Pediatric Physiotherapy: Children and Teens

How does pediatric physical therapy differ from physical therapy for adults?

Pediatric physical therapy differs from physical therapy for adults because it must take into account a child’s ongoing growth, developmental milestones, and physical changes. A systematic review identifies and evaluates studies on a specific topic. A 2023 review focuses on care that helps children and adolescents aged 2 to 18 with cerebral palsy move and participate in activities. Cerebral palsy is a group of movement disorders linked to damage to the developing brain. The review concludes that treatment plans must be tailored to the age, developmental level, goals, and preferences of the young person and their family¹. This area of practice addresses the needs of developing children and is one of the various fields within physical therapy.

At Physioactif, our physical therapists treat children and adolescents for sports injuries and growth-related issues. They assess problems with muscles, bones, and joints using approaches tailored to the patient's age and stage of development.

What is pediatric physiotherapy?

Pediatric physical therapy is a field of care that helps children and adolescents move and participate in physical activities². Some programs also provide care for young adults. This field requires knowledge of growth, development, and health issues specific to these age groups.

In pediatric physical therapy, the evaluation may focus on the child’s motor skills, activities, and environment. A review published in 2024 describes the same type of assessment. It focuses on developmental coordination disorder, which is a persistent difficulty coordinating movements. The review examines physical abilities, the body parts involved, activities at home or at school, and the opportunities provided by the child’s environment³. The recommended interventions vary depending on the condition, the child’s developmental level, the goals, and the observed response.

Main areas of intervention:

• Assessment of large movements, such as walking, and precise hand movements, such as grasping a toy
• Treatment of growth-related muscle, bone, and joint problems
• Management of Pediatric Sports Injuries
• Age-appropriate exercises and activities to help regain abilities after an injury
• Strength, balance, and coordination exercises tailored to assessed needs
• Preparing to Return to Practice and Competition After an Injury

Target Ages: Pediatric physical therapy is intended for children and adolescents, from birth through the end of adolescence. The exact age limit depends on the healthcare setting and the specific needs of each young person.

Physioactif Context: Our physiotherapists treat common pediatric conditions such as sports injuries, growth-related issues, and torticollis. For complex developmental conditions (like cerebral palsy or significant motor delays), we refer to specialized pediatric programs in a hospital setting.

How does movement develop in children?

Motor development involves milestones such as holding up the head, sitting up, and walking, at rates that vary from child to child. The World Health Organization (WHO) tracked 816 children in five countries. Nearly 90% reached five of the major milestones studied in the same order. Crawling was the most common exception. The ages at which these milestones were reached overlapped significantly⁴. These milestones help track progress and discuss any difficulties; they are not sufficient to make a diagnosis.

The first year of life and developmental milestones that may continue beyond 12 months:

• Head control: Keeping the head steady while an adult is holding the baby is a 4-month milestone according to the CDC, the U.S. public health agency.
• Rolling over: Rolling from the stomach to the back is one of the CDC's 6-month milestones.²
• Unassisted sitting: In the WHO study, the age at which 98% of children achieved this milestone ranged from 3.8 to 9.2 months⁴.
• Crawling: Crawling on all fours, using hands and knees, appeared between 5.2 and 13.5 months for 98% of children who acquired this skill. Some children skip this stage.⁵ Of the 816 babies observed by the World Health Organization, 4.3% never crawled on all fours, using their hands and knees⁴.
• Standing with support: This skill emerged between 4.8 and 11.4 months in 98% of the children in the WHO study⁴.

Second year (12-24 months):

• Walking without assistance: In the WHO study, 98% of children began walking between 8.2 and 17.6 months. Walking can therefore begin before a child’s first birthday⁴.
• Stairs and Running: Running and climbing a few steps, with or without assistance, are among the developmental milestones for 2-year-olds listed in the CDC guidelines.
• Ball and Jumping Preparation: Kicking a ball is another milestone for 2-year-olds. Jumping with both feet off the ground is covered in the following milestones.

Third year (24-36 months):

Brief one-legged balancing, jumping, and walking on tiptoes may appear in the children’s games of this period⁶. The CDC includes the two-foot jump—where both feet leave the ground—in its 30-month milestones. Walking on tiptoes while playing is distinct from a typical gait in which the heels remain lifted.

The CDC milestones describe skills present in at least 75% of children at the specified age. The WHO windows describe a different measure: the period during which 98% of the children observed have acquired the skill. These two tools therefore do not provide the same thresholds. A concern warrants discussion, even if a skill falls within a broad window.

