Physiotherapy for Children: A Complete Guide

Who is pediatric physical therapy for?

Pediatric physical therapy helps children and adolescents who have difficulty moving, are in pain, or have an injury. It supports motor development and recovery. Care is tailored to the child’s pace and the family’s needs. Parents are involved in discussions to understand the situation and treatment options.

What is pediatric physiotherapy?

Pediatric physical therapy evaluates and treats movement difficulties in newborns, children, and adolescents.¹ It may be used to address developmental delays or injuries to muscles, bones, or joints. Treatment is adapted as the child grows. Play helps engage the child in the recommended activities.

Pediatric physical therapists assess muscle strength, coordination, balance, posture, and a child's ability to perform age-appropriate movements, such as rolling, walking, or jumping.² They work with parents to create personalized treatment plans that fit into the daily lives of the child and their family.

Family-Centered Approach

A family-centered approach takes into account the priorities, schedules, and constraints of the child and their family members. The physical therapist selects activities in consultation with the family. As needed, the therapist explains the treatment to the parents and shows them activities they can do at home.

What Conditions Does Pediatric Physiotherapy Treat?

Pediatric physical therapy is used, in particular, to treat delays in motor development, infant torticollis, sports injuries, and movement difficulties associated with cerebral palsy.³ These health issues in children require care tailored to their age and needs.

Motor Developmental Delays

Motor development delay refers to the delayed onset of movements such as rolling over, sitting up, or walking.² The assessment describes the child’s abilities and identifies any other needs. It helps in selecting activities and determining whether another service should also be involved. Progress depends on each child’s individual situation.

Physical therapists can use play activities to provide the baby with opportunities to explore different positions and movements. The activities are tailored to the baby’s abilities and the results of the evaluation.

Growth-Related Conditions

Osgood-Schlatter disease and Sever's disease are conditions characterized by pain caused by repeated strain near a growth plate in active young people. They are two of the most common growth plate disorders during childhood and adolescence. This is the conclusion of a Cochrane review, which compiles and evaluates studies on a given topic.⁴ Growth is a contributing factor, but it is not the sole cause. A systematic review—that is, a study that searches for and evaluates research addressing a specific question—identifies several factors associated with Sever’s disease, including participation in sports.⁵ Studies do not always agree on the relative importance of each of these factors. Osgood-Schlatter disease affects the front of the knee, while Sever’s disease affects the heel.

Osgood-Schlatter Disease

Osgood-Schlatter disease causes knee pain in children and adolescents during growth spurts. It primarily affects young people who participate in sports that involve jumping and running. It is caused by repeated pulling of the patellar tendon against the tibia, the bone at the front of the leg. This tendon connects the patella—the small bone in front of the knee—to the tibia. The tendon’s attachment to the tibia is located near a growth plate: this is the part of the bone that has not yet finished forming and remains open as the young person grows.⁶ The pain is located at the tibial tubercle, the small bony bump just below the patella, and it often worsens during running, jumping, and walking up stairs.⁷

Osgood-Schlatter disease is usually treated without surgery. A 2021 review reports favorable results with certain stretching exercises, but the studies are few in number and of varying quality.⁸ None of the trials in this review compared an exercise program to a placebo or to standard care. In a randomized trial, participants are randomly assigned to receive one treatment or another. The 2026 Cochrane review also considers most of the evidence regarding damage to the growth plates in the leg to be uncertain.⁴ Adjustments to activities, exercises, and a return to sports are determined based on the young person’s symptoms, abilities, and goals.

Sever's Disease

Sever's disease causes heel pain in children and young adolescents. It is caused by tension from the Achilles tendon—which connects the calf muscles to the heel—on the growth plate of the calcaneus. The calcaneus is the heel bone, and this tension results from repeated minor trauma.⁹ It is seen in young people who play sports, especially those who run and jump. Participation in sports is one of the factors studied, along with several others, and the results vary from one study to another.⁵

For Sever's disease, treatment may include temporary adjustments to daily activities, exercises, and advice on footwear. Heel lifts raise the heel. Orthotics are insoles that support the foot. A 2013 review suggested that orthotics provide better short-term relief than heel lifts, although the evidence is limited.¹⁰ The 2026 Cochrane review, however, found little or no difference between these two options in terms of pain and short-term activities, with moderate certainty.⁴ This comparison does not measure their effect relative to no treatment. The choice depends on the young person’s symptoms, intended activities, and response to treatment.

