Children initially begin to walk between the ages of 12 and 15 months. In the early stages of walking, you may notice your child “waddling” with their feet wide and their arms out like an airplane. Once a child has become more comfortable with walking, you may notice them becoming “brave” and attempting to walk fast or even run. As a child goes through these stages of development, you may find your him or her falling several times during the day.

It’s normal for children to fall frequently as they are learning to walk. In the early stages of walking/running, a child is learning to plan movements, find their balance and explore new-found independence.

As children gain more control of their body, you will find they begin to walk with a narrower base and their arms are at their side. A child will walk/run with decreased hesitance and you should notice less falls. This will occur within the first 2-3 years of learning to walk.

When should you be concerned about your child’s falling? There are many different reasons why children lose their balance throughout the day.

• Pay attention to when your child is falling and ask yourself a few simple questions:

• Did the type of shoe he or she is wearing change? Often times children have difficulty finding their foot placement with new shoes, especially ones that are heavy (such as a boot) or non-supportive (such as a sandal or slip-on shoe.

• Are they only falling when reaching a curb or changing surfaces? Sometimes vision can play a big role in a child’s ability to maintain balance with walking and running. If you suspect a visual deficit, you should contact an eye care specialist.

• Does your child only fall when playing with peers their age? Children have to think constantly about their next move when walking/running during play. You may find that they will trip or fall when attempting to keep up with peers their age. This could be the cause of decreased coordination, meaning they are having a difficult time organizing movements during play, causing them to fall.

• Try to pay attention to how your child is falling, sometimes a child may have a difficult time clearing their toes when walking/running and will fall. This would be good to mention to your pediatrician for possible referral to a physical therapist.

If your child is falling more than 10 times per day and doesn’t fit into the above categories, it may be beneficial to talk to your pediatrician about a physical therapy evaluation to assess your child’s needs.

About the author

Morgan Hubbard, PT, DPT, is a physical therapist at Cook Children's. Physical therapy at Cook Children's focuses on large motor and functional skils to enhance development, restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's has Rehabilition Services in locations in Fort Worth, Hurst and most recently in Mansfield. If you would like to schedule an appointment or speak to our staff, please call 682-885-4063.

Multiple studies suggest that walking even 20 minutes daily can decrease your risk of mortality and improve your quality of life. Read how a busy working mom finds the time to exercise, and read her perspective on the many benefits of regular exercise. Come on moms out there! You can do it! If not for yourself, then for the long term health of your family.

New year. New you!

From Alison Groom:

Being a working mom of three small kiddos is a hard job for anyone, but finding the time to be healthy and active while being a working mom of three kiddos can be a tough job in itself. For me, finding the time to do something active can be hard and I am certainly not perfect at making it a daily priority, but I do my best to do it as much as possible throughout the week.

What I have recently noticed is that my kids watch and mimic every single thing I do. The way my 3 year old talks to her baby dolls is often a reflection of how I speak to her. The same goes for what I eat and how I live my life. Statistics say that if a parent smokes cigarettes, the children in the home will likely smoke as an adult too.

This is also the same for being active. If my children learn the fundamentals of being healthy and staying active as kids, they will likely continue that throughout the adolescent years and into their adult lives. My 7 year old has started wanting to exercise with me and will often ask to run on the treadmill when we are playing in the driveway. I keep our treadmill in the garage because it keeps me from having an excuse not to run.

I am a wimp when it is cold and I do not run when it is raining, so if it is in the garage, I have zero excuses for why I cannot run on a cold or rainy day. We often go for "family walks" after dinner too. We look like a circus sometimes with my 3 year old wanting in and then out of the stroller, the two giant dogs getting tangled leashes or tripping up my 6 year old, but it is family time. It is a time that we talk about our day, we teach our kids about nature and try to find interesting new things to discover. It is also a great time to talk about being healthy and about the benefits of walking and exercising for our growing bodies. It is exercise that allows us uninterrupted time with our precious kids, which is a win win if you ask me. J

Exercising does not have to take an hour to do. I work from home, so when I put my kids down for a nap, I hustle out to the garage to run on my treadmill. It may only be a 10 minute run, or a 20 minute fast paced walk.

Sometimes, I only have time to do a couple sets of pushup and sit ups, but that is better than nothing! A walk around the block can quickly turn into two laps around the block, and then to a mile and so on. Making a conscious effort to walk faster while grocery shopping can be a simple step toward elevating your heart rate and getting your metabolism up for the day. The hardest part about working out for me, is putting on my shoes. Once they are on, I am ready to go.

