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Is Your Baby Sitting But Not Rolling Over? Here’s Why
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Hello, proactive parents! I'm Dr. Lauren Baker, a pediatric physical therapist, and I'm here to share some wisdom on a common question I receive: "Why is my baby sitting but not rolling over?"
If you've found yourself wondering this, you're in the right place. I've dedicated my career to assisting proactive parents like you in supporting your baby’s movement milestones with ease and confidence.
The journey from tummy time to sitting up is an exciting adventure, filled with significant milestones that each play a crucial role in your baby's growth. But what happens when your baby masters sitting up before conquering the art of rolling over?
Let's dive in together and try to figure out a few reasons why this might be.
The Significance of Rolling Over
Rolling over is a milestone that typically occurs between 3 to 6 months, most commonly between 4 to 6 months.
It's not just about moving from back to belly or vice versa; it's a complex coordination of muscles, balance, and movement across different planes. This skill is foundational, setting the stage for future movements and milestones, including crawling (in my opinion, the hardest of them all!).
If babies do not have all of the things they need in order to roll over, such as struggling with tummy time, not being introduced to sidelying play (don’t worry almost no one tells parents about it unless they have a pediatric PT as a friend or family member!), or they have tension in their body — they could be at risk of not rolling over OR not rolling over in all four directions.
The Transition to Sitting Up
Sitting up, usually achieved between 6-9 months, signifies a new level of independence and strength for your baby. Often babies enjoy being upright, so they are highly motivated to master this milestone.
Other things, like babies being in sit me ups or seated containers like bumbos can get babies extra comfortable in the sitting position, which can actually make them less inclined to do the hard work involved with rolling or other movement patterns compared to their peers who spent more time on the floor.
It’s recommended that babies only spend up to 15 minutes in a seated device or any container that does not allow a baby to move freely on the floor (pack n plays or baby gated areas don’t count since babies can roll or move freely).
Sitting, especially in the beginning involves a different set of skills and muscle groups than rolling. Babies are primarily focusing on stability and balance, trying to simply stay upright against gravity and their legs in ring sit act as kickstands to assist in keeping them up.
Since babies tend to enjoy being in an upright position, most of the time babies struggle more with rolling than they do learning to sit. Especially because rolling is a much more dynamic motion that requires flexibility, strength, and coordination.
The Milestone Mix-Up: Sitting Without Rolling
Many parents notice their babies hitting the sitting milestone without mastering rolling over, which typically precedes it. When this happens, parents might wonder if it’s okay that their babies skipped or did not fully master rolling. The truth is, babies who skip rolling are often struggling with an underlying blockage to their movement patterns.
Rolling is much harder than sitting 99% of the time for babies. It requires mobility, strength, coordination, and is honestly a beautiful symphony of movement when they can do it well. But because it requires them to master a lot of moving pieces and building blocks, instead of just staying upright, they tend to go toward the path of least resistance: sitting.
The Role of Movement Planes in Rolling
Rolling is not just about moving from point A to point B; it involves a sophisticated dance across multiple planes of movement. This complexity makes rolling a challenging milestone for some babies, especially if their movement in one or multiple planes is restricted.
Human movement, including your baby's developmental milestones, occurs across three primary planes:
Sagittal Plane: Involves forward and backward movements, like walking or going up/down stairs
Frontal/Coronal Plane: Encompasses side-to-side movements or the I’m a little teapot motion
Transverse Plane: This is where rotation happens and usually it requires one half of the body to move on another half of the body, which makes it even more complex
Rolling is unique because it predominantly occurs in the rotational (transverse) plane, making it more complex and challenging for some babies. Sitting for example, is in the sagittal plane mostly as babies often either go forward or backwards when they are first learning to sit.
As sitting evolves, it can incorporate all three planes, but if rolling was skipped or a struggle you might find that more advanced sitting skills can become impacted like going from sitting into all fours (which requires rotation like rolling!).
For the most comprehensive information on this topic, please watch the video below as it includes picture examples and walks you through how you would use the book Tummy Time and Learning to Roll as a resource to help babies struggling with rolling.
TIMESTAMPS:
1:30 what ages babies roll over
2:40 what plane of movement rolling occurs in (this is important to understand why babies would skip rolling)
3:50 why rotation is the hardest plane of movement
4:30 why sitting is easier than rolling
6:43 does the baby have a mobility block in the rotational plane? and how to use Tummy Time and Learning to Roll book to figure this out
9:45 Neck mobility screens and exercises
10:40 upper trunk mobility screen and exercises
11:40 weakness in upper trunk, chest, and arm/shoulders and why tummy time is important regardless of age
13:20 most important aspect if a baby is sitting but not rolling
15:00 why having the right amount of flexibility and strength is important for everyone including babies
17:33 container use considerations, what not to use, and what to do instead
19:23 happy sitters and future consequences and how rolling helps crawling
23:40 jump ahead past break
25:21 top four things you want to focus on if a baby is sitting but not rolling
ALTERNATIVE CONTAINER IDEAS:
Upseat
Ingenuity Seat
PT Approved Equipment/Containers for Babies
TOY IDEAS:
Best Toys for Babies Learning to Roll
Best Toys for Babies
Tummy Time Toys
Identifying the Challenge: Mobility or Strength?
When a baby sits without rolling, it prompts us to investigate whether the challenge lies in mobility or strength.