Before giving a child an anti-inflammatory medication, consult a pharmacist or doctor. A meta-analysis combining several studies found no clear evidence of an increase in bone healing problems in children after taking these medications.¹¹ Another review of six studies in children supports this conclusion, particularly for short-term use around the time of a fracture or surgery: no increased risk of delayed or failed bone healing was observed. These results do not address tendon healing and do not resolve the issue of all high-risk fractures or prolonged use.¹²

Persistent leg pain in a young athlete does not always have the same cause. A review article describes five causes to distinguish among athletes: pain on the inside of the shin known as medial tibial stress syndrome, a small bone crack known as a stress fracture, excessive pressure in a muscle group during exercise known as compartment syndrome, and compression of a nerve or the artery behind the knee.¹³ The symptoms are similar. A physical examination and, if necessary, targeted tests help identify the cause before choosing a treatment.¹³

Congenital torticollis

Congenital torticollis is characterized by a tendency to keep the head turned or tilted to one side.^{14, 1} Congenital torticollis may be accompanied by a difference in the shape of the skull on either side and differences in motor development; the evaluation is used to assess these factors. In infants being monitored for torticollis, transient asymmetry in movement was more often associated with motor delay and a flattened head on one side.¹⁵ A systematic review also notes a link between a flattened head and developmental delay, particularly motor delay. This link does not prove that one causes the other.¹⁶

Early treatment for congenital torticollis includes gentle neck movements, active exercises, varying positions, and guidance for parents. A synthesis of reviews reports that professionally guided stretching improves neck mobility, with moderate certainty.¹⁷ It also supports providing guidance to parents and changing the child’s position throughout the day.¹⁷ The 2024 guideline recommends guided movements when mobility is limited, active neck and body movements, symmetrical movements, environmental adaptations, and information for parents.¹⁴ A review of 100 trials, published in 2025, reports short-term improvements in mobility and symmetry after adding manual techniques to other treatments. The confidence in these results remains low to very low. Adverse effects are poorly reported.¹⁸

Microcurrent is a low-intensity electric current. A study involving 20 infants compared it to a placebo device that did not deliver any current, in conjunction with exercises and therapeutic ultrasound. This ultrasound uses sound vibrations that are inaudible to the human ear.¹⁹ This method is also mentioned in a general review of pediatric care.¹

Cerebral Palsy

Cerebral palsy is a group of permanent movement and posture disorders caused by damage to the developing brain.³ The brain injury occurs before birth or during infancy. It does not progress, but its effects on movement may change as the child grows.²⁰Physical therapy can help improve mobility, daily activities, and independence. Physical therapy also addresses spasticity: certain muscles offer greater resistance when a limb is moved quickly to stretch them. This resistance stems from a stretch reflex—an automatic muscle contraction that has become too easily triggered.²¹

Treatment may include exercises, manual techniques, walking training, and adaptive equipment. A trial divided 18 children with cerebral palsy into two groups of nine. One group received an adapted sports program. The other group received the same program along with support to modify the environment and facilitate the chosen activities.²² This second group achieved better results in terms of performing the selected activities, satisfaction, and the families’ sense of empowerment after the program. School attendance was also better at the follow-up. Other outcomes did not differ clearly between the groups. This small trial primarily aimed to assess the feasibility of conducting a larger study; its favorable results remain preliminary.

Musculoskeletal Injuries

Injuries to muscles, bones, and joints in children include ligament sprains, muscle strains or tears, fractures, and sports-related overuse injuries. Physical therapy can address symptoms, mobility, strength, and activities depending on the injury. Certain risk-reduction strategies are specific to a particular injury and sport, though they do not prevent all recurrences. Among adolescents, sixteen trials pooled in a single review reported a decrease of approximately 37 percent in injury rates with exercise programs. The injury rate was lower, but some injuries still occurred.²³ Another review also reports fewer injuries with prevention programs. The effect varies depending on the program’s content. Data are lacking for children under 14 and in individual sports.²⁴

Rehabilitation programs, which help children regain the abilities needed for daily activities, are tailored to the child's developmental level and include progressive exercises, manual techniques to reduce pain and stiffness, and guidance on safely returning to sports.

