Tuck, Not Stretch (Physical Therapy for Preemies)

Preemies develop differently than full term babies. And here is a great example…

Full term babies spend their time in the womb tucked in a ball-like position. When full-term babies are born, they often “spring back” to that ball, or fetal, position. Their brains have developed enough to keep their muscles in this flexed position, which builds strength and enables them to calm and soothe themselves.

Preemies, on the other hand, lack the muscle and brain development needed to keep their limbs close. Since Jax born born 17 weeks early, he spent considerable time with his arms and legs spread out to the sides in a “flattened” position. We learned right away that this was not an ideal position.

Here's an example of a positioning tool that helped Jax stay in a position in which he could breathe. The tools also helped him stay in the fetal position. See the side support and the top support?
Here’s an example of a positioning tool that helped Jax stay in a position in which he could breathe. The tools also helped him stay in the fetal position. See the side support and the top support?

Even when Jax was in critical condition, the nurses made it a priority to turn him from his back to his side as much as possible. (In the early weeks, we were unable to turn him onto his stomach because he had an umbilical line.) Sometimes the change in position would help his breathing, other times he would spell and they would have to move him again. It was a constant “thing” trying to get him into a position where he could breathe better. Once we found a position that worked, we would prop him up with positioning tools to help him stay in that position. The tools also helped him stay in the “fetal position” with his arms and legs tucked in to his body.

I didn’t know it at the time, but this was a form of Physical Therapy.


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In the hospital, Jax received regular Physical and Occupational Therapies to help his muscles grow and develop.  He received infant massage to help prevent his muscles from becoming stiff. He was turned multiple times a day from his back to his side to his stomach to his other side to prevent “flat head.” We were taught to bring his arms and legs to midline and to use our hands to mimic the walls of the uterus to help him get used to the fetal position. However, even with all this work, often times, the only position that would allow him to breathe better would be him laying flat on his back, arms and legs spread out to the side.

Jax spent four extra months learning how to stretch out when he should have been learning to tuck in.

Because of this, we knew Jax had a very high chance of needing additional Physical Therapy support once he got home. At our last Early Intervention and Pediatrician appointments, we mentioned that Jax felt “tight” in his legs and was unable to bring his toes to his hands or mouth. The pediatrician also noticed that he has reduced reflexes in his legs and feet. This is preventing Jax from being able to roll over, sit, or scoot.

See how Jax's legs are straight while his cousin Will's are bent? That's one reason why Jax will be starting Physical Therapy soon.
See how Jax’s legs are straight while his adorable cousin Will’s are bent? This is one reason why Jax will be starting Physical Therapy soon.

While these things can be an indicator of Cerebral Palsy, the doc feels that is not something to worry about yet. We will start Physical Therapy to help Jax learn to bend his legs. I’m sure it will be a success and Jax will be rolling over before we know it! And then it’ll be time for child proofing!

Did your preemie receive Physical Therapy? How did it go? What did they do? Did they like it? We’re new to this, so any advice or thoughts you have are more than welcome! Please let us know about your experiences in the comments.


*An Early Start participates in the Amazon Associates Affiliate program. Some of the links listed are products sold on Amazon.com. If you click on one and make a purchase within a 24 hour period, we will receive a tiny commission from Amazon.com at no additional cost to you.

Author: Andrea M

Oh man, what an adventure! I went into labor unexpectedly when I was 23w3d pregnant. Jaxson was born weighing 1 lb 8 oz. A tiny little peanut, but boy was he feisty. He still is! We love it now, but we probably won't when he is a teenager. I write about our journey and all other things that come with it, including a brain tumor. We look forward to "meeting" you - come hang out with us...we're pretty cool.

7 thoughts on “Tuck, Not Stretch (Physical Therapy for Preemies)”

    1. It sounds as if your child wasn’t showing any symptoms that required PT – that’s great! But, I have found throughout our journey that I’ve had to be a “mama bear” and really push for things I thought Jax needed. We weren’t “offered” PT, I had to ask for it. In Minnesota, we have a program through the school district called Early Intervention that helps us determine if / when additional support is needed. Do you have Early Intervention in your state? How old is you child now? Is he or she showing signs of needing PT?


  1. I LOVE PT. Our boys have gotten PT once a month (and now Emmett gets it twice a month and Beckett graduated) since they came home from the NICU. It’s just like playing for them and while it’s hard work, our therapist is so nice and they just love her. Plus it tires them out like nothing I do with them and they always took/take great naps afterwards!

    And both my boys took forever before they had any interest or ability to grab their toes. But it all happens eventually, especially with PT to help it along.


    1. Thanks for sharing your experiences! I’m actually looking forward to starting – it will be fun to see how Jax responds. I’ve heard nothing but good things from other parents. I hope we get a nice therapist, too!


  2. The amount of things I have learned from your posts is amazing. I was sure the learning curve would be different with a preemie, but I didn’t realize all the things you simply take for granted having a “normal” pregnancy and birth. Thankfully you had\have a amazing team working with Jaxson. As parents we are the voice for our children, its wonderful that your doctor is tuned in and on the same page. Jax will continue to be a rock star and be rolling and (gasp)scooting around in no time!


    1. It really is amazing how much I’m learning, too! Like you know those Exersaucer / Johnny Jump-up play things? Those are great for full-term babies because it helps them stretch out, but they aren’t good for preemies for the same reason. Crazy!


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