Make a decision for yourself and for those precious children who ARE watching your every move to be healthy. Take twenty minutes out of your day for you to have a moment for yourself. Exercising is also a GREAT way to release your tensions and anxieties of your day. I often take a moment to run or workout just to clear my head and have a moment to do ME for a minute. That can be so hard for people to do, but it is so beneficial. I promise, if you take twenty minutes to yourself each day, you WILL be a better mother, a better wife, and a better you. Look into different methods of exercise. Reach out to friends, neighbors, or family to see if anyone is also wanting to exercise but needs someone to hold them accountable. Having a partner to walk with around the neighborhood or do a workout video with when the kids go to bed is great! It gives you some time to interact with another adult, vent about your day, and also to be held accountable to doing your workout each day. Start with baby steps and find the right workout or activity for you. If you find pleasure in what you choose, you will likely stick with it.

So who is considered a “running” athlete? Cross-country and track first come to mind, but don’t forget sports such as soccer, football, or lacrosse. A typical soccer game played at the varsity level can consist of 7-9 miles, if an athlete plays the entire game. And in the peak of the season, a cross country athlete might run 20-30 miles per week or more.

Each sport comes with its own recommendations of training intensity for kids. The number one rule to remember when it comes to fitness in kids is to emphasize fun and safety. When running stops being fun or aches and pains become commonplace, that’s when we need to worry we’re pushing our kids too far. Keep these tips in mind to help prevent injuries.

• Invest in a good pair of running shoes, socks, and appropriate clothing. Most local running stores have employees trained in gait (walking) and running analysis. They make educated recommendations on proper footwear for each individual. Running shoes should be changed every 300-500 miles or if breakdown is occurring. Moisture wicking (not cotton!) socks and clothing are also important to prevent blisters and help with body heat regulation.
• Maintain a well-balanced diet, and drink plenty of water every day – not just race/game day. Proper nutrition is important in all kids but especially in athletes.
• Avoid running in extreme heat or cold. High humidity should also be avoided. If you are running in warm weather, remember to wear bright, reflective clothing made of wicking material, and be sure to hydrate often. If running in cooler weather, dress in thin, wicking layers, and don’t forget gloves and a hat. Hydration is still crucial in colder temperatures, too.
• Stretch both before and after running. It’s important to stretch the major muscle groups in your legs – quads (thighs), hamstrings (back of your thighs), calves, and hips. Dynamic stretching  prior to running is an excellent warm-up, while static stretching can be used as part of a cool down. Foam rolling is also beneficial for these muscle groups.
• Follow intense running/workout days with an easy or rest day. Youth should have 1-2 rest days per week.
• Running should not be your only form of exercise. Cross training is very important. Biking, swimming, and elliptical are excellent alternatives.
• Build your mileage gradually - no more than a 10 percent increase per week. The most common injures that affect runners are typically the result of overuse. Too sharp of an increase in mileage can predispose runners to injuries like shin splints, tendinitis, or even stress fractures.
• Taking a walking break is not a sign of failure. Walk/jog intervals can help with increasing overall endurance.
• If possible, avoid running on uneven or slanted surfaces (like the sides of roads).
• Be alert and aware of your surroundings. Run with a partner or let someone know which route you’ll take. If you listen to music while running, keep one ear free. Avoid running at night.
• Work with coaches/trainers on proper running technique. Many local running stores also offer free classes on running form.
• Don’t ignore pain! “No Pain, No Gain” does not apply. Unfortunately, aches and pains from running can happen. Don’t ignore it or think it will go away.

If your child is having pain from running or you are concerned about risk of injury, a visit to a physical therapist can be extremely beneficial. At Cook Children’s, our SPORTS physical therapists have experience with the common injuries that affect runners. We also have staff members who are active runners and understand the demands of the sport.

About the author

Melissa Bro, PT, DPT, is a physical therapist for the Cook Children's SPORTS Rehab program. Our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete's bones, muscles, body and mind. As a part of Cook Children's integrated pediatric health care system, our patients have access to a multitude of pediatric specialty areas with board certified doctors, as well as laboratory services, nutritional consultations and sports medicine counseling.

Patients benefit from this integrated system because it allows our staff to use all of the system's resources during treatment. It also improves communication between the various departments whose physicians are focused on caring for children and adolescents.

If you have a young runner, sign them up for the Cook Children's 5K at 9:30 a.m. on Saturday, Feb. 27, 2015, as part of the traditional Cowtown running weekend.

Jonathan has set an example for his entire family. At 11 years old, Jonathan was scheduled to compete in his fourth Cowtown, the Cook Children's 5K, event before it was canceld. And while he had hoped to place in the top three against more than 8,000 other kids, Jonathan's mom said her son has already motivated the family to achieve more goals than they ever could have ever expected.

Jonathan, his two brothers -- Elijah, 13, and Matthew, 10, -- and their dad, Juan, all run. This weekend’s race will be Jonathan’s sixteenth 5K in five years. Elijah has run in six Cowtown 5Ks and 18 total in eight years and Matthew was scheduled to run in his first Cowtown and third race since October of last year.