Platelet-rich plasma injections use a concentrate derived from the patient's own blood, which is then reinjected into the injury site. A study published in the *New England Journal of Medicine* examined 80 adult athletes aged 18 to 50 with a recent hamstring tear—the muscles at the back of the thigh. It did not show a faster return to sports compared to a placebo injection.²⁵ Follow-up also showed no reduction in new injuries or any benefit on clinical examination or medical imaging.²⁶ These results in adults are not sufficient to determine the appropriate treatment for a child.

A 2023 review of primarily male athletes aged 14 to 49 found no consistent benefit from these injections. Nor does it provide evidence to favor one exercise program over all others. Limited evidence suggests, however, that exercises in which the muscle resists movement while lengthening may speed up a return to full training. The certainty of these findings remains very low.²⁷ The gradual resumption of movement and sports should be planned based on the nature of the injury and the young person’s abilities.

Respiratory Conditions

For a premature newborn, respiratory care is provided by the neonatal care team. If respiratory physical therapy is being considered, the team selects the appropriate care based on the baby’s health status and risks.³

Brachial Plexus Injuries

An injury to the brachial plexus near the shoulder affects the network of nerves in the arm. It can weaken certain movements.³ The brachial plexus is the network of nerves that extends from the neck and upper back to the arm, forearm, and hand. Weakness in the arm or a loss of movement may suggest this condition; an examination is needed to confirm the cause.²⁸ Physical therapy may be part of the management plan to maintain mobility, work on existing abilities, and promote the use of the arm as the child progresses. Seven randomized controlled trials report short-term improvements in range of motion, strength, or difficulties using the arm, whether physical therapy is provided alone or in combination with other approaches. The quality of this evidence remains low, so caution is warranted.²⁹

What happens during a pediatric physiotherapy assessment?

A pediatric physical therapy evaluation includes a discussion with the parents and an assessment of the child's movements.² The physical therapist asks about the pregnancy, birth, and development. The therapist then observes the child’s strength, movements, and interactions with the therapist, depending on the child’s age and the situation.

The physiotherapist observes the child in various positions and activities to assess:

• Posture and the Position of the Various Parts of the Body
• Muscle strength (ability to sit, stand)
• Everyday movements, such as rolling, crawling, and walking
• Flexibility and Range of Motion
• Balance and coordination
• Responses to sensory input, such as touch or changes in position

Motor Development Milestones

The assessment uses age-appropriate milestones, adjusted according to the expected date of birth in cases of prematurity. The World Health Organization study of 816 children provides the following intervals. These cover approximately 98% of developmental milestones, with 1% occurring earlier and 1% occurring later; however, they cannot be used on their own to diagnose a developmental delay:

• Babies first learn to hold up their heads and move their arms and legs. Later, they learn to roll over, sit up with support, and hold objects. The age at which these milestones occur varies from child to child.
• In the study, sitting without support began between 3.8 and 9.2 months. Crawling began between 5.2 and 13.5 months. However, 4.3% of the children had never crawled. Standing with assistance began between 4.8 and 11.4 months.³⁰
• The baby then learns to move around with support, and later without assistance. In the same study, walking with assistance began between 5.9 and 13.7 months. Standing without assistance began between 6.9 and 16.9 months. Walking without assistance began between 8.2 and 17.6 months.³⁰ If you have any concerns about your child’s development, talk to a professional.
• The 8.2- to 17.6-month range for walking without assistance extends into the second year. The child may also learn to explore stairs before being able to climb them while standing upright.³⁰ A study of 732 families primarily described climbing stairs on all fours and descending while backing down. The reported average ages were approximately 11 months for climbing and 12.5 months for descending. Access to stairs was associated with earlier climbing, with no clear difference for descending. Parents’ demonstrations and the children’s experiences were also studied. These observations are not a recommendation to let a baby explore stairs alone.³¹ If walking is delayed and you have concerns, talk to a professional.
• Running, jumping with both feet together, and going up and down stairs are all part of a young child’s motor development. The pace at which these skills are acquired varies widely. If you have concerns about your child’s motor development, talk to your doctor or pediatrician.

A diagnosis of developmental delay requires a comprehensive professional evaluation.

