While the first lady is busy addressing the major national epidemic of childhood obesity, getting children to eat healthier foods and exercise more to control their weight, there is also a problem at the other end of the spectrum: children who exercise too much for their own good.

Actually, left on their own, most pre-adolescent children are closer to their body sense than adults. They are better able to be in the present moment with their feelings and emotions, more spontaneously jump and run and ride their bikes, and are more likely to stop, rest, or change activities in relation to signals from their own body. 

A problem arises when adults push children into competitive sports where winning matters more than what may be good for the child's body, mind, and health. Counting both in-school and after school programs, somewhere between 30 and 45 million children in the US between 6 and 18 years will engage in organized sports in any given year. In addition, a new wave of competitive sports is being created and marketed for the toddler years, ages 2 to 6. The sports may include the traditional baseball, basketball, and football, or the newer ones like soccer, lacrosse, rugby, cheerleading, dance, ice skating, and hockey.

And, as these numbers go up, so does the incidence of pediatric overuse injuries. These injuries may begin as slight pains after exercises but with the pressure to play and perform, many children engage in the sport with continuing pain before, during, and after exercise.

The American Academy of Pediatrics Council on Sports Medicine and Fitness has made the following recommendations. Children should be engaged in only sport and limiting "sporting activity to a maximum of 5 days per week with at least 1 day off from any organized physical activity. In addition, athletes should have at least 2 to 3 months off per year from their particular sport during which they can let injuries heal, refresh the mind, and work on strength, conditioning, and proprioception in hopes of reducing injury risk. In addition to overuse injuries, if the body is not given sufficient time to regenerate and refresh, the youth may be at risk of 'burnout.'"

Proprioception and interoception are the two central components of our body sense.  Proprioception is our ability to feel the coordination (or lack of coordination) between the arms and legs while moving, sensing our shape and size (fat or thin), and sensing our location relative to objects and other people. Proprioception is part of a complex neural network that begins in the peripheral proprioceptors (nerve endings that sense muscle stretch and relaxation as well as vestibular senses like balance and coordination). Interoception is comprised of sensations such as warm, tingly, soft, nauseated, dizzy and emotions such as happy, sad, or threatened.

Our ability to feel ourselves via proprioception and interoception is crucial to health and well-being. Body sense is part of a whole-body network of neurons including the pre-frontal cortex (coping, regulation, deepening of felt experience), the insula (interoception), the limbic system (emotion and body state regulation of safety-threat), sensory and motor cortices (action and expression), the parietal cortex (proprioception), the autonomic nervous system (sympathetic-arousal and parasympathetic-relaxation), the cerebellum (muscle and motor function), and brain stem (survival and breathing functions) all of which is connected to peripheral nerves that send information to and from the brain regarding self-monitoring, self-regulation and the maintenance of homeostasis.

When we take the time to feel our own bodies, this network can send signals to the muscles and internal organs to initiate cellular repair and growth functions. When we suppress our body sense feelings, it is more difficult for the body to locate, regulate and repair stresses and strains, which ultimately leads to disease, pain and dysfunction.

Children will suppress their body sense in deference to adult demands and they are more at risk for long-term problems from overuse injuries because their muscles and bones are still growing. Even moderate amounts of stress can impair normal regulatory and repair functions and also hinder essential growth process. The risk is that young athletes who are pressured to perform beyond their limits will develop life-long muscle and joint problems, not to mention potential damage to self-regulatory neural circuits and damage to their self-confidence.

Does this mean that youth should not be permitted to engage in competitive sports? It's not the sport or the competition that creates problems. Athletics (and music and dance) are important outlets for fun, creativity, personal fulfillment, pride, skill building, and group camaraderie. These activities, when done with educational goals in mind, can be life-long lessons in paying attention to our bodies in ways that build health and competence. So long as these outcomes are the goals, then children will thrive.

Children suffer both physically and emotionally when adult expectations for a particular level of achievement, or for winning at all costs, take precedence over the educational and life-affirming aspects of sport. Parents, coaches, teachers and children need to be educated to understand basic body function. We all require activity and rest, competition as well as basic fitness conditioning, challenge and safety.

The most essential component of any training regimen, however, is body sense. Children and adults need to learn to pay attention to and heed the signals from their bodies so that appropriate decisions can be made about doing more or less. Coaches and parents need to respect a child's complaints about pain and fear so that these conditions can be investigated and discussed.  It is one problem to perform with physical pain. If that physical pain is compounded by the emotional pain of not being heard by the people you are supposed to respect, children may feel even more lost, discouraged, and even resentful. Learning how to use and rely on our body sense should be a part of every child's education.  

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