Children are not small adults - and they can’t be treated this way for pain or injury. Children’s bodies are constantly going through different stages of growth and development. Children’s growing bodies have many unique differences from their adult counterparts that go well beyond the size and strength of their muscles and bones. One example is having vulnerable areas called ‘growth plates’, which are not present in the bodies of mature adults, and must be carefully considered by health professionals when treating children for musculoskeletal pains and problems.
Aside from their physical and motor development, it’s equally important to consider the cognitive and perceptual stages that kids are at when they come for treatment. This means carefully constructing treatment plans and interventions that meet kids where they’re at and remain playful, child-directed and meaningful - something that takes skill and experience, and where our physiotherapists excel.
We work collaboratively with families to support young children aged 0-9 years, as well as adolescents aged 10-17 years. We often monitor and assist with developmental delays (whether they’re diagnosed or undiagnosed), help maximise a child’s motor and sensory development in their early years, and help optimise comfort and sports performance while treating pain and injuries in adolescents. The earlier a child begins competitive sports (and hence the greater the demands on their body), the more they can benefit from working with a physiotherapist.
What Can A Children’s Physio Help With?
The simplest answer is that if you’ve noticed something that seems ‘odd’ in your child’s movement or development, or with their physical posture, a children’s physio can likely help.
- Developmental delays: when children do not meet recommended developmental milestones (read more on expected milestones in the next section)
- Neurological conditions e.g. Cerebral palsy: with conditions like Cerebral Palsy where a child’s ability to move and maintain their balance and posture are compromised, physiotherapy works to help overcome the physical challenges and support optimum mobility, function, posture and balance in children and throughout adulthood.
- Genetic conditions e.g. Down syndrome: physiotherapy helps those with Down syndrome to function as independently as possible throughout different phases of their life. This often involves supporting strength development and helping them enjoy movement to benefit their overall health.
- Problems related to a premature delivery: when babies are born prematurely, they can benefit from a comprehensive assessment to determine any areas of muscle weakness, neurological signs and their rate of development. From here, a treatment plan will be made to help them get the best start.
- Hypotonia: meaning low muscle tone and being nicknamed “floppy baby syndrome” in newborns. Physiotherapy can help children improve their muscle strength and support their development.
- Newborn conditions, e.g. torticollis: newborns may experience a range of conditions that physio can help with including torticollis, which is better known as a twisted or wry neck where the head predominantly stays twisted to one side.
- Poor tummy time tolerance: physiotherapy can help support babies in making the most of their tummy time (including alternative movements) so they can gain the musculoskeletal benefits of this position.
- Hypermobility: hypermobile or excessively flexible children can greatly benefit from physiotherapy through gentle strengthening exercises, advice on optimal positioning and posture, and education on how to best support residual hypermobility through the years.
- Gait concerns e.g. in-toeing, toe walking: gait concerns often indicate a musculoskeletal variation, which physiotherapy can assess, diagnose, and form a management plan for.
- Sports injuries: physiotherapy is well known for helping people of all ages recover from musculoskeletal pain and injuries.
- Rehabilitation after surgery: surgery has a wide range of effects on the bodies of children, as well as adults. Physiotherapists work with children to optimise their recovery and help them get back to playing and exploring.
- Rehabilitation after childhood illness: many children face significant downtime from normal life due to ongoing illness or disease. Physiotherapists work alongside these children to help them return to optimal movement and function.
Hip dysplasia: hip dysplasia is a condition often diagnosed shortly after birth where the hip joint is improperly developed.
How we help with hip dysplasia.
My Child Doesn’t Have A Diagnosis - What Are Some Signs I Should Be Looking Out For At Home?
Every child has a period of time before they are diagnosed - and this can be a concerning time for parents whose gut instincts tell them that something is off, but they’re not quite sure what. Trust your instincts and have your child checked by your physio - you will either get reassurance that your child is developmentally on track, or if something is wrong, you stand to gain an earlier diagnosis and management plan. Some signs parents notice before bringing their kids in for an appointment can include:
- Difficult to settle, feed or handle. Issues with any of these tell us that there could be something going on that is contributing to these problems, and it warrants further investigation.
- Too “stiff” or too “floppy" and dislikes being moved; or strongly favours the use of one side of the body. This tells us that there could be underlying musculoskeletal issues like hypotonia or muscle contractions that are impacting your baby’s development, and it warrants further exploration and support.
- Your baby has poor head control. By 2 months of age, your baby should be able to hold their head up on their own, and do this steadily and without support by 4 months old.
- Your baby dislikes being placed on his/her tummy and does not appear to push up with the arms like other children. There are many reasons that babies may not enjoy tummy time - and it does not necessarily mean that anything is wrong. What it does mean is that you need to find alternative ways of helping your baby get the benefits that tummy time offers, which is building head, neck and shoulder strength that helps them achieve gross motor milestones such as rolling, crawling and sitting.
- Disinterested in people and toys. By 6 months old, typically developing infants enjoy playing with others (particularly their parents), respond to the emotions of others, like to look at themselves in the mirror, and are curious about toys - trying to reach them and often bringing them to the mouth.
- Your child engages in a lot of repetitive movements with little variety. Children are naturally curious as everything in the world is new to them, so they tend to be explorative by 6 months of age, trying to get things that are out of reach. Having little variety in their movements means testing and investigation is warranted to see what could be the cause.
- Being slow to achieve rolling, sitting, crawling, or walking. According to the CDC, your child should be able to roll over in both directions by 6 months, sit without support (and get themselves into the sitting position) by 9 months, and be walking by 18 months.
- Appears clumsy, or has problems with balance, coordination and ball skills. While some attribute general clumsiness to simply the nature of the child, it is very possible that there is an underlying musculoskeletal, neurological or other cause behind this clumsiness that can often be improved with physiotherapy.
- Showing poor posture in sitting and standing. While it’s natural to assume that slouching is a ‘choice’ (likely from our own habits), for some children, it may be linked to their musculoskeletal or nervous systems and warrants further investigation.
- Sensory issues such as sensitivity to touch, overreacting to loud noises, afraid of heights and fast-moving activities or having difficulty knowing the position of his/her body and its relationship to the surroundings.
Note: all milestone descriptions listed are according to the CDC milestone guidelines and checklists.