Mobility First
Mobility issues often hinder the ability to roll over. A tight muscle or restricted movement in one direction can be enough to make rolling a challenge. I recommend starting with mobility screens to ensure your baby can move freely in all directions and if not, figure out which directions are more difficult and might be limiting their movement.
The mobility screens to look at include:
Neck flexibility
Arm flexibility
Upper Trunk flexibility
Lower Trunk flexibility
Upper and Lower Trunk combined flexibility
All mobility exercises recommended for rolling are linked in the mobility screen sections of the Tummy Time and Learning to Roll book, included in 240 color photographs and a free online video course that comes with the book.
Building Strength
After addressing mobility, the next step is building the strength necessary for rolling. This includes strengthening the neck, shoulders, back, and core muscles to support the complex movements involved in rolling over. Ensuring your baby has the muscular support to perform rolling movements is crucial. The book outlines exercises that target the necessary muscles for rolling, including the neck, shoulders, and core.
Typical exercises for babies to improve rolling include focusing on:
Core strength
Neck strength
Ability to tolerate Tummy Time
Sidelying Play
Arm strength
All strength exercises recommended for rolling are linked in the exercise sections of the book, included in 240 color photographs and a free online video course that comes with the book.
Practical Tips for Encouraging Rolling and Sitting
Let's put theory into practice with some actionable steps to support your baby's journey to rolling over:
1. Limit Container Use
Avoid over-reliance on devices that restrict movement, such as bouncers or seats. These can hinder the natural exploration and strengthening needed for rolling. Limit container use for maximum 15 minutes at a time up to 2 hours per day.
Floor play or “yes space,” play such as a baby gated area or pack n play can help babies explore safely. Floor play helps babies develop muscles more than containers, in fact, most containers restrict movement or promote non-optimal movement patterns.
2. Engage in Targeted Play
Incorporate exercises and play that encourage rotation and lateral movement. The strategies in my book, Tummy Time and Learning to Roll: A Baby Development Book for Ambitious Parents and Pediatric Healthcare Providers to Help Babies Learn to Roll Independently are designed to be fun and engaging, making tummy time a more fun experience for both you and your baby.
3. Seek Professional Insight
If rolling remains elusive by six months, a consultation with a pediatric physical therapist can provide personalized guidance tailored to your baby's unique needs.
4. Embrace the Journey
Remember, every baby's developmental path is unique. Celebrating small victories and maintaining a positive, proactive approach will make the journey more rewarding.
Why Does It Matter?
Understanding and addressing the reasons behind a baby sitting but not rolling is more than just about hitting milestones.
It's about ensuring a well-rounded development that lays the groundwork for future skills like crawling, walking, and beyond. Moreover, it highlights the importance of movement diversity from an early age, encouraging a range of motions that promote strength, coordination, and balance.
If a baby does not roll in all four directions, they are limited by something and typically it can be easily solved with some strategic exercises.
If babies are blocked in rotation and skip rolling they are at risk of skipping crawling as getting in and out of sitting and into all fours requires rotation and side bending both motions that are utilized in rolling (and often the reasons why rolling is not occurring).
Babies who skip crawling are at risk for having difficulty with pre-academic skills such as reading and writing as the foundational movement patterns needed for those skills are first developed in the all fours position.
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
As we've explored, sitting without rolling is a common scenario that, with the right strategies, can be addressed effectively. By understanding the intricacies of baby movement, focusing on mobility and strength, and applying targeted exercises, you can support your baby in mastering both sitting and rolling.
If you're navigating this developmental puzzle, know that you're not alone. I'm here to support you every step of the way, because I believe parents can influence how their children move when they are armed with knowledge, strategies, and a whole lot of heart.
Together, we can ensure your little one achieves their milestones with confidence and joy.
Thank you for joining me in this exploration of baby movement. Your dedication to your baby's development inspires me every day. Here's to many more milestones achieved and happy, healthy development for all our little ones!
Note: Always consult with a healthcare professional before starting any new exercise regimen with your baby. This information is meant to inform and support, not replace, professional medical advice.
Trunk Stretching Exercises For Babies To Help Them With Rolling or Crawling
this blog contains affiliate links
Hi there, proactive parents! I'm Dr. Lauren Baker, your pediatric physical therapy bestie, dedicated to helping proactive parents like you support their babies in moving with confidence and ease.
Today, we're diving into an essential aspect of your baby's development: trunk rotation. Understanding and fostering this ability can significantly enhance your baby's progress towards milestones such as rolling, transitioning in and out of sitting, and even future activities like walking, running, and hopping.
Let's explore why trunk rotation is crucial and share two easy exercises you can do to improve it.
Why Trunk Rotation Matters
Trunk rotation refers to the ability of the top half of your child's body to move separately from the bottom half.
This skill is vital for:
Complex Movements: It enables actions like rolling, which require the upper body to rotate in one direction while the lower body rotates in the opposite direction.
Developmental Milestones: Trunk rotation is foundational for rolling over (both ways!), sitting independently, crawling, and the more complex motions your child will eventually tackle, like jumping and hopping.
Often we need flexibility before we are able to fully utilize the muscles that allow our bodies to move in the ways we want (or need) them to.
The Importance of Stretching in Trunk Rotation
A baby's trunk can move in three main planes:
Side to side — like the “I'm a little teapot” dance
Front and back — how we walk or go up stairs
Rotation — think of sitting in a chair and looking behind you
For functional movements, especially rolling, your baby needs to twist one part of their trunk in one direction while the other part remains in the opposite direction.