After the assessment

After the evaluation, the physical therapist explains the results to the parents and works with the family to develop a plan. This plan outlines the goals and how progress will be measured. It may also include activities to do at home.

What treatments are used in pediatric physiotherapy?

Pediatric physical therapy treatments include exercises, manual techniques, gait and balance training, and specialized equipment.³² The physical therapist selects the methods that best meet the child’s needs. Goals may include building strength or improving coordination, reducing pain and stiffness, or facilitating a specific activity.

Play-Based and Age-Appropriate Approach

The game allows you to offer activities tailored to the child's age and interests.¹ An obstacle course, for example, can help develop balance, coordination, and strength. The activities are designed to meet the treatment goals and can be adjusted as the child makes progress.

For infants, activities may include tummy time, but only while the baby is awake and under supervision. When sleeping, the baby should lie on his or her back. Playtime can also introduce different textures or encourage movement with the help of parents. For preschoolers, the physical therapist may use imagination, songs, and toys to encourage the desired movements.

Therapeutic Exercises

Therapeutic exercises are designed to strengthen specific muscles, improve coordination, and teach movements that are useful in daily life. They are progressive, starting with simple movements and gradually increasing in complexity as the child makes progress.

Exercises may include:

• Strength training, such as standing up from a squatting position or bending the knees with one foot in front of the other
• Stretches to improve flexibility
• Exercises for balance and body awareness (knowing where your limbs are without looking at them)
• Activities that use both sides of the body together
• Practicing stairs, jumps, and running

Manual therapy

Manual therapy involves guided joint movements, massage, and stretching performed by hand. The physical therapist adapts these techniques to the child’s age and response. A review of the mechanisms underlying these techniques describes responses from several body systems. Explanations based on mechanical changes in tissues remain uncertain, as does their link to clinical outcomes.³³ Another review of 25 studies found no clearly established overall reduction in muscle stiffness immediately following a massage. The results regarding tendons were inconsistent.³⁴ These measures of stiffness are not sufficient to conclude that no child can experience relief or gain mobility.

In an infant with muscular torticollis, gentle stretching can improve neck mobility.¹⁷ These stretches can target the sternocleidomastoid muscle, which connects the area behind the ear to the sternum (the bone in the center of the chest) and the clavicle (the bone between the top of the chest and the shoulder). The healthcare professional demonstrates the technique to the parents and adjusts the frequency. The movements should remain gentle. Stop if the baby resists, shows signs of pain, breathes differently, or changes color, and then seek advice from the healthcare professional. Refer to the torticollis guide.

Gait and Balance Training

Walking training helps children develop or improve their walking skills. This may include exercises on various surfaces, using parallel bars for support, and activities that strengthen the muscles needed for efficient walking.

Balance exercises can progress from stable positions to more challenging tasks. They are selected when the assessment indicates that balance is relevant to the child's activities.

Prescription of Equipment and Assistive Devices

Depending on the child's needs, the physical therapist may recommend braces to support a part of the body, shoes tailored to a specific foot condition, a walker or cane, as well as seats or cushions to help with positioning.

This equipment is carefully selected and adjusted to support a child's development and facilitate activities that the child can do on his or her own.

Home exercise program

Depending on the child’s condition, goals, and family situation, the physical therapist may suggest activities for the child to do between sessions. A home exercise program is not a mandatory part of every treatment plan. Regular practice gives the child more opportunities to repeat the activities learned between appointments.

Home exercise programs are designed to fit into daily routines—for example, by adding stretches while changing a diaper or balance exercises during play.

When should you consult a pediatric physiotherapist?

You should consult a physical therapist who works with children when a movement difficulty, persistent pain, or needs following an injury are causing concern for the child or their parents.² Delayed development, asymmetrical posture, or difficulties with sports may warrant a consultation. Rehabilitation care is planned based on the evaluation.

