Children’s physiotherapy, or paediatric physiotherapy, is a specialised area of physiotherapy. It serves the unique needs of babies, children and young adults from birth to leaving school.
Paediatric physiotherapists' training allows them to manage the physical, mental and educational needs of children.
Children may have developmental, learning, neurological, respiratory or musculoskeletal difficulties. Paediatric physiotherapists can assess and treat a wide range of conditions with the child and their parents. These conditions can be the result of illness, disability or injury and may include:
- Acute soft tissue injuries such as muscle strains, ligament sprains and joint injuries
- Fractures and leg-lengthening procedures
- Congenital conditions such as talipes equinovarus (CTEV) where the feet are abnormally positioned
- Acquired brain injury (ABI) after accidents or illness
- Developmental conditions such as cerebral palsy (CP) and Down’s syndrome
- Difficulties coordinating movement
- Breathing problems such as asthma and cystic fibrosis (CF)
- Physical disability and learning disabilities
- Developmental delays in the achievement of head control, sitting balance, crawling and walking skills
Why Physiotherapy For Children?
Studies have demonstrated that physiotherapy can restore movement and body function. It can also help children reach their full potential, achieve appropriate development and good quality of life.
Children are not just small adults. They have specific physical, developmental, mental and emotional needs. These must be considered for the best outcome.
Physiotherapists can also encourage physical fitness and promote health in children without movement or functional issues. Healthy children and teenagers on physiotherapy programmes have a lower risk of problems such as low back pain.
What Do Children’s Physiotherapists Do?
Children’s physiotherapists specialise in assessing and treating children from birth to 19 years old. They may have respiratory, developmental, musculoskeletal, neurological or other conditions. The physios work closely with parents, GPs, teachers and school nurses to assess the individual needs of the child. This involves looking at:
- The performance of movements, balance and coordination
- Developmental milestones such as crawling, sitting unaided and walking
- Musculoskeletal problems such as development dysplasia of the hip (DDH or clicky hips), hypermobility and Osgood-Schlatter’s Syndrome
- Respiratory function and management of infections
- Gait problems due to in-toeing, flat feet, toe walking or falls
- The ability to carry out activities of daily living
The assessment aims to help the physiotherapist identify areas that need improvement. They can then decide how this can be achieved. This information is used to develop a plan of treatment and exercise activities most effective for that particular child.
Attention is also given to ensure that all activities are safe, as well as stimulating and fun. This helps to sustain engagement and motivation throughout the programme.
Where Can Children Have Physiotherapy?
Paediatric physiotherapists work with children privately, or through the NHS, in many different settings. These may include the child’s home, nursery or school. Some children may need their physiotherapy carried out in a clinic or hospital.
Which Treatments Are Provided For Children?
As with adults, physiotherapy with children involves a wide variety of different activities. This ranges from isolated exercises to negotiating obstacles to ball exercises, climbing, swimming and more.
These activities, tailored to the child’s specific needs and therapy goals, fall into five main categories:
- Movement and exercise. Such as muscle strengthening, stretching and neurological movement techniques such as Bobath
- Respiratory care, including chest clearance and fitness training
- Manual therapy, where the therapist uses their hands to improve joint and muscle movements
- Splinting and orthotics
- Hydrotherapy, in which physiotherapy exercises are performed in water
The Importance Of Toys
Toys are used during activities with very young children as a way to stimulate play and curiosity. But they can also achieve specific health targets.
Encouraging toddlers with delayed development to reach and grasp for toys is an effective way to improve balance and mobility. This can be done during seated everyday tasks like eating and bathing. And parents can be trained by the physiotherapist so this kind of activity can be carried out in the home.
Physiotherapy For Babies
Paediatric physiotherapists do a significant amount of work with very young babies.
Children with cystic fibrosis (CF) need help to clear mucus from the lungs to prevent and manage respiratory infections. Parents need to be taught respiratory techniques for long-term management of this condition.
Neurological or developmental problems may present with abnormal postures and movement. Parents can stretch out tight structures and encourage normal movements. They can also discourage abnormal postures and movement patterns.
Babies with clicky hips or talipes may be in a harness or serial plaster of Paris casts respectively. Physiotherapists manage these conditions routinely under the supervision of an orthopaedic consultant. They can review babies regularly to ensure a good result.
How Can I Find A Children’s Physiotherapist?
To find a paediatric physiotherapist near you, enter a place or postcode in the Local Physio search bar. Then select ‘treatment for children’ from the specialities drop-down menu. All therapists on Local Physio are fully qualified and registered with the Health and Care Professions Council (HCPC).
Calvo-Munoz I, et al. Preventive physiotherapy interventions for back care in children and adolescent: a meta-analysis. BMC Musculoskeletal Disorders, 2012; 13:152, http://www.biomedcentral.com/content/pdf/1471-2474-13-152.pdf
The Association of Paediatric Chartered Physiotherapists, Physiotherapy for children, December 2013, http://apcp.csp.org.uk
NHS Choices, Physiotherapy – How it Works, 2012, http://www.nhs.uk/Conditions/Physiotherapy/Pages/How-does-it-work.aspx
NHS Scotland, Child Health Services, What are Physiotherapists, 2005, http://www.scotland.gov.uk/Resource/Doc/69582/0017136.pdf
Early Childhood Teacher Association (ECTA), Australia, Physiotherapy with Children, http://www.ecta.org.au/_dbase_upl/08_07_AugVideolinq_Slides.ppt
Valvano J, et al. Activity-focused motor interventions for infants and young children with neurological conditions. Infants & Young Children, 2006; 19(4):292-307 https://depts.washington.edu/isei/iyc/valvano_19.4.pdf