Ensuring your baby can move equally well in both directions is crucial for their overall mobility and the development of symmetrical movement patterns aka we need babies to move equally in both directions and the same on each side.
Before we go into the exercise, we need to talk about two methods that can get us to the same destination. Before filming this video I ONLY had heard about traditional stretching, where we bring a body part to feel the stretch, hold it for at least 30 seconds, and then do the opposite side so we’re balanced.
Since this video has been published, I have been additional trained in Total Motion Release Tots or TMR Tots.
TMR uses a different approach to increase motion. It shortens the muscle to relax it, then increases body awareness through bouncing or another option. This ONLY happens on the easy side.
So going forward, you can use either of these exercises by using Traditional Stretching by doing both sides OR TMR approach where you ONLY use one side, the easy side holding for 1-2 minutes, and follow up with 30 seconds to 1 minute of bouncing.
I personally prefer the TMR approach because it feels a little like magic, babies fight it less, relax into it more, and overall I get the best results when using this option.
That being said, traditional stretching is not WRONG – it’s simply a different route to get to the same destination, I just happen to find that the TMR approach has less traffic lights :)
Ideally, regardless of which option you use, you follow up with some tummy time, sidelying play, back play, or rolling/crawling/sitting practice.
For the most comprehensive information, it’s recommended to watch the full video below.
Exercise 1: Stretching Baby's Trunk Rotation on Their Back
This first exercise is designed to improve your baby's trunk rotation while they're lying on their back. It's a gentle way to stretch and promote flexibility.
How to Do It:
Lay your baby on their back.
Gently hold under one of your baby's knees and bring it across their body towards the opposite elbow. Keep your hand resting on their same side shoulder to note when it start to lift off the ground, this shows you when you have taken up all the available range. The baby is now in trunk in rotation.
Repeat on the other side, noting if one side feels tighter or more challenging to stretch than the other. Only go to the baby’s available range and not past.
You can use this position to increase range of motion in the following ways if a baby shows tightness in both directions (both shoulders are off the ground) or one (just one shoulder is off the ground more than the other).
Traditional Stretching: Like it says in the video, you can hold both of these positions for 30 seconds to 2 minutes based on the baby’s attention span and tolerance. This is going to increase range of motion by pulling on the shortened tissue and you might find that the baby resists the “tight” or difficult side. This can be frustrating for parents if a baby kicks out of a position while they are trying to improve their mobility. Always allow babies to move out of positions if they are uncomfortable and never push past the level of resistance present.
TMR Tots Approach: ONLY hold the baby in the easy direction for 1-2 minutes and follow up with 30 seconds to a minute of bouncing. This often gets quicker results (you can always check both directions before/after for a quick bit but only HOLD the EASY side) because the baby is able to easily relax into the easy direction thus allowing the muscles to relax and improves in overall flexibility on both sides.
It often feels a little bit odd when I teach it to parents, but I do really like this approach and use it almost exclusively.
Exercise 2: Holding Position for Trunk Rotation
My favorite exercise doesn't require dedicated time out of your day because it can be incorporated into how you hold your baby as you go about your routine. It's a fantastic way to stretch your baby's trunk rotation while engaging with them.
How to Perform:
Hold your baby with their back against your chest, keeping their trunk steady against your body.
Slide one hand between the FRONT of your baby's legs and then rest your hand on their bottom cheek that is the same side as your arm – if your left arm is holding the baby, your other hand is going to go through the front of their legs and rest your hand on their left buttock or vice versa.
Gently rotate your baby's pelvis by bringing your bottom elbow backwards/behind you to the level of their available range (as far as they easily go and not past). Make sure to keep their shoulders aligned with yours (their chest does not move and they should stay vertical).
The motion at your elbow creates a gentle twist in their trunk by moving their pelvis (think of like how you would twist out a wet wash cloth but instead of horizontal, it’s vertical).Walk around, allowing your baby to see the world from this new perspective. This not only helps with trunk rotation but also provides sensory stimulation.
Traditional Stretching: Like it says in the video, you can hold both of these positions for 30 seconds to 2 minutes based on the baby’s attention span and tolerance. This is going to increase range of motion by pulling on the shortened tissue and you might find that the baby resists the “tight” or difficult side. This can be frustrating for parents if a baby kicks out of a position while they are trying to improve their mobility. Always allow babies to move out of positions if they are uncomfortable and never push past the level of resistance present.
TMR Tots Approach: ONLY hold the baby in the easy direction for 1-2 minutes and follow up with 30 seconds to a minute of bouncing. This often gets quicker results (you can always check both directions before/after for a quick bit but only HOLD the EASY side) because the baby is able to easily relax into the easy direction thus allowing the muscles to relax and improves in overall flexibility on both sides.
**to determine the easy side, use the floor exercise (exercise #1) to determine which shoulder is closest to the ground.
Right shoulder closest to ground = Right Upper Trunk Rotation is Easy = YOUR RIGHT ARM goes around their chest.
Left shoulder closest to ground = LEFT Upper Trunk Rotation is Easy = YOUR LEFT ARM goes around their chest.