Parents may seek advice regarding their child’s posture or an apparent difference in leg length. The healthcare professional interprets these observations in light of the patient’s pain, activities, and physical examination. A study comparing 27 adults with pain to 29 people without pain found no clear difference in lower back curvature between those with and without pain.³⁵ This result does not measure leg length or the children’s posture.³⁵

Warning Signs in Infants

For infants (0–12 months):

• Consult a healthcare provider if your baby has difficulty controlling his or her head or is not making progress with movements such as rolling over. According to NICE, the British organization that publishes these health recommendations, a baby who cannot sit up without support by 8 months should be evaluated by a healthcare provider. The age should be adjusted in cases of premature birth.
• Tell the doctor if you notice a lack of progress in mobility, stiffness, or excessive floppiness. Also mention any marked preference for one hand before the age of one. Some children do not go through the crawling stage; this observation alone is not enough to diagnose a developmental delay.
• Constant head tilting or rotation (torticollis)

Warning Signs in Young Children

For children ages 1 to 5, signs should be interpreted based on their age and the skills they have already acquired. Be sure to consult a healthcare provider in the following situations:

• Failure to walk independently by 15 months in girls or by 18 months in boys, according to NICE guidelines. Age is adjusted for preterm birth. Read the consultation guidelines.
• Unusual falls, persistent difficulty maintaining balance, or a persistent tendency to walk on tiptoes.
• Difficulty going up or down stairs
• Asymmetry in movement or posture
• Delays in motor skills (running, jumping, throwing)
• Avoiding physical activities or active play

Warning Signs in School-Aged Children and Adolescents

For older children and teenagers, consult if:

• Knee or heel pain that persists despite rest; growing pains are one of the possible causes
• Sports injury requiring rehabilitation
• Pain that limits participation in activities
• Posture or gait problems
• Coordination difficulties or unusual clumsiness
• Slow recovery after an injury

Widespread muscle pain or persistent weakness warrants a medical evaluation. The doctor will investigate the various possible causes and determine whether any tests are necessary, including a vitamin D level test in certain situations.³⁶ Read the dosing instructions for pediatric use.

When should you seek medical care right away?

Sudden or rapidly worsening weakness in an arm, leg, or face requires immediate medical evaluation. An abnormal, new way of walking also requires immediate pediatric care. Go to the emergency room if an abnormal neck posture develops after a head or neck injury. The loss of previously acquired movements should be reported to a doctor immediately so that an evaluation can be arranged. Read the recommendations regarding these signs.

Early Detection and Intervention

Identifying a developmental delay early on makes it possible to assess the child's needs and refer the child more quickly to the appropriate services.² The timing and type of intervention then depend on the child’s condition, abilities, and goals.

Discuss your concerns with a professional before the problem becomes more serious. A physical therapist can assess your child’s movements, explain developmental milestones, and determine whether treatment or a referral to a medical professional is needed.

What is the role of parents in pediatric physiotherapy?

Parents share their observations, participate in decision-making, and can help their child resume the activities offered. Their involvement is tailored to the child's age, level of independence, and needs, as well as the family's circumstances.

Active Participation in Sessions

During physiotherapy sessions, parents are encouraged to observe, ask questions, and learn the techniques the physiotherapist uses. This involvement helps parents understand the treatment goals and feel confident in their ability to support their child.

The physical therapist may ask the parents to help with certain exercises or positions, depending on what the child and his or her family are able to do.

Home exercise program

Home exercises give children opportunities to practice what they learned during their sessions. The physical therapist can provide instructions, demonstrations, or worksheets tailored to the family’s needs.

When a home activity is part of the plan, its duration, frequency, and integration into the child’s daily routine are discussed with the family. It is adjusted based on the child’s response, though it is not possible to predict a general effect on the speed or extent of progress.

Encouragement and Motivation

Parents can encourage their child’s efforts and highlight their progress. Age-appropriate rewards can be discussed, but their effectiveness has not been clearly established. A review notes that positive outcomes are most likely when activities are tailored to the child, varied, and useful in their daily life. Data on motivation remain scarce and of varying quality.³⁷ Another review lists providing children with opportunities to succeed among the strategies reported by professionals.³⁸

For older children, explaining the purpose of an exercise can help them understand the treatment. For example: “This exercise builds the strength you need for soccer.” In a review of 20 studies, professionals report that clear explanations of the treatment and the child’s role are among the strategies used to support the child’s engagement.³⁸ This review describes the reported practices; it does not prove the effectiveness of each encouraging phrase.³⁸

Communication with the Care Team

Parents act as a link between the various healthcare professionals involved in their child's care. They share information about progress at home, concerns, and any changes they observe, allowing the physiotherapist to adjust treatment as needed.

