Large, spontaneous m/n = 1/1 helical cores are predicted in tokamaks with extended regions of low- or reversed-magnetic shear profiles in a region within the q = 1 surface and an onset condition determined by constant (dp/dρ)/B2t along the threshold. These 3D modes occurred frequently in Alcator C-Mod during ramp-up when slow current penetration results in a reversed shear q-profile. The onset and early development of a helical core in C-Mod were simulated using a new 3D time-dependent equilibrium reconstruction, based on the ideal MHD equilibrium code VMEC. The reconstruction used the experimental density, temperature, and soft-X-ray fluctuations. The pressure profile can become hollow due to an inverted, hollow electron temperature profile caused by molybdenum radiation in the plasma core during the current ramp-up phase before the onset of sawteeth, which may also occur in ITER with tungsten. Based on modeling, it is found that a reverse shear q-profile combined with a hollow pressure profile reduces the onset condition threshold, enabling helical core formation from an otherwise axisymmetric equilibrium.