TIMESTAMPS:
0:48 what trunk rotation is needed for
1:07 why trunk rotation in babies is important and why they need to stretch in trunk rotation
3:00 exercise 1: how to stretch a baby in trunk rotation on their back
3:53 the easier way to stretch a baby in trunk rotation
4:43 exercise 2 holding position that helps stretch a baby in trunk rotation
6:00 this philosophy is different than traditional stretching and is called TMR (total motion release) for this type of release please see video here: Total Motion Release Technique for more explanations
TOY IDEAS:
Best Toys for Babies Learning to Roll
Best Toys for Babies
PT Approved Equipment/Containers for Babies
Tummy Time Toys
Understanding Trunk Rotation
Why It's Effective: These exercises stretch the upper and lower parts of the trunk in opposite directions, mirroring the essential movement patterns needed for rolling and other developmental milestones.
Why This Matters
Investing a few minutes daily in these simple exercises can make a significant difference in your baby's physical development. Trunk rotation is a cornerstone of movement, and by fostering this skill early on, you're paving the way for your baby to achieve milestones with greater ease and confidence.
Working Together for Your Baby's Best Start
If you've tried these exercises and have questions or if you're seeking more personalized guidance, I'm here for you. Check the pinned comment for a link to book a one-on-one consultation with me or schedule right here. We can dive deeper into your baby's developmental journey, ensuring you have all the tools and knowledge to support their growth every step of the way.
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
As parents, taking the time to understand and support your baby's development is one of the greatest gifts you can give. Trunk rotation is just one piece of the developmental puzzle, but it's a critical one. By incorporating these simple exercises into your daily routine, you're not only bonding with your baby but also actively contributing to their future success in rolling, crawling, and beyond.
Thank you for joining me on this journey to support your baby's development. Remember, you're doing an incredible job, and I'm here to support you. Stay tuned for more tips and insights to help your baby move with confidence and ease! If you haven’t yet, consider subscribing to the youtube channel for more videos for baby to toddler development.
How to Test A Baby’s Trunk Flexibility With This Rolling and Crawling Exercise
this blog contains affiliate links
Hello there, proactive parents! I'm Dr. Lauren Baker, a pediatric physical therapist, here to share some valuable insights into your baby's development.
Think of me as your pediatric PT bestie for all things related to helping your little ones move with confidence and ease. Today, we're diving into a topic that's both fascinating and crucial for your baby's growth: trunk mobility.
To be honest, it sounds kind of boring, but let me tell you – once you know about it, you will be able to unlock secret, hidden blocks that your baby might be experiencing if rolling or crawling is a struggle.
So, let's get started on this journey together!
Introduction to Trunk Mobility in Babies
You might not realize it, but trunk mobility is a big deal for babies. It's the foundation upon which many gross motor milestones like rolling, sitting, crawling, and walking are built.
However, many parents aren't aware that babies can have restrictions in their trunk, leading to a preference for moving in one direction or not being able to access the motion necessary in both directions, causing them to stay in one position like sitting or lying on their back.
This can cause muscle imbalances and make those milestones especially rolling and crawling more challenging than necessary.
Why It Matters to Test A Baby’s Trunk Flexibility
Muscle Imbalances: Tightness in the trunk can lead to asymmetrical movement patterns (this means that one side moves well, while the other doesn’t), potentially impacting your baby's ability to reach milestones smoothly. This can also occur globally if babies are tight in both directions.
Gross Motor Milestones: Proper trunk mobility is essential for rolling back to belly and belly to back, sitting independently, crawling, and eventually walking.
Quick Trunk Mobility Test: Elbow to Knee
For the most comprehensive information and examples on a baby please watch the youtube video below.
I'm excited to share a simple mobility test that you can do at home to check for trunk tightness or decreased mobility in your infant. This test can reveal if there's a significant difference in mobility from one side to the other.
How to Perform the Infant Trunk Mobility Test
Positioning: Gently place your baby on their back, then grasp under their left knee with one hand and behind their elbow with your other.
Movement: Gently hold beneath your baby's elbow and try to touch it to the opposite knee, only going as far as their resistance allows (never pushing past their resistance and always stopping when there is no more slack available).
Notice the motion of the knee coming to the elbow occurs at your baby's pelvis not their actual hip joint. The bottom of the baby should lift up into flexion (baby’s back and bottom are rounded).
Observation: Notice if one side seems easier or more difficult for your baby compared to the other. If one side the elbow and knee easily come together, touching or almost touching but the opposite is 3-4 inches a part, note the side that is difficult and approximately how far away the knee is from the elbow.
TIMESTAMPS:
2:32 Test for Babys Trunk Flexibility
3:14 indepth breakdown of how to complete the test
4:27 what this means and how it could impact crawling or rolling
TOY IDEAS:
Best Toys for Babies Learning to Roll
Best Toys for Babies
PT Approved Equipment/Containers for Babies
Tummy Time Toys
Understanding the Infant Trunk Mobility Test Results
If you find that there's a noticeable difference between the two sides, it might indicate trunk restrictions. This doesn't mean your baby won't hit their milestones, but they might face more difficulties.
It is important to note trunk restrictions, especially if a baby if struggling with a functional task, in their cases movement milestones like rolling, sitting, crawling, or walking.
What Differences Mean and How to Break Them Down
Every child is different, so the follow is a typical understanding of movement limitations; however, not every single child will present this way and it’s important to note how your child is moving and if there is any tightness present AND difficulty with milestones, to reach out to a pediatric PT to further assist in resolving.
Right Elbow – Left Knee is difficult or not as close: This is likely due to decreased range of motion or mobility in the right rotation of the upper trunk and/or left side bend of the lateral trunk (upper and/or lower trunk).