How long does pediatric physiotherapy treatment last?

Pediatric physical therapy treatment can last from several weeks to several months, and some cases require longer-term care. The duration depends on the child’s condition, treatment goals, and progress. For example, in a study of 980 children with congenital muscular torticollis without a hematoma, the reported treatment durations were 1.5 months for treatment starting before one month of age and 5.9 months for treatment starting between one and three months of age. A hematoma is a collection of blood in tissue. These findings do not predict the duration of treatment for a specific child.³⁹

Session frequency

The frequency and duration of follow-up vary from child to child. The physical therapist adjusts them based on the child’s condition, response to treatment, and the family’s goals. A specific goal may require only a few appointments. A developmental delay or a problem affecting the nerves or the brain may require longer-term care.

The frequency and type of appointments vary depending on the condition, goals, needs, and observed progress. They are reassessed during follow-up care. For muscular torticollis in infants, the 2024 guidelines recommend consulting a doctor if differences in posture or mobility do not begin to improve after four to six weeks of comprehensive care, or if progress plateaus after six months. See Recommendation 15.

Factors Affecting Duration

Several factors affect the duration of treatment:

• Severity of difficulties: This is assessed in light of the child's diagnosis, abilities, goals, and progress
• Child's age: Age can influence the treatment plan, but its impact depends on the child's condition and abilities.
• Doing Activities at Home: The agreed-upon activities can be done between appointments according to the instructions provided
• Other Health Issues: Other health issues may prolong treatment
• Family Goals: The duration depends on the activities involved and the progress needed to achieve them

Measuring Progress

Physical therapists use tests that are administered the same way from one visit to the next, along with specific activity measurements, to track the child’s progress. These regular evaluations allow them to adjust the treatment plan and determine when goals have been met.

The physical therapist can illustrate progress with a concrete example: “Your child can now stand on one foot for 10 seconds, compared to 3 seconds a month ago.” These numbers show one way to track progress; they are not a target for all children.

Is pediatric physiotherapy painful?

Pediatric physical therapy can sometimes cause discomfort during the evaluation or exercises. The physical therapist observes the child’s response, asks the child how they feel when possible, and adjusts the activity based on the child’s symptoms, the treatment goal, and the child’s tolerance.

Pediatric physiotherapists are trained to work within a child's comfort zone and use playful approaches to make sessions enjoyable. If an exercise or technique causes pain, the physiotherapist immediately adjusts their approach.

For a growth-related pain condition, the physical therapist may discuss activities, symptoms, and exercises with the young person. The choices depend on the condition, function, and the observed response.

Welcoming Environment

A suitable environment can make the session more reassuring for the child. The physical therapist may use toys, a play area, and appropriate equipment. The child's preferences and what makes them feel secure are discussed with the parents.

Is pediatric physiotherapy covered by insurance?

Private insurance plans may cover pediatric physical therapy depending on the terms of the policy. The number of sessions, the maximum amount covered, and the required documentation may vary. Please refer to the OPPQ’s guidelines.

Before the first appointment, check with your insurance provider to confirm your child's coverage. Depending on your policy, a doctor's referral may be required for reimbursement, even if you can see a physical therapist directly through a private practice.

Physical therapy services provided through the public health care system are covered by the government. To find out what services are available to your child and what other forms of assistance may be available, talk to your child’s care team. Eligibility depends on the program and your specific situation.

References

Links open in a new tab.

