Why Is My Baby Not Crawling or Rolling? Parents Need To Test Their Baby’s Lower Trunk Side Bend
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Hey There Proactive Parents! I'm Dr. Lauren Baker, your go-to pediatric physical therapy bestie, and I'm thrilled to share some invaluable insights on helping your babies move with confidence, especially in rolling and crawling!
Today, we're diving into the magical world of helping your little ones learn to roll over (or crawl!) focusing on enhancing trunk mobility in a gentle, effective way.
Grab a cozy spot, and your favorite warm beverage (my current favorite is LMNT hot chocolate with some coconut milk!) and let's embark on this journey together.
Understanding Trunk Mobility
If this is your first blog post that you’ve read on my website, you might not know this but trunk mobility is BY FAR one of my most favorite topics to explain to parents.
The reason is because it's crucial to baby development, especially as a baby learns to roll over belly to back and back to belly. It’s the first time that as a parent, you might notice that there is a struggle, if they are lacking trunk mobility.
But often, parents are not educated that their babies even need trunk mobility, let alone that it’s essential for them to have in order to roll or crawl or heck even get from sitting into all fours to attempt crawling!
If your baby tends to favor one side such as only rolling over their left arm but not their right, or struggles with pivoting on their belly to the left or right, they might have a tight muscle preventing full range of motion.
With crawling, it can limit crawling all together or it often shows up as hitch crawling or booty scooting, both of which are not ideal ways for babies to crawl (we want hands and knees on the floor, and if they’re not moving in that way, then we want to know why!).
Hitch Crawling or Janky Crawling is when a baby is crawling with both hands on the floor, but only one knee. Typically the other knee is up near their trunk and their foot is on the ground. Typically THAT side of their trunk (the side of the foot on the ground) is tight.
Booty Scooting is when babies scoot forward/backwards on their bottom. This is typically due to multiple underlying reasons, one often being trunk tightness.
But don't worry, today we’re here to learn one option for helping babies resolve this tightness!
Total Motion Release (TMR)
Total Motion Release (TMR) is a gentle, innovative approach to improving mobility without the traditional stretching methods that might cause damage to the muscles. Traditional stretching pulls on muscles to lengthen them, which can cause micro damage to the muscle fibers, often resulting in soreness.
The TMR technique focuses on utilizing your baby's easier side of movement to encourage relaxation and increased mobility on the tighter side. It's a game-changer, especially for babies, as it's non-invasive, pretty relaxing, and highly effective.
Key Points of TMR:
Focuses on the "easy" side: TMR targets the side where movement is more effortless, enhancing mobility without strain.
Gentle and effective: Unlike traditional stretching, TMR avoids potential muscle damage, making it ideal for babies.
Recommended professional evaluation: It's best to have your child evaluated by a trained provider before attempting TMR techniques at home see this list of tmr trained therapists to see if there is one in your area.
How to Test and Apply TMR
Testing Side Bending Range of Motion:
Lie your baby on their back
Use the "C" hand shape (watch video for full explanation) by placing your fingers and palm on your baby’s buttocks with your thumbs between their legs
Gently guide your baby's pelvis towards one side like you are sliding along the floor (do not lift at all, keep full body in contact with the floor) until their trunk makes a “C” or backwards “C” shape. If the baby’s trunk does not easily make a C shape, stop at the level of resistance.
You may need to place your foot between their armpit and trunk on the opposite side if their upper trunk is trying to move away.
Identify the easier side: Observe which side your baby bends towards more comfortably, this is the easy side. If both sides go easily and make a full C shape at the trunk, the baby likely does not have any tightness in this direction. See our other directions of TMR here: category TMR link.
TIMESTAMPS:
0:46 ways to increase range of motion
2:36 how TMR is different than stretching
4:00 testing side bending range of motion in babies
6:15 using TMR lower trunk sidebend to improve mobility
10:23 figuring out which side to do on your child
12:56 UT / LT rotation TMR release
TOY IDEAS:
Similar Teething Toy
Teething pacifier
Best Toys for Babies Learning to Roll
Best Toys for Babies
PT Approved Equipment/Containers for Babies
Tummy Time Toys
Applying TMR for Lower Trunk Side Bend:
Choose the easy side: Start with the side your baby naturally bends towards more easily.
Hold the position: Gently create a backward "C" shape with your baby's trunk on the easy side and hold for about two minutes, ensuring comfort and no resistance from your baby. If they kick out of it, allow them to move out of the position, distract them, and attempt again. Focus on 2 total minutes not counting the amount of time a baby needs for a short break.
