A Unique Child

How to Help Children Avoid Long-term Back Health Problems

Used appropriately, technology offers a host of learning opportunities for young children – but accessing it can also lead to poor posture and, potentially, long-term back health problems. Lorna Taylor explains the issues and offers solutions…

Did you know that back pain is the leading cause of disability amongst the UK working-aged population? Its cost to the economy is more than hosting the 2012 Olympics every year. But it’s not just a problem for adults: recent research shows that increasing numbers of young children are experiencing back and neck pain. Many are seeking treatment, requiring medication and are increasingly absent from school because of it.

Children spend approximately 30% of their waking hours at school, and sometimes even longer in early years settings, yet there are no regulations to keep posture and back health in check, despite the numerous benefits to concentration, health and learning it brings. The latest statistics suggest that 72% of primary children experienced back and/or neck pain during the past year at school, while developmentally our youngest children are walking later. Together with the increasing number of under-ones needing treatment and physiotherapy stretches for tight neck muscles and associated Flat Head Syndrome, it’s becoming apparent that an awareness of back health, posture and motor development is important for those working in early years settings, from baby room to Reception.

This is particularly the case as studies show that children who suffer back pain are four times more likely to experience it as an adults – so prevention and the formation of good back-health habits during childhood are really key.

The trouble with technology

The spine is a vulnerable structure: it has to provide strength to keep us upright but it also has to be flexible to allow us to move. Growing spines are especially vulnerable and (as with adults’) are susceptible to cumulative strain injury, brought on over time, especially when awkward, prolonged postures are encountered – for example, those we often adopt when accessing ICT…

ICT now plays a huge part in our children’s lives, both in educational settings and at home – unfortunately, using it can see them hunched over handheld touchscreen devices or laptops, sitting awkwardly on the floor or on one-size-fits-all furniture. Society has also become more sedentary in general, and because children spend more time sitting in the car going to structured activities and to/from school, younger children have fewer opportunities to simply play and develop the core muscles they need to maintain a healthy spine.

How can you help?

1. Be healthy posture aware

For educators, it’s important to recognise what ‘bad’ posture looks like, to help prevent it becoming a long-term problem. A sidelong view of a healthy spine looks like the letter ‘S’ with three curves, rather than a single curved, damaging ‘C’ shape. Our heads are heavy and need to be efficiently balanced on top of our spine. From behind, a healthy spine is straight upright.

Children should be encouraged to adopt, and learning environments arranged to allow, healthy postures when sitting and standing. Tummy time should be provided daily for children under six months.

2. Limit harmful postures

Flexed, curved postures should be limited for children where possible; regular changes of position and movement should be encouraged. Have in mind a ‘30:30 stretch and wriggle’ – every 30 minutes, move and stretch for 30 seconds.

Limit floor sitting for Reception and preschool-aged children to a maximum of 10 minutes at any one time. Alternatively, allow them to move and sit with their legs in front of them, to alternate sides or sit on a posture-improving cushion. Keep in mind that if children are fidgeting, they are likely to be uncomfortable and are trying to adjust their posture. Could they stand up and move before sitting down again? They are likely to be more focused afterwards.

3; Use ICT safely

When using tablet equipment, use a protective case with a stand, or raise the tablet up so it is at an angle for viewing. If these devices are used on a flat desk or floor, a damaging, curved posture will be encouraged.

Laptops may be more portable but best practice suggests children and adults should use computers with the top of the screen level with their eyes. If using a laptop on a flat desk or table, raise the screen (on books or a stand) and use a separate keyboard and mouse. This applies at home too.

4. Find the right furniture

You should consider trialling and investing in quality, ergonomically designed furniture that supports healthy sitting. This should be seen as an investment in children’s health and concentration; avoid the cheapest ‘bucket chairs’ you can source. A PosturePad wedge cushion can also help with floor sitting and tummy time.

Improving back health

Encouraging physical activity and healthy eating can help to safeguard children’s back health – they play an important role in building up muscle strength and maintaining flexibility.

Physical Activity will likely already be an integral part of your day which is great. In Reception, remember to avoid restricting break and PE times, and encourage physical activity during breaks. Remember that children aged five should have at least one hour of aerobic exercise every day.

Other strategies

● Ensure adequate warm-up / cool-down before and after structured physical activity sessions.

● Incorporate movement and standing into lessons, where possible.

● Encourage adequate hydration. The shock-absorbing discs of the spine are 80% water, therefore adequate hydration is essential for optimum back health. Can you provide water stations and prompt children to drink?

● Continue to encourage healthy eating – a healthy weight/body mass index limits stress on the joints and muscles of the spine.

Although back pain is becoming more common in children, it should never be considered normal. All episodes of back pain lasting more than two weeks should be reported to a GP. Ask if anyone in your setting has back/neck pain – if they do, what do they think contributes to it? Encourage children to report any discomfort to a parent/carer.

Five steps for safer lifting

Technology isn’t the only risk factor. Young, growing spines are especially susceptible to injury from twisting forces, which can occur when pupils lift, carry and/ or move heavy or awkward objects incorrectly (this includes school bags). If children do move chairs, resources or equipment, do they know how to do it safely? Would your setting be covered if a child injured themselves?

Remind children of the rules for lifting objects safely (these apply for adults too)...

● Get close to the object you are lifting.

● Place your feet wide apart to keep yourself steady.

● Get a good grip on the object.

● Move down and up using your hips and knees, not your back.

● Use a smooth action when lifting (avoid rushing or twisting).

Known as a passionate and active campaigner for improved back health and ergonomics within the education sector, Lorna Taylor is a paediatric physiotherapist with over 12 years’ experience and the founder of Jolly Back.