1. Srushti Sudhir C, Sharath HV. A Brief Overview of Recent Pediatric Physical Therapy Practices and Their Importance. Cureus. 2023;15(10):e47863. (Back to sections: 1, 2, 3, 4)
2. Choose PT. Guide | Physical Therapy Guide to Developmental Delay. 2023. (Back to sections: 1, 2, 3, 4, 5)
3. Physiopedia. Principles of Pediatric Physical Therapy. (Back to sections: 1, 2, 3, 4)
4. Williams CM, Krommes K, Paterson KL, Haines T, Caserta A, Thorborg K. Non-surgical treatment for lower limb apophyseal injuries. Cochrane Database Syst Rev. 2026;7(7):CD015156. (Back to sections: 1, 2, 3)
5. Nieto-Gil P, Marco-Lledó J, García-Campos J, Ruiz-Muñoz M, Gijon-Nogueron G, Ramos-Petersen L. Risk factors and associated factors for calcaneal apophysitis (Sever's disease): a systematic review. BMJ Open. 2023;13(6):e064903. (Back to sections: 1, 2)
6. Ladenhauf HN, Seitlinger G, Green DW. Osgood-Schlatter disease: a 2020 update on a common knee condition in children. Curr Opin Pediatr. 2020;32(1):107-112. (Back to section: 1)
7. Vaishya R, Azizi AT, Agarwal AK, Vijay V. Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review. Cureus. 2016;8(9):e780. (Back to section: 1)
8. Neuhaus C, Appenzeller-Herzog C, Faude O. A systematic review of conservative treatment options for Osgood-Schlatter disease. Phys Ther Sport. 2021;49:178-187. (Back to section: 1)
9. Smith JM, Varacallo MA. Sever's Disease (Calcaneal Apophysitis). StatPearls. 2026. (Back to section: 1)
10. James AM, Williams CM, Haines TP. "Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever's disease): a systematic review." J Foot Ankle Res. 2013;6(1):16. (Back to section: 1)
11. Wheatley BM, Nappo KE, Christensen DL, Holman AM, Brooks DI, Potter BK. Effect of NSAIDs on Bone Healing Rates: A Meta-analysis. J Am Acad Orthop Surg. 2019;27(7):e330-e336. (Back to section: 1)
12. Stroud S, Katyal T, Gornitzky AL, Swarup I. Effect of nonsteroidal anti-inflammatory drugs on fracture healing in children: A systematic review. World J Orthop. 2022;13(5):494-502. (Back to section: 1)
13. Edwards PH, Wright ML, Hartman JF. A practical approach to the differential diagnosis of chronic leg pain in athletes. Am J Sports Med. 2005;33(8):1241-9. (Back to sections: 1, 2)
14. Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatr Phys Ther. 2024;36(4):370-421. (Back to sections: 1, 2)
15. Watemberg N, Ben-Sasson A, Goldfarb R. Transient Motor Asymmetry Among Infants With Congenital Torticollis—Description, Characterization, and Results of Follow-Up. Pediatr Neurol. 2016;59:36-40. (Back to section: 1)
16. Martiniuk AL, Vujovich-Dunn C, Park M, Yu W, Lucas BR. Plagiocephaly and Developmental Delay: A Systematic Review. J Dev Behav Pediatr. 2017;38(1):67-78. (Back to section: 1)
17. Ellwood J, Draper-Rodi J, Carnes D. The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: a synthesis of systematic reviews and guidance. Chiropr Man Therap. 2020;28(1):31. (Back to sections: 1, 2, 3)
18. Antares JB, Jones MA, Chak NTN, Chi Y, Li H, Li M, et al. Efficacy of non-surgical, non-pharmacological treatments for congenital muscular torticollis: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2025;26(1):178. (Back to section: 1)
19. Kwon DR, Park GY. Efficacy of microcurrent therapy in infants with congenital muscular torticollis involving the entire sternocleidomastoid muscle: a randomized placebo-controlled trial. Clin Rehabil. 2014;28(10):983-91. (Back to section: 1)
20. Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification, and Treatment Options. Neuropsychiatr Dis Treat. 2020;16:1505-1518. (Back to section: 1)
21. Mukherjee A, Chakravarty A. Mechanisms of spasticity—for the clinician. Front Neurol. 2010;1:149. (Back to section: 1)
22. da Silva LC, Magalhães RC, Soares Santos A, Andrade Ramos de Souza AC, Ribeiro EM, Xavier JMR, et al. Modified Sports Intervention Combined with a Context-Focused Intervention for Children with Cerebral Palsy: A Feasibility Randomized Clinical Trial. Physical & Occupational Therapy in Pediatrics. 2025;45(6):934-955. (Back to section: 1)
