7 Basic Core Muscle Exercises for Children with Moderate to Severe Physical Difficulties

This page offers ideas, information and activities to help develop a child’s core stability. These exercises are for those who may find sitting independently difficult or who aren’t on their feet.

Core stability refers to the strength in ther tummy and back and the amount of control and balance between the two sets of muscles. Core stability is generally built up as we develop and try out new and more complex movements.

Core stability is key to the workings of our whole body. If we have better core stability, our arms and legs will work better as they are attached to a stable base. With a better core it is much easier to have good fine and gross motor skills (movement skills). 

A better core also allows our child to balance in different positions. It enables them to stay still and balanced while their arms and legs work (e.g. playing) or to stay upright when on a moving surface (e.g. a wheelchair without straps). Our bodies are constantly seeking balance so having a strong core helps our child to concentrate better as they are able to stay still.

  • If your child’s muscles are weak or if one muscle is weaker than the other, or if the messages to the muscles tell them to work too hard (high tone) or not hard enough (low tone) then it is highly likely that your child will have poor core stability and your child’s other movement skills will be affected.

  • If they are not mobile, they may have difficulties with sitting balance. Poor core stability can also impact learning as the child has to regularly move to keep their balance – they may find it hard to concentrate, may struggle to sit still or have poor fine motor skills such as writing or drawing.

  • A good core is a great starting point for any child (or adult for that matter) so working through these activities will be helpful for any child.

Here are the basic exercises to help your child develop some core muscle strength and stability, try these first

Go down the list and find the first level that they would struggle with. This is your starting point. Work on that skill until they can manage it. If they can’t manage a certain exercise, move them back a section or move onto the next section. You should be practising several exercises/ activities in the same period to be most effective. 

If your child achieves all of these, move on to the More Advanced Core Exercises.

Tummy time is a great basic exercise to build core muscle strength

  1. Tummy Time is a brilliant position for strengthening your child’s neck and back. Use a rolled up towel or wedge under their chest to help them to push up on their arms to lift their head (as shown).

  2. As they improve, help them to prop through their elbows while looking up.

  3. Next try to encourage them to be propping through their hands – it may be that a bigger rolled up towel under their chest helps them achieve this.

  4. Once they can do this over a roll, try without the roll.

  5. Read them a book or they can watch TV here so they are motivated to keep looking up and pushing through their hands or elbows. 

  6. A progression of this is reaching with 1 hand for a toy or to roll a ball, while leaning on the other arm/ elbow or hand. This will work their core much harder than keeping both arms down. It will also introduce rotation which is key to core stability.

  1. With your child lying on their back, encourage them to touch their toes.

  2. You could put bells or beads on their feet and help them bring their feet up in the air for the child to reach towards their toes.

  3. If they struggle bringing their feet up, place a small rolled up towel under the bottom of their bottom so their feet are already off the floor.

  4. You could also roll up a towel and put it under their head and shoulders to help them see what they are doing and bring their arms off the floor. 

  5. Once they can touch their toes, encourage them to reach for the opposite foot with the opposite hand. This brings rotation into the trunk which is so often missing for children with physical difficulties.

1) This can be in ring sit (with their hips wide and knees a bit bent) side sitting (legs going off to one side and leaning through 1 arm), long sitting (with legs straight out in front) or crossed leg sitting.

2) Start by helping them into the position and slowly reduce your support to see if they can stay still. If you need distraction, watching or reading are good as they can stay still for these. 

3) Once they can stay still, start playing with them so that they are using their hands but staying upright. 

4) Move on to reaching outside their base of support – side to side, in front or reaching behind them. 

5) You could also play ‘stuck like glue’ where they have to try and stay upright and you try (gently) to push them over.


1) Once they can sit still on the floor, try sitting them up over your leg, sat astride a roll or on a bench so their feet are on the floor but their bodies are not supported.

2) Hold them by their chest to start with and try to move your hands towards their hips as their balance improves. As they adjust to this stay close so you can help them if they fall. They can watch or read something in this position so they don’t have to use their hands. Use this position for a regular activity like evening TV to get lots and lots of practice in.

3) When they are able to balance when they are still, challenge them by encouraging them to reach out to the side for a toy, reaching to the floor and back up or trying to reach out behind them to challenge their core and their balance.

Sitting on a gym ball is a balance exercises for your child to try once they have completed the other exercises

1) Once your child has sitting balance on the floor or on the bench/roll, you could try working some sitting balance on a moving object. This could be on a wobble cushion, on a gym ball or, if they fit on your lap, you could use your lap as a moving surface. 

2) Make sure you have complete control of the ball and your child to try this – it may take 2 adults. If you are using the ball, you can wedge it into the corner of the room to make it more stable until you are more confident in our handling. 

3) Hold them at their hips so you have control of their bottom on the ball. Very slow move the ball in all directions.  

4) As they get more confident you can move in bigger movements. Hold the position at the extreme of where they can go to make it a little harder but have a second person ready to catch them if they fall. 

This is a fabulous position to work the core.  

1) Start by getting your child to try maintaining a hands and knees position. It may be easier to start with your child sitting back on their heels and just balancing through their arms.

2) As they get stronger, move their bodies forward in slow progressions, just a little bit further each time you try this activity until their shoulders are over their hands and their hips are over their knees. 

3) If their body shoots forward, bring them back to sitting on their heels and start again going forward very slowly – stopping at several stages until they get enough control to stay in 4 point kneeling.

4) In these positions the best things to do are to watch something on a TV or tablet/ iPad or to read books. 

Rolling is a fabulous activity which can use some lovely rotation muscles. Many children with physical difficulties miss this stage out as rotation can be extra hard for them so it is a good activity to encourage.

To roll to the right from back to front to back.

  1. Lift the right arm straight above your child’s head

  2. Bend the left hip and knee up.

  3. Use a toy to encourage your child to look to the right and reach across the body with the left arm to initiate rolling. Help them bring their left leg over if this is too hard for them to do on their own.

  4. As they roll over onto their tummy, straighten out the left leg so they are flat on their tummy with both arms out in front of them.

  5. To get from tummy to back, bend up the right leg so the knee comes up towards the chest.

  6. Encourage your child to push up with their right hand on the floor so that they roll over onto their back.

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