology just to keep my sanity as a mom of three. These things are helpful and are great additions when used in moderation. But sometimes we as humans intervene a little too much. Let your child move and play naturally as they would without baby equipment and technology. Their brains and bodies intuitively know what they need and they will do it automatically if we will just let them. This creates a child with a coordinated body and an organized brain that gives them a foundation and love for both moving and learning that we just can’t separate. Because after all, our heads are actually attached to our bodies.

Tiffany is a physical therapist and owner of Body Logic PT and Wellness, an outpatient PT clinic inside of Metro Fitness. She treats people of all ages with orthopedic and neurological deficits.

It’s all in the name…

Ok, so this might be my first blog ever, so be gracious. We opened the doors of Body Logic PT & Wellness a little over 3 months ago now. What a huge blessing it has been in my life so far. I am so very thankful for all of the family & friends who have encouraged us, believed in us, and prayed for us!  You know who you are – keep doing it!  So, for the last few months, people keep asking “What’s up with the name “Body Logic” and the logo – is there a meaning behind it?”

Hunker down, cause here goes the long version.

First, I wanted to communicate the idea of “Body”, to convey treatment of the “whole body”, the whole person.  No one is ever just a back or a shoulder – you have a heart, a soul, a mind, a body…… a person is attached to those things. If there is one thing that I have become more and more convinced of over the years it is this- If we start to separate problems out, and not treat people as one “unit”, we tend to end up with more problems and never get to the root cause of things.

Second, I wanted to communicate the idea of “knowledge”- thus the word “Logic”.  I wanted to convey knowledge in several different areas. Obviously, I need the necessary knowledge as the clinician, knowing and understanding your problems and why you came to me, but hopefully developing a relationship that goes much deeper than that.  I am not one who separates professional and personal all that well – I am pretty much the same in both areas.  So, I want to get to know you and you know me- I enter your life and you enter mine. The PT /patient relationship is intimate, much more so than a lot of other medical relationships. I will spend a large amount of one-on-one time with you and in that time we will get to know and understand each other better.  My hope is that people enter as patients, but always leave as friends.

I also wanted to convey “knowledge” for the patient.  If you don’t understand what is going on with your body and what we are trying to accomplish with therapy, I have not done my job and you will be less inclined and motivated to comply with the things I am recommending to you. But, if I teach you exactly what is happening, and you understand and take ownership of it, then you are much more empowered to do what is necessary to get better.

There is also a component of knowledge of myself, so I will get personal for a moment.  I know that may sound a little goofy, but it is part of the place that I have come to now, personally and professionally, that led me to open my own clinic.  I am almost 42 and have practiced about 18 years now. For approximately the last 14 years, I have worked part-time in several different clinics, mostly for friends that owned private practices. I have had 3 children during that time and have never apologized that my family has always been my priority.  I have worked at about 20 different PT clinics and with probably a hundred different therapists over the years. I have had the unique experience of gleaning little bits from all of these experiences, and letting them mold me.   I am eternally grateful for all of the clinicians who have inspired me, mentored me and poured into me over the years.  I now am at a place of being comfortable in my own skin, better understanding & embracing the areas God has gifted me and letting go of the areas that he has not.   I am much more aware of my own limitations and realizing that I cannot help everyone, and being thankful for the humility that it brings.  So…….. I now have a better “knowledge” of who I am as a wife, mom, daughter, sister, friend and physical therapist, and how all these parts of me fit together and hopefully make me a better PT.  I pray that I have become more compassionate & loving and have hopefully wasted less time being prideful, judgmental and at least a little less worried about what others think.   I trust God a whole lot more, worry a little bit less and trust the process and the path, wherever it may lead.

So, why the gear?!! Well it goes back to the things I have already mentioned – all things working together. All PT’s are at least a little mechanically inclined,  so we get the idea of a gear – how our joints work, basic physics, but also the continued idea of treating the “whole” person. A single, one toothed wheel is worthless – it must be combined and meshed with others in order to be a productive, fully functioning gear.  Thus our bodies, all parts of it, must work together to do the same- everything is connected.

It is the same with us as people and professionals.  We need each other and are dependent upon each other. We were never meant to function in isolation but were created for community.  Alone, a one toothed wheel is left unproductive.  But, perfectly place us together, and watch us become something much bigger than the sum of the parts.  I have learned that oftentimes, several different wheels must be inserted to REALLY help someone- different clinicians, physicians, disciplines, philosophies, counselors, teachers, etc.  Some wheels may be larger and play much more substantial roles, but they all are necessary and work together to hopefully produce the needed outcome.

So, for me, this is Body Logic.   It is knowing myself as a person and a PT, knowing you as a patient and a person,  knowing what you may need, what I can offer, and then placing all of those wheels together to hopefully begin  healing.  For me, ultimately, it is the opportunity to be a small part of infusing HOPE into another person’s life and for that, I am eternally grateful.

But…… I promise that if you ask me this question in person I will just say, “Because it sounded and looked cool”.

Tiff