Babies may experience difficulty with:
Back to belly over the left arm
Belly to back over the right arm
Pivoting on their belly to the left
Sit to all fours to the right
Crawling on all fours
They may also present with Hitch crawling with R foot on the ground and L knee on the ground
Left Elbow – Right Knee is difficult or not as close: This likely is due to decreased range of motion or mobility in the left rotation of the upper trunk and/or right sidebend of the lateral trunk (upper and/or lower trunk).
Babies may experience difficulty with:
Back to belly over the left arm
Belly to back over the right arm
Pivoting on their belly to the right
Sit to all fours to the left
Crawling on all fours
They may also present with Hitch crawling with L foot on the ground and R knee on the ground
Both are difficult or pretty far apart > 1 inch: Babies may show difficulty in back to belly / belly to back / crawling / or transitioning in/out of all fours. They may also be okay with one direction but not all directions ie back to belly or belly to back over one arm but not in all four directions (belly to back over R arm, belly to back over L arm, back to belly over R arm, back to belly over L arm).
They may also present with booty scooting or prolonged army crawling, because these positions do not require side to side (side bend) or rotation directions.
If You Notice Asymmetries
Seek Professional Help: A pediatric physical therapist can provide hands-on assessment and personalized strategies for babies or speaking to a pediatric physical therapist through an online parent consultation can help you understand the movement that your child is presenting with and assist in finding either proactive play strategies or providers in your area.
Don't Panic: Consider any limitations as a data point to be proactive rather than a cause for alarm. Often, these “tests” are orthopedic in nature indicating that the baby is struggling with muscle tightness, not necessarily difficulty in coordinating the movement together.
Pediatric physical therapists can help you figure out any red flags for development if you do have more global concerns.
The Impact of Infant Trunk Mobility on Development
Restrictions in trunk mobility can influence various developmental milestones because these activities require multi-plane movements, such as rotating the trunk while also bending at the trunk, while fighting gravity.
Rolling is the most specific milestone in which trunk rotation and side bending can significantly limit a baby’s experience and achievement of movement milestones. See the Learning to Roll book, that I released in October 2023 for a comprehensive guide to improve trunk mobility and master tummy time and rolling in all four directions.
When a baby is beginning to sit independently they need trunk mobility is key to maintaining balance and posture, trunk mobility allows the muscles to turn on and off in sequence during different demands of gravity such as reaching to the front or side.
When babies move from their back to sitting and sitting to all fours, they need both side bending and rotation in order to do it. Most babies who struggle with rotation, begin to choose alternative, disadvantageous movement patterns such as booty scooting instead of crawling on all fours.
This is often due to them not having the available movement and with focused intention and support, they can often achieve crawling on hands and knees.
If you're concerned about your baby's trunk mobility or just want to ensure they're on the right track, remember, I'm here to help, you can schedule an online parent consultation at any time.
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
Your role in your baby's developmental journey is monumental, and by being proactive, you're setting the stage for their future success. If you have any questions or need guidance, feel free to reach out. If you haven’t yet, please consider subscribing to the youtube channel or share it with a parent friend.
Together, we can ensure your baby moves with confidence and joy!
Thank you for joining me today, and remember, you're doing an incredible job as a parent. Stay tuned for more tips and insights to support your baby's growth and development!
How to Improve Head Control in Babies with the Pull To Sit Exercise
this blog contains affiliate links
Hey there, proactive parents! I'm Dr. Lauren Baker, a pediatric physical therapist, author, and your guide to learn how to help your babies move with confidence and ease.
Today, I'm thrilled to share with you a fun exercise known as the "pull to sit" – that's not just a game-changer for your baby's core strength but also a milestone checker used by pediatricians worldwide.
Why is the Pull to Sit Exercise a Milestone Checker?
Because it is a good gauge to see if a child is able to tuck their chin and hold it in that position against gravity when their body is going up and going down.
This shows that the neck muscles on the front (deep neck flexors) are working both in their ability to activate AND in their ability to hold that position for a prolonged period of time (long enough to not give up half way through the motion).
Babies three months and older have appropriate neck strength if they can complete a chin tuck while being brought into a sitting position and back into a lying position without letting their head fall backwards, what healthcare providers call a “head lag.”
Head lags mean that babies lack the neck strength to hold their heads in the chin tucked position throughout that movement, either because the muscles are weak or tight.
This position can also be used as an exercise to help build that neck strength in babies who are typically developing or who have developmental delays.
This exercise is truly all about empowering your little one to build the muscles needed for rolling, sitting independently, crawling, and beyond. Let's dive into making your baby's movement milestones memorable and fun!
Why the Pull to Sit Exercise is a Must-Try and Must Master Movement
Pull to sit is fundamentally a test that checks for your baby's ability to activate their deep neck flexors, tuck their chin, and use their shoulder girdle and abdomen to sit up from a lying position.
Typically Pediatricians check this motion by placing their fingers in both of a baby’s hands and the baby pulls themselves into a sitting position.
Not all Pediatricians will check both the “up” and “down,” component of the movement and traditionally if a baby is able to do the “up” portion, they are deemed appropriate in age development.
This milestone typically emerges around three months, signaling that your baby is on the right track with their head control and is ready to tackle the world—one sit-up at a time.
Observing Your Baby's Response to the Pull to Sit Exercise
Normal Response: A baby tucks their neck and uses their arms and abdomen to pull into a sitting position. The baby uses their arms to PULL themselves into sitting, meaning they bend their elbows and bring their chest forward the full way.