Entertain and comfort: Offer your baby a toy or engage with funny faces and sounds to keep them calm and distracted during the hold. Teethers or small toys they can hold in their hands are great.
Incorporate vestibular motions: Following the TMR session, gently bounce your baby for 30 seconds to a minute to help regulate their central nervous system and cement the newly gained range of motion.
Practice what’s difficult: directly after bouncing, practice a play position or milestone that is difficult such as tummy time, sidelying play, back play, rolling, all fours, getting in/out of sitting, or crawling with support.
Retest mobility: After the hold, gently test both sides again to observe any improvements in mobility.
Repeat if necessary: If the sides still aren't equal, you may repeat the hold, always ensuring your baby's comfort. Often I encourage families to complete this 2-3x/day if possible only on the easy side and always following up with 30 seconds to 1 minute of bouncing.
Curious About Learning More on Tummy Time, Rolling, or Both?
The absolute best book for parents on tummy time and rolling is: Tummy Time and Learning to Roll: A Baby Development Book for Ambitious Parents and Pediatric Healthcare Providers to Help Babies Learn to Roll Independently. The book comes with a free online video course to help parents fully understand how to complete the different exercises, printable checklists to know exactly where your baby is at, and when to reach out for additional help.
This book was written by Dr. Lauren Baker, PT, DPT, ATC, MTC, who is a Pediatric Physical Therapist in Boise, Idaho, trained in helping parents learn how to help their babies move and master their milestones. She loves teaching parents how to see how their babies are moving as well as how to influence those movements though play positions and exercises to help babies move with confidence and ease.
Tummy Time and Learning to Roll is the first book in the Proactive Play series written by Pediatric Physical Therapist Dr. Lauren Baker in order to help Ambitious Parents and Pediatric Healthcare Providers learn how to help babies master tummy time and learn to roll. It is meant to help ambitious parents understand baby development from birth to six months (tummy time to rolling).
This book is a mix of easy-to-follow and more in-depth information than is typically found in baby development books because Dr. Baker believes parents deserve to have all the information at their fingertips.
This book breaks down each piece of movement in checklists so that parents know what their babies need for tummy time and rolling. It also covers what areas might limit a child with rolling, why it is so important, and when to seek help from a pediatric PT.
This book comes with colored photos and easy-to-follow demonstration videos that can help parents implement safe, strategic play-based exercises with their babies in 20 minutes per day.
A Great Resource For:
Parents and Pediatric Healthcare Providers of babies 0-6 months
Parents of babies who are struggling with tummy time, rolling back to belly, belly to back, or only to one side
Access to simple, easy-to-follow videos of play positions and exercises
Learning the four pillars of movement needed in order to master rolling
240+ Color Photo Examples of:
Tummy Time, Sidelying, and Back Play
Developmental Toys and Equipment
Hand Placement and Strategic Play Positions
Common Areas of Restriction or Weakness
When To Reach Out For Help
What If You Want Extra Help?
If you have concerns about their movement, remember, you can always reach out to a pediatric physical therapist. It's your right as a parent to advocate for your child's development.
Sometimes, a few tips and tricks are all you need to get your baby moving better. We're here to support you and release those mama worries. If you are looking for in home pediatric physical therapy, check our listing of therapists.
For those eager to learn more or seeking personalized guidance, I offer online video parent consultations internationally which can be scheduled by clicking here. I am dedicated to answering questions and providing tailored play activities for each unique developmental journey.
When Should Babies Receive Pediatric Physical Therapy?
Parents can call and schedule with a Pediatric Physical Therapist at any time, for any concern in all fifty states without a referral from their Pediatrician.
Pediatric Physical Therapy is medically indicated in all babies who are not rolling in all four directions by six months (back to belly over their right arm AND left arm + belly to back over their right arm AND left arm).
Pediatric Physical Therapy is medically indicated if you notice a flat spot on the back of an infants head (possible plagiocephaly), a tilt of their head consistently to one side (ear to shoulder - possible torticollis), or a rotation preference of their neck (consistently look only to the right or left - possible torticollis).
Many Pediatric Physical Therapists including Dr. Baker, can successfully treat flat spots (Plagiocephaly) without a helmet with a combination of therapy and positioning strategies if seen prior to 4 months (0-3 months is ideal). Dr. Baker uses the Baby Begin Method of repositioning.
Flat spots can be due to in-utero positioning, rotational preference (right sided flatness most common) and babies are at an increased risk for flatness if they are male, were breech, multiple birth, premature, have difficulty with tummy time, or are in containers > 2 hr/day.