23. Zhang ZX, Lai J, Shen L, Krishna L. Effectiveness of exercise-based sports injury prevention programs in reducing injury rates among adolescents and their implementation in the community: a mixed-methods systematic review. Br J Sports Med. 2024;58(12):674-684. (Back to section: 1)
24. Rössler R, Donath L, Verhagen E, Junge A, Schweizer T, Faude O. Exercise-based injury prevention in children’s and adolescents’ sports: a systematic review and meta-analysis. Sports Med. 2014;44(12):1733-48. (Back to section: 1)
25. Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JA, Bierma-Zeinstra SM, et al. Platelet-rich plasma injections in acute muscle injury. N Engl J Med. 2014;370(26):2546-7. (Back to section: 1)
26. Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JA, Bierma-Zeinstra SM, et al. Rationale, secondary outcome scores, and 1-year follow-up of a randomized trial of platelet-rich plasma injections for acute hamstring muscle injury: the Dutch Hamstring Injection Therapy study. Br J Sports Med. 2015;49(18):1206-12. (Back to section: 1)
27. Afonso J, Olivares-Jabalera J, Fernandes RJ, Clemente FM, Rocha-Rodrigues S, Claudino JG, et al. Effectiveness of Conservative Interventions After Acute Hamstring Injuries in Athletes: A Living Systematic Review. Sports Med. 2023;53(3):615-635. (Back to section: 1)
28. Benjamin K. Part 1. Injuries to the brachial plexus: mechanisms of injury and identification of risk factors. Adv Neonatal Care. 2005;5(4):181-9. (Back to section: 1)
29. de Matos MA, Souto DO, Soares BA, de Oliveira VC, Leite HR, Camargos ACR. Effectiveness of Physical Therapy Interventions in Children with Brachial Plexus Birth Injury: A Systematic Review. Dev Neurorehabil. 2023;26(1):52-62. (Back to section: 1)
30. WHO Multicenter Growth Reference Study Group. WHO Motor Development Study: windows of achievement for six gross motor development milestones. Acta Paediatr Suppl. 2006;450:86-95. (Back to sections: 1, 2, 3)
31. Berger SE, Theuring C, Adolph KE. How and when infants learn to climb stairs. Infant Behav Dev. 2007;30(1):36-49. (Back to section: 1)
32. Choose PT. Resource | What Is Pediatric Physical Therapy? 2024. (Back to section 1)
33. Keter DL, Bialosky JE, Brochetti K, Courtney CA, Funabashi M, Karas S, et al. The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews. PLoS One. 2025;20(3):e0319586. (Back to section: 1)
34. Löbell R, Glänzel MH, Prates IM, Petter GDN, Marqueti RC, de Oliveira RR, et al. Short-term effectiveness of massage techniques on the stiffness of myotendinous structures: a systematic review and meta-analysis. Res Sports Med. 2026:1-26. (Back to section: 1)
35. Murrie VL, Dixon AK, Hollingworth W, Wilson H, Doyle TA. Lumbar lordosis: a study of patients with and without low back pain. Clin Anat. 2003;16(2):144-7. (Back to sections: 1, 2)
36. Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003;78(12):1457-9. (Back to section: 1)
37. Meyns P, Roman de Mettelinge T, van der Spank J, Coussens M, Van Waelvelde H. Motivation in pediatric motor rehabilitation: A systematic literature review using self-determination theory as a conceptual framework. Dev Neurorehabil. 2018;21(6):371-390. (Back to section: 1)
38. Antoniadou M, Granlund M, Andersson AK. Strategies Used by Professionals in Pediatric Rehabilitation to Engage the Child in the Intervention Process: A Scoping Review. Phys Occup Ther Pediatr. 2024;44(4):461-488. (Back to sections: 1, 2, 3)
39. Petronic I, Brdar R, Cirovic D, Nikolic D, Lukac M, Janic D, et al. Congenital muscular torticollis in children: distribution, treatment duration, and outcome. Eur J Phys Rehabil Med. 2010;46(2):153-7. (Back to section: 1)
40. Corbi F, Matas S, Álvarez-Herms J, Sitko S, Baiget E, Reverter-Masia J, et al. Osgood-Schlatter Disease: Presentation, Diagnosis, and Treatment: A Narrative Review. Healthcare (Basel). 2022;10(6).
41. Waghe VR, Ramteke SU. The Role of Physical Therapy in Osgood-Schlatter Disease in an Adolescent Volleyball Spiker: A Case Report. Cureus. 2024;16(2):e53534.
42. Australian Sports Physiotherapy. The Role of Physical Therapy in Osgood-Schlatter and Sever's Disease. 2024.