If a baby does not bend their elbows to pull themselves into the sit position and both of their arms stay straight DO NOT pull them into a sitting position with their arms straight. This automatically demonstrates difficulty with this movement and go into the exercise portion with your hands supporting behind their shoulders.
Weakness/Not Mastered:
Head Lag: If your baby’s head goes backward (into extension) and they are not able to keep their chin tucked during ANY part of this test (going up or going down).
This can happen if a baby hasn't had ample tummy time, hasn’t practiced this motion before, struggles to grab their feet, has tightness in their neck or chest, or hasn’t been introduced to sidelying play.
Head lag can be at the beginning, in the middle where a baby seems to “give up” and their head falls backward, or a forceful “no longer interested” by flinging their head/body backwards.
Most times, going down is going to be more difficult than going up and keeping your fingers available to support the head so it doesn’t go backwards if a baby stops maintaining the chin tuck is always encouraged.
Not using the arms to pull and keeping the elbows straight: Sometimes parents pull their babies into a sitting position with the baby’s arms straight, this can cause damage to their arm and shoulder muscles because the baby is not engaging their shoulders and bringing themselves into sitting.
When testings at the arms/hands, parents should encourage the baby to do all the work, going as slowly as needed. If the baby is not bending their arms to pull themselves into sitting, immediately provide support behind the shoulder blades and complete the screen that way.
When completing as an exercise I always continue to provide support behind the shoulder blades when doing 5-10 repetitions. I will “test” 1-2 at the hands to make sure they can do it, but prefer to always support at the shoulders to focus more on the trunk and neck strength vs arm strength.
How to Practice the Pull to Sit Exercise Safely and Effectively
For the most comprehensive information and examples using babies, please watch the youtube video below
For Babies Not Yet Pulling Actively: Modification
If your baby isn't engaging their muscles during pull to sit, don't fret! We'll start with modifications to build up their strength gently.
Elevate: Start with your baby elevated where their shoulders are above the level of the hips. I do this usually by placing their shoulders and upper back lying backwards on a boppy, but parents can do this using a wedge, cushion, or throw pillow.
Elevating the baby pulls out the toughest first 25% of the motion as gravity is the meanest between 0-25 degrees when going from lying on your back to sitting (either on your own or with help). By elevating, we simply remove that difficult portion to build strength in the easier range.
Once we master the modified version by completing x10 repetitions, moving onto harder version will be easier.
Support and Slow Motion: Support your baby under their shoulders, moving slowly to encourage them to tuck their chin and engage their core. You can add into toys in their lap when coming into sitting or using a pacifier to keep them engaged and calm.
Calming Techniques Between Reps: Offering gentle bounces or a snuggle between reps can soothe your baby, making the exercise more enjoyable.
For Babies Ready for More Challenge
Go Flat: Using an incline, like a boppy pillow, reduces the challenge by focusing on the upper 50% of the movement, making it easier for your baby to practice the pull to sit. Once they can complete x10 in a row on a boppy with chin tucked in both going up and going down, move them to flat on the floor and build up to x10 there.
Bonus for Parents & Babies: For older babies, encourage them to use their hands to pull up from the ground or from your lap. When parents place the baby on their lap they even get a core workout too.
TIMESTAMPS:
0:41 introduction to pull to sit and what it is and why doctors test pull to sit
1:43 what happens if a baby has a head lag in pull to sit
1:58 what to do if your baby is not using their arms in pull to sit
2:38 pull to sit 3-6 month olds
3:03 how many pull to sits should you do with your baby
3:15 calming techniques for babies why cry during exercises
3:30 how to support the head and neck with supine to sit
4:00 how babies tend to compensate if they have weak neck muscles
4:36 vibrating oral toy to increase the effectiveness of pull to sit
5:15 how to build the most strength for head control
5:35 what to do if your baby is struggling with pull to sit
8:07 modified pull to sit on an elevated surface
9:16 advanced pull to sit on parents legs using arms
10:03 pull to sit with hands from the ground (older baby)
TOY IDEAS:
Z Vibe Teether
Z Vibe Tips
Vibrating pull toy (similar)
Small Tummy Time Boppy
Prop a pillar
Wedge
Best Toys for Babies Learning to Roll
Best Toys for Babies
PT Approved Equipment/Containers for Babies
Tummy Time Toys
Key Takeaways for Successful Pull to Sit Exercise Sessions
Watch for Compensations: If your baby tries to use upper trunk extension instead of tucking their chin, support them under their shoulders to encourage core engagement.
Use Props: A small, vibrating oral motor toy can encourage your baby to grasp with both hands, promoting a tucked position and engagement of the right muscles.
Praise and Encouragement: Celebrate every effort, no matter how small, with lots of praises and cuddles.
Understanding Your Baby's Strength and Tolerance
Babies have varying levels of tolerance for exercises. If your baby can only handle a few repetitions before needing a break, that's perfectly okay. The goal is to encourage movement without pushing too hard, respecting your baby's limits and celebrating their progress.
Every single repetition will build on itself, if a baby has to start with x3 from an elevated surface done 5x/day, that is fine. Add them into diaper changes.
Once x3 are consistently tolerated (and may even enjoyed!) start adding repetitions until you can successful get to x10 in a row. THEN make it more challenging by going flat on the floor or decreasing the height of the incline (wedge to boppy to small throw pillow to floor).