Final Thoughts
Congratulations on taking this step towards enhancing your baby's mobility! Remember, every baby is unique, so observing and understanding their specific needs is key. If you're eager to learn more or need personalized advice, don't hesitate to reach out for a one-on-one online parent consultation. Together, we can ensure your little one moves confidently and joyously.
Remember, you're doing an amazing job, and by seeking out ways to support your baby's development, you're setting the stage for a lifetime of healthy, happy movement. Let's keep learning and growing together! If you haven’t yet, consider subscribing to the youtube channel for more support on milestones for infants to toddlers.
Thank you for joining me on this journey. Here's to many more milestones and joyful moments with your little ones!
Prevent Avoidable Motor Delays: How To Test Your Baby's Trunk Mobility
this blog contains affiliate links
Hello! I'm Dr. Lauren Baker, a pediatric physical therapist. Today, I'm thrilled to share insights on one of the most crucial aspects of your baby's development - trunk rotation. This aspect of movement plays a pivotal role in milestones like rolling, sitting, crawling, and walking and it’s one of the least known aspects of movement and baby development in the parent world. Today, we are going to change that!
Why Is Upper Trunk Rotation Important?
Upper trunk rotation is essential for your baby's overall mobility. It's the foundation for many activities, including the ability to roll over, going from lying on the ground to sitting up, going from sitting to crawling, and it is even needed when we walk.
When we talk about trunk rotation, we're referring to the upper half of the body moving independently from the lower half, this of sitting in a chair and twisting your shoulders to look behind you (your upper half is moving but your lower half isn’t). This movement is crucial for maintaining our position against gravity, for getting in and out of positions, and for combining motions which we need for complex movements like walking and crawling.
Assessing Trunk Rotation in Babies
To ensure your baby is developing symmetrically and has mobility equally side to side, it's vital to assess their upper trunk rotation. When doing this, we're looking for equal movement on both sides. A limitation on one side can affect how your baby moves, potentially leading to preferences that might impact their development down the line.
Tightness in one direction can also lead to avoidance of movement in that direction, which is often why you see babies choose to only roll to one side (if we know what is limiting them, we can help them fix it! And then they can roll equally to both sides).
Baby Mobility Exercises: Enhancing Trunk Rotation
To encourage healthy trunk rotation in your baby, first try to see if your baby’s upper trunk can go equally in both directions. While they are sitting between your legs, gently move their upper body from forward to the right, stopping when you feel resistance (this is as far as you should go) and then forward to the left, again stopping when you feel resistance.
Watch the video below start to finish for the most comprehensive explanation and demonstration or click on the hyperlink to go directly to the exercise to watch in order to make sure you do it correctly!
TIMESTAMPS:
1:27 why upper trunk rotation and baby trunk rotation is important
4:52 straddle baby trunk rotation assessment
5:17 ring sit baby trunk rotation assessment
6:23 baby between parent's legs baby trunk rotation assessment
TOY IDEAS:
Trunk Weakness in Babies: Spotting and Addressing It
If you notice that your baby struggles with trunk rotation (typically you will feel resistance or they will express displeasure in that direction) or they seem to favor one side, it might indicate trunk weakness or tightness. Weakness and tightness are often companions, as a tight muscle is also a weak muscle, so sometimes when we increase the range and resolve the tightness, we then have to strengthen those muscles.
However, if you do not notice your baby has tightness when doing the upper trunk screen, but they do still show a preference, they could have weakness in the muscles that are needed to go in the direction they are avoiding. Weakness can be associated with tightness or it can be the only thing affecting the child.
It's important to be aware if your baby is experiencing trunk weakness. Signs of this can include a lack of balance in sitting, difficulty in holding themselves up (normal sitting age is 6-9 months), or favoring one side (if their little body forms a “C” shape in lying down or sitting). If you notice any of these signs, incorporating specific exercises can help strengthen their trunk muscles, see the youtube core strengthening playlist here.
What Is a Baby's Trunk, and Why Is Its Control Vital?
The trunk is the body's core, including the chest and abdomen. Trunk control is essential for stability and forms the basis of all movement. A strong trunk enables your baby to explore the world more confidently. Babies need full mobility of their trunk in order to build or access the full strength of their core, which is why assessing upper trunk rotation in infants is so important.
Regularly assessing your baby's trunk control (strength and mobility) can provide valuable insights into their development. Look for whether they have mastered rolling back to belly (right and left), belly to back (right and left), how well they hold themselves up when sitting, their reactions to gentle movements (do they throw themselves back or collapse forward when sitting), and their ability to engage in playful activities that involve twisting, such as bringing both hands to one side in sitting.