Preschool years (3-5 years):

• Hopping, throwing, and catching a ball
• Going up and down stairs independently
• Improved balance and coordination

School age (6-12 years):

• Practicing more precise movements and combinations of movements
• Learning the specific techniques of the sports being played
• Rapid growth (growth spurts)

Adolescence:

• Motor skills continue to develop based on experiences, activities, and the individual
• Growth plates are areas of cartilage—a tissue that is more flexible than bone—that allow bones to grow longer. They gradually turn into bone as growth comes to an end. A team observed their closure in 958 young people aged 14 to 21.5 using magnetic resonance imaging. This test produces detailed images of the inside of the body without using X-rays. Closure does not occur at the same time in the wrist, knee, ankle, and heel. The differences observed were associated with sex, stage of puberty, and body mass index—a ratio of weight to height⁷. Bone mass gain also depends on sex, ethnicity, and the stage of puberty. Height growth, muscle-to-fat ratios, physical activity, and diet are also factors⁸.
• Bone strength and characteristics follow individual trajectories

When to Request an Evaluation: Talk to a professional about difficulty moving or the loss of a skill⁹. A loss of a previously acquired skill requires a medical evaluation. Seeking early consultation allows for identifying the cause and organizing appropriate care. The outcomes of early treatment depend on the specific problem; they are not the same for all developmental delays. NICE, a British organization that develops clinical guidelines, distinguishes in its recommendations for children between developmental difficulties and signs that require immediate care, as detailed below.

What are common pediatric conditions treated in physiotherapy?

Physical therapy can treat congenital muscular torticollis and help children who walk on their tiptoes or who have Osgood-Schlatter or Sever's disease. The evaluation determines which treatments are appropriate and which situations require a medical evaluation.

Congenital Muscular Torticollis

Congenital muscular torticollis is characterized by the head tilting to one side and turning toward the other. It is caused by the shortening of the sternocleidomastoid muscle, which connects the sternum and the clavicle to the base of the skull, behind the ear¹⁰. The Academy of Pediatric Physical Therapy, a U.S. organization of pediatric physical therapists, has published a guide for assessing and treating this condition¹⁰. The 2018 recommendations were updated in 2024. A review published in 2024 reports prevalence estimates ranging from 0.2% to 2% of newborns¹¹. These estimates vary across studies and do not represent a universal rate.

Key characteristics:

• Head tilted to one side, chin turned to the opposite side
• Difficulty turning your head completely
• Preference for looking or feeding from only one side
• You may feel a small lump in the muscle (“torticollis lump”)

Physiotherapy treatment:

The 2018 guide describes care tailored to the assessment¹⁰. The 2024 guide retains five components of care to be offered first: gently stretching the neck when mobility is limited, actively moving the neck and body, encouraging similar movements to the right and left, adapting the environment, and informing parents. The plan may include the following measures:

• Soft-tissue mobilization, such as a gentle massage of the neck muscles, if appropriate for the situation
• Passive neck stretches, in which the adult gently guides the baby's head using the techniques taught by the physical therapist
• The physical therapist selects the directions of movement, the number of repetitions, and the duration based on the evaluation. A 2024 review on congenital muscular torticollis reports benefits from three approaches. The first is soft-tissue work, which involves a gentle massage of the neck muscles. The second is passive stretching, in which an adult moves the baby’s head on their behalf. The third is manual therapy, a set of mobilizations, massages, and stretches performed by hand. The improvement was primarily in the range of rotation—that is, how far the head turns from side to side¹¹. Another review, published in 2023, concludes that the new studies provide a basis for strengthening the level of recommendation for passive neck mobility exercises¹². The number of repetitions and duration vary from one study to another.
• Short periods on the stomach while the baby is awake, under supervision, and tailored to the baby’s tolerance. When sleeping, the baby should remain on his or her back.
• Games that actively encourage turning the head and moving both sides of the body, with toys placed appropriately
• Advice for parents on positions and activities at home. An overview of torticollis and positional plagiocephaly—a flattened head on one side—supports this advice. For torticollis, it also reports improvements in mobility from stretches performed by a professional, with moderate confidence in the results. Methods for measuring effects and providing care vary, which limits the classification of treatments and the selection of a universal duration¹³

When to Seek an Evaluation: A head that remains tilted or turns mainly to one side warrants a prompt evaluation¹⁴. The guide recommends seeking evaluation as soon as this asymmetry is noticed. In a study of 980 children, 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. This association supports early consultation, though it does not guarantee these timeframes for every baby. Stretching exercises must remain gentle: stop the maneuver if the baby resists, appears to be in pain, changes color, or breathes differently, and then have the technique reevaluated. These precautions are included in the 2024 guidelines. See also our guide on congenital torticollis.

Walk on tiptoes

Idiopathic forefoot walking is defined as a persistent gait pattern on the forefoot with no identifiable medical cause¹⁵. The term “idiopathic” means that no cause has been found after ruling out other possible explanations. This description refers to children with no identified medical cause who still walk on their toes after the age at which heel-to-toe walking is expected. Walking on tiptoes without a medical cause is seen in some preschool-aged children, and its reported prevalence varies across studies. In Sweden, 1,436 five-and-a-half-year-old children were evaluated at the same age. Among them, 2.1% were still walking on the balls of their feet, and 4.9% had done so at some point¹⁶. Another research team reviewed the published literature on the subject. They note that data remain limited, both regarding the prevalence and the classification of this gait pattern¹⁷.