Why Gravity Matters
Gravity is the invisible force that your baby battles with every pull to sit. Initially, gravity pushes babies harder because it is stronger in a perpendicular direction than it is at an angle, making the first part of the movement from floor to 25 degrees incline more challenging.
As your baby pulls up, gravity then goes from pushing them down to being less intense to even at times assisting them.
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
Thank you for joining me on this journey to strengthen your baby's core muscles through the pull to sit exercise.
Remember, every baby develops at their own pace, and the goal is to support them with love, patience, and encouragement. If you have any questions, don't hesitate to reach out for an online parent consultation.
Together, we can ensure your baby builds the strength they need to explore the world around them with confidence.
Stay tuned for more tips and tricks on helping your little one move better, and don't forget to share this post with other parents in your circle. If you haven’t yet, make sure to subscribe to the youtube channel and share it with other parents looking for proactive play ideas for their babies.
Here's to happy, healthy development for all our littles!
How To Stretch A Baby’s Neck and Arm Muscles With Baby Backbends
this blog contains affiliate links
Hello, proactive parents! I'm Dr. Lauren Baker, a pediatric physical therapist with a passion for helping active parents and their little ones move better. Today, I’m super excited to share with you a playful and effective exercise to stretch your baby’s abdomen, neck, and arms.
This routine is not just fun but crucial for developing flexibility, supporting milestones like rolling, sitting, crawling, walking, and addressing conditions like torticollis. Our goal is to make movement a magical experience, for both parents and babies.
As a bonus, this exercise also incorporates the vestibular system, an important sensory system that helps your baby begin to understand where they are in space and help them balance.
Stretching the Neck, Arms, and Belly: Baby Backbends on a Stability Ball
This exercise is often a baby favorite, don’t be surprised if you find them giggling and loving this exercise because it is new and novel.
This exercise uses a stability or exercise ball to help your baby ensure they have the flexibility they need in the front part of their body. Often babies can have tightness in the front of their necks, sides of their trunks/under their arms, and the front of their bellies.
The stability ball provides a gentle and supported way to help babies relax in this position, while incorporated gentle backward/forward motion in order to help facilitate the stretches.
How to Do It
for the best and most comprehensive information, make sure to watch the youtube video down below
Type of Ball: The first thing you’re going to need for this exercise is a stability ball or exercise ball. Often families have one in the home already, but if not one can be purchased off amazon, at target, or walmart, second hand or even borrowed from a family member or friend.
The best size is between 45-65 centimeters and can depend on the size of the baby. Babies that are small and 3-4 months I often recommend small stability balls closer to 45cm but most babies do well on a 55cm stability ball.
Sometimes, 65cm balls can be tough for smaller parents get close to their baby, so I don’t often recommend that big of a ball, but if that is what you have at home, just deflate it a little bit so it isn’t too tall.
When you are on your knees, you want to be able to have your baby lying back on the ball at approximately your hip/lower chest level. You want to make sure you can comfortably bring your chest over the top of the ball to bring them back into a supported sitting or held position.
Position: Keep your body close to your baby and gently lay your baby on their back on the top of the stability ball, with their feet near your body, face up, and the top of their head pointing away from you.
Support: Place your hands securely on their pelvis, I prefer to keep both hands on the top of the pelvis, you want to make sure the baby’s legs lay straight and don’t curl up toward their bellies. You want the baby to be in a gentle backbend.
Action: Gently roll the ball forward and backward, allowing your baby’s head to relax and stretch out the belly. The baby’s neck should be open with their head resting on the ball.
Benefits: This movement stretches the abdomen, neck, and arm muscles and provides vestibular input, which is calming and helps with sensory integration.
TIMESTAMPS:
0:50 stretch for babys neck and belly exercise #1 backbends on stability ball
1:21 stretch for babys neck exercise #2 both hands down backbends on stability ball
2:25 using bounces to calm baby down and increase vestibular regulation
3:07 stretch for babys neck exercise #3 one arm down backbends on stability ball
6:03 how to use exercises to a baby's tolerance
45-75cm stability balls [multiple colors and all sizes]
TOY IDEAS:
Best Toys for Babies Learning to Roll
Best Toys for Babies
PT Approved Equipment/Containers for Babies
Tummy Time Toys
There are two options for where the arms go:
Arms at the sides to emphasize stretching the neck
Arms above the head to emphasize stretching the neck and arms
If a child has a history of torticollis, sometimes holding the arms at the sides will assist in focusing on the neck, but the truth is that sometimes it feels harder to hold the child in the right position when holding their arms down.
These days, I personally prefer allowing the child’s arms to be free, ideally overhead. A lot of children have tightness in the front of their chest and when they are lying backwards over the stability ball, their upper trunks are in extension, this makes bringing their hands overhead even hards, putting more of a stretch on the sides of their trunk.
To help encourage the relaxation of these muscles, I love when another family member or sibling is standing or kneeling by the baby’s head and gently touches the arms encouraging them to go straight.
You do not want to push the baby’s arms toward the ball, you only want to gently stroke the childs arms or tickle the arms or try to get them to reach for your hands. The goal is for the baby to relax their arms overhead over time, not the first time.
Tips for Helping Babies Relax & Stretch Their Arms & Necks
Gentle Guidance: Use your hand to gently guide the top of their chest and stretch the fascia.
Come Up With Ease:
2-5 months: To help your baby come up, bring your chest close to their body and bring your arms behind the baby to support their body and head. Bring them to your chest and lift off the ball.