Juan has been inspired by his sons to run and in the process lose about 60 pounds in the past six years. He’s managed to keep the weight off by training and was going to run his first half marathon at Cowtown.

And while the family all competes at some level, it's Jonathan who has excelled the most with the most raw, natural ability. Lorena Barron, Jonathan’s mom, credits his first grade teacher, Mrs. Gaylene Chrystie, and his running coach, Cindy Rau, both at Burton Hill Elementary School in Fort Worth, for helping to motivate him to work hard.

"Jonathan liked running from the beginning," Lorena Barron, Jonathan's mom, said. "He was very good and competitive right away. So when Jonathan first started, he didn't have to try as hard. His teachers explained to be good in sports, you have to be good in school. You need to try hard in everything you do, including in the classroom. If he wanted to continue running as he got older or even someday compete in college, he would have to make good grades."

Jonathan listened. He became more focused in school and his grades improved. He became driven. Even at such an early age, Jonathan has learned to set goals for himself and work hard to achieve them, thanks to what he's learned from running. Jonathan ran the Cowtown 10k last year, the longest he had run at the time. He won his division and overcame the pain he felt from the longer distance.

"Running makes me feel happy," Jonathan said. "I liked being competitive. I like when I win, but even when I haven't won, I feel good if I know I've run my best. When I ran my first 10K, it was way harder. My legs hurt after the fifth mile. That was the longest I'd ever run. But I felt really good after it was over because I finished it."

Since he began running, Jonathan has changed in many ways from being more confident to being fit. He drinks water instead of soda now and orders grilled chicken and salad over burgers and fries. But he's not the only one who's seen the benefits of running.

"Running has helped the whole family," Lorena said. "When Elijah started running, Jonathan and my husband wanted to train with him. Being as overweight as Juan was, it wasn't very easy on him. But he kept going and now he's just as healthy as my sons. I don't run, but I walk with them. We all try to eat healthy and take care of ourselves. Running has helped to make our whole family healthier."

Sweat was dripping off my shirt and I could not escape that feeling of needing to throw up, almost wishing I could, but not actually vomiting. It doesn’t sound all that inviting, but I was really interested in coming back the next day to try it all again.

Why?

Because my nurses had invited me.

Because they were getting up for their 6 a.m. boot camp every morning.

Because they were loving every minute of it and sticking with something to better their health (despite the fact that the schedule was crazy and the workouts demanding).

I would think that most people do not want to get up and work out at 6 a.m. (I think there was even a 5 a.m.class but…I’m not that crazy!). Those that do love it, could probably get up and work out on their own by running or lifting weights by themselves.

Why are programs like boot camps and Crossfit so successful?

I believe it is because of one main reason: they are SOCIAL CLUBS.

(Wait Crossfitters, don’t get mad yet.)

I certainly don’t mean that the people going to these workouts are sitting around drinking coffee and chatting. I’ve done a few of each type of workouts and I can guarantee they are working hard.

What is a social club?

1. People gathering around a common interest.
2. People attending to better themselves or increase their knowledge.
3. People encouraging one another.

People who gather together and workout get many benefits besides simply getting their workout in. They are motivated to show up because they provide accountability. “Where were you this morning?” They are encouraged to continue working even when things are hard. “Come on, just one more, you can do it.”

Unfortunately, there are not as many opportunities for our teens to have this type of experience, which is why I am advocating that we bring this mindset into our homes.

Here are some comments I frequently hear during my teenager visits:

“I try to get them outside but they just don’t want to.”

“All they want to do is sit around and watch TV.”

Yep, that’s right, that may be all they want to do. That is probably all they will do unless you make exercise social for them.

One of the major contributors to children’s physical activity is whether their friends are active. Friendships are often centered around shared goals or activities. If those shared interests are active, it is more likely that your child will be active. If those shared interest are passive, getting your child to be active may be more difficult. A study from 2012 in Pediatrics showed that even children as young as 5-12 years would increase their physical activity by 10 percent to match their friends.

But, it’s not just friends that influence your child’s activity level. Parents' activity level, but more importantly their encouragement, also have big effects on their child’s activity levels.

Here are some ways you could possibly make this work for you teenager:

1. Find a common activity the whole family enjoys- Maybe it’s just getting out and kicking a soccer ball around or playing catch. Maybe it’s something more intense, it doesn’t matter just do something together.
2. Set a family goal- Make it a goal to do something physical as a family 6 days a week. If you accomplish that goal, have a family cheat day where you get to watch a movie and have a special treat (or whatever reward would motivate your kids).
3. Run a 5K as a family- Set a goal to run a 5K sometime in the next 3 months. Find the race, sign up and start trying. There are plenty of Apps and online programs you can use to help work your way up to the distance. There is no goal for time or speed, just that everyone finishes.

I’ve made a decision that I’m no longer able to accept this:

“They just won’t get out and exercise.”

Without this:

“Are you getting up to do it too?”