Crossing the Midline: A Cognitive and Physical Milestone
An interesting aspect of trunk rotation is its connection to cognitive development. When babies learn to cross the midline (bringing both hands from one side of the body to the other), they're not only enhancing their physical abilities but also strengthening neural pathways in the brain.
These pathways help with future academic milestones such as reading and writing. When babies have trunk tightness, they might avoid crossing midline in one or both directions, which can decrease their opportunities to develop and strengthen these pathways. This can lead to them being at a disadvantage compared to their same age, non-restricted peers.
Pediatric Physical Therapy Exercises for Babies
Incorporating pediatric physical therapy exercises into your baby's routine can be a game-changer. Simple activities like rolling over exercises and trunk control exercises can boost their development significantly.
Making sure that you resolve any tightness by completing the associated releases/stretches is equally important. If you ever find that the tightness is not resolving or you need assistance, reaching out to a local pediatric physical therapist can be the best, most effective thing for you and your baby. See our list of mobile pediatric physical therapists here.
Trunk Movement in Infants: Encouraging Healthy Development
Encouraging various trunk movements is key to your baby's development. This includes exercises that promote rotating, an easy switch in most families routines is to place toys to the side of the child instead of always in front.
This encourages the child to reach to the side and also bring both hands to the side (rotating at their trunk) in order to manipulate or grab the toy. It’s okay to start with the easy side and then build up to adding in the hard side (or assisting with the hard side and letting them do the easy side). Each of these movements contributes to a well-rounded and robust physical development.
Curious About Learning More on Tummy Time, Rolling, or Both?
The absolute best book for parents on tummy time and rolling is: Tummy Time and Learning to Roll: A Baby Development Book for Ambitious Parents and Pediatric Healthcare Providers to Help Babies Learn to Roll Independently. The book comes with a free online video course to help parents fully understand how to complete the different exercises, printable checklists to know exactly where your baby is at, and when to reach out for additional help.
This book was written by Dr. Lauren Baker, PT, DPT, ATC, MTC, who is a Pediatric Physical Therapist in Boise, Idaho, trained in helping parents learn how to help their babies move and master their milestones. She loves teaching parents how to see how their babies are moving as well as how to influence those movements though play positions and exercises to help babies move with confidence and ease.
Tummy Time and Learning to Roll is the first book in the Proactive Play series written by Pediatric Physical Therapist Dr. Lauren Baker in order to help Ambitious Parents and Pediatric Healthcare Providers learn how to help babies master tummy time and learn to roll. It is meant to help ambitious parents understand baby development from birth to six months (tummy time to rolling).
This book is a mix of easy-to-follow and more in-depth information than is typically found in baby development books because Dr. Baker believes parents deserve to have all the information at their fingertips.
This book breaks down each piece of movement in checklists so that parents know what their babies need for tummy time and rolling. It also covers what areas might limit a child with rolling, why it is so important, and when to seek help from a pediatric PT.
This book comes with colored photos and easy-to-follow demonstration videos that can help parents implement safe, strategic play-based exercises with their babies in 20 minutes per day.
A Great Resource For:
Parents and Pediatric Healthcare Providers of babies 0-6 months
Parents of babies who are struggling with tummy time, rolling back to belly, belly to back, or only to one side
Access to simple, easy-to-follow videos of play positions and exercises
Learning the four pillars of movement needed in order to master rolling
240+ Color Photo Examples of:
Tummy Time, Sidelying, and Back Play
Developmental Toys and Equipment
Hand Placement and Strategic Play Positions
Common Areas of Restriction or Weakness
When To Reach Out For Help
What If You Want Extra Help?
If you have concerns about their movement, remember, you can always reach out to a pediatric physical therapist. It's your right as a parent to advocate for your child's development. Sometimes, a few tips and tricks are all you need to get your baby moving better. We're here to support you and release those mama worries. If you are looking for in home pediatric physical therapy, check our listing of therapists.
For those eager to learn more or seeking personalized guidance, I offer online video parent consultations internationally and Pediatric Physical Therapy in Boise, ID and the Treasure Valley – by clicking to the appointment tab or by clicking here. I am dedicated to answering questions and providing tailored play activities for each unique developmental journey.
Final Thoughts: Empowering Your Baby’s Journey
Remember, every baby develops at their own pace, and what's important is providing them with opportunities to explore and strengthen their abilities. By incorporating these simple exercises and being mindful of their trunk rotation, you're setting your baby up for a lifetime of confident movement, as well as decreasing the risk of difficulty with crawling on hands and knees.