6 months+: To help your baby come up, gently roll them to the side and encourage pushing up with their arm, going into a sit to sidelying to sit “sit up,” fostering a mix of strength and flexibility.
Use Bounces: Between repetitions, if your baby has head control, you can bring them into sitting and gently bounce on the ball. This can be soothing and is great for vestibular input.
How Many Times or How Long? Babies do really well with this exercise when completing 10-30 times or for 2-5 minutes total (with seated or holding breaks).
If a baby struggles with this exercise, it might be due to tightness in the front of their neck or chest. This is still a great exercise for babies with tightness in those areas to do, but parents may need to go slower to their specific baby’s tolerance.
If a baby only tolerates 5 forward/backward motions, then stop there and build 1-2 more if tolerated. It may take a few days or week to slowly build up to 10-30x.
Making It a Soothing Routine
These activities are perfect for winding down and getting ready for bed. The combination of stretching and vestibular input from bouncing can be incredibly soothing for your baby, making this routine a fantastic prelude to nighttime calmness.
This obviously should not be done before bedtime, if a baby struggles with this exercise, doing it during wake periods would be more appropriate in those cases.
Why This Matters: Babies Who Struggle With Tummy Time
This isn’t just about stretching; it’s about nurturing your baby’s development in a holistic way. These exercises promote flexibility, enhance sensory integration, and build a foundation for future milestones.
When baby’s have tightness in the front of their bodies including their arms, chest, or neck they are at risk for struggling with rolling and tummy time.
In order for babies to lift their heads in tummy time, they need both the strength in the back of their neck muscles to lift their head against gravity AND they need to have the flexibility in the muscles in the front of their neck and chest to ALLOW the head go into extension.
Additionally, babies need to be able to bring their elbows to the side and slightly in front of their shoulders in order to be able to push through the ground and lift their chest and head up.
If babies have tightness in the side of their trunks and arms, one or both arms might not be able to come forward, because the tight muscles are pulling the elbow back.
This makes it inefficient, so babies are not able to have their elbow in the appropriate position and they’re not able to push through the ground to lift their chest and head/neck as they would if they had the flexibility in the side of their trunk, their chest, and arms.
These same muscles, if they are tight, can also impact rolling both back to belly and belly to back. For more information on how tight muscles impact rolling, see the Tummy Time and Learning to Roll: A Baby Development Book for Ambitious Parents and Pediatric Healthcare Providers to Help Babies Learn to Roll Independently
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
Embracing Baby’s Tolerance and Celebrating Effort
Every baby is unique, with their own preferences and tolerance levels. It's crucial to follow their lead, celebrating each attempt and giving plenty of cuddles and praise. Remember, it’s not about pushing; it’s about encouraging and supporting your baby’s journey so that they learn to love and feel safe during movement.
If You Have Questions:
Never hesitate to reach out to a local pediatric physical therapist. They're the experts who can guide you through understanding and enhancing your baby’s movement. And, of course, I’m here too! I offer international parent consultations to dive deep into education and exercises for specific milestones. You can also ask any questions you have on baby development or what you’re seeing in how your child is moving.
Let’s Keep the Conversation Going
Your experiences, questions, and insights are invaluable. Drop a comment below the video, share your stories, and let’s create a community where all of us, together, can empower our little ones to move with joy and confidence.
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Thank you for joining me in this delightful journey of movement and growth. Remember, every little stretch, every giggle, and every moment spent together builds a foundation for a lifetime of healthy movement. Here’s to happy, healthy babies!
Sitting: with & without support
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Curious About Learning More on How To Teach Babies To Sit On Their Own?
The absolute best resource for parents on helping their babies learn to sit is the free online course: Learning to Sit by Dr. Baker.
To gain immediate access to the online course, click the link above, submit your information, and the online course instructions will be emailed to you directly.
The free online video course is designed to help parents fully understand how to help their children sit independently and trouble shoot what building block of sitting the child might not have mastered yet.
It comes with video examples of exercises, printable checklists to know exactly where your baby is at, and information on when to reach out for additional help.
This online course was created 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.
It is meant to help ambitious parents understand baby development from 4-9 months (propped to independent sitting).
This online course breaks down each piece of movement in checklists so that parents know what their babies need for sitting and it also covers a checklist to make sure babies have mastered rolling in all directions (otherwise, this could be a reason why sitting is still a struggle!)
It also covers what areas might limit a child with sitting, why it is so important, and when to seek help from a pediatric PT.
This online course 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 4-9 months
Parents of babies who are struggling with sitting with or without support
Access to simple, easy-to-follow videos of play positions and exercises
Learning the four pillars of movement needed in order to master sitting
8 Online Course Modules
Building Blocks of Sitting
Sitting Checklists
Propped Sitting/Sitting with Support
Independent Sitting
Strength Exercises
Mobility Exercises
Sitting Specific Play Exercises
Next Steps: How to Prep for Crawling
What If You Want Extra Help?
If you have concerns about your baby’s ability to tolerate a sitting position, have what they need to master sitting without support, or if they are not sitting by themselves and are over nine months, 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.
I’m here to support you and release those worries.
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 – which you can learn more about by scheduling a free 20 minute chat with me (Idaho only) or an online parent consultation 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 sitting on their own, without support or their hands by nine months. Proactive Pediatric Physical Therapy recommend if a child is not sitting on their own by 8 months.
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).
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.
Prevent Avoidable Motor Delays: How To Test Your Baby's Trunk Mobility
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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.