Characteristics:

• Habitual walking on the forefoot, with heels not touching the ground
• No identifiable cause related to the nervous system, muscles, bones, or joints following the evaluation
• Ankle mobility, including the movement of the foot toward the shin, can vary from one child to another. A Cochrane review on idiopathic toe-walking included children with or without limitations in this movement in its studies¹⁵

Therapeutic approaches:

The studies do not allow for the selection of a single treatment for all children who walk on their toes. The 2019 Cochrane review identified four studies, but only one—involving 47 children—provided data suitable for comparison. It compared a cast alone to a cast combined with a botulinum toxin injection, a substance that temporarily relaxes the muscle. The additional benefit of the injection remains highly uncertain¹⁵. The choice between observation, exercises, orthoses—that is, supports worn in the shoe or around the ankle—and other treatments depends on the child’s age, symptoms, and treatment goals.¹⁸

Some results are favorable for orthotics, but remain limited. In a trial involving 18 children, a brace that wraps around the ankle and a rigid insole placed under the foot improved gait patterns while they were worn. After six weeks, the improvements measured immediately after removing the devices persisted in the group using the insole, but not in the group using the ankle brace. This small trial does not conclusively establish their long-term effectiveness. The 2024 review also includes studies of children with different causes of toe-walking; therefore, not all of their results apply to the idiopathic form¹⁸.

Exercises and advice are sometimes recommended, although their specific effects on idiopathic toe-walking remain uncertain:

• Stretching the calf muscles, when mobility warrants it
• Exercises to strengthen the muscles that lift the foot toward the shin
• Walking exercise with specific instructions on how to place your heel
• Parental education on appropriate footwear

Osgood-Schlatter Disease

Osgood-Schlatter disease causes pain in the small bony bump on the front of the shinbone, just below the knee¹⁹. This bump is called the tibial tuberosity. A tendon is a strong band of tissue that transmits force from a muscle to a bone. At the knee, the tendon that connects the patella—the small bone at the front of the knee—to the tibia pulls on this growth plate. The irritation caused by this repeated pulling is called traction apophysitis²⁰. A 2007 review primarily describes boys aged 12 to 15 and girls aged 8 to 12 experiencing pain, swelling, and tenderness in this area²⁰. These ages are guidelines, not criteria that exclude younger or older children. Our guide on Osgood-Schlatter disease details the evaluation and treatment.

Mechanism of the condition:

The most widely accepted explanation is the repeated pulling of the knee tendon on the small growth plate located just below the kneecap, at the front of the tibia²¹. This general explanation does not allow for the identification of a single cause in a child.

Contextual factors to be evaluated:

• Sports Practiced and Frequency of Jumps
• Running, changes of direction, and other movements performed
• Recent Trends in Growth and Business Volume
• Strength, Mobility, and Tolerance for Physical Activities

Physiotherapy management:

The assessment describes symptoms, limited activities, strength, mobility, and the knee's response to exertion. These observations are used to tailor activities and exercises²².

Physical therapy can support symptom management, strength and mobility training, and a gradual return to activities²³. A review reports that about 90% of people recover without surgery, through rest, ice, modified activities, and exercises²⁰. Another review describes the physical therapy evaluation, methods for pain relief, and stretching exercises²². These results pertain to a comprehensive care regimen; they do not allow for isolating the contribution of each individual intervention.

Development:

Osgood-Schlatter disease usually resolves once growth in that area of the tibia has stopped²⁰. However, a small number of young people continue to experience discomfort—particularly in the knees—or limitations in their activities¹⁹. Treatment focuses primarily on relieving symptoms and adjusting activities during this period. For adults who continue to experience symptoms despite non-surgical treatment, surgery may sometimes be considered¹⁹.

Sever's Disease (Calcaneal Apophysitis)

Sever's disease affects a growth plate in the heel bone, the calcaneus. Along with Osgood-Schlatter disease, it is one of the conditions associated with pain caused by repetitive stress on the legs in young people²⁴. It may be suspected in cases of heel pain during growth, particularly in active children. A systematic review describes Sever’s disease as an overuse injury. It causes heel pain that can limit walking and sports²⁵. Another review, covering 11 studies and 1,265 young people, lists age and participation in sports among the factors studied²⁶. However, the studies contradict one another: sports participation is an associated factor, not a proven cause in every child. The evaluation takes into account activities, symptoms, and other possible causes of heel pain²⁷.

Physiotherapeutic treatment:

Treatment may include temporarily adapting activities, providing explanations, and prescribing exercises tailored to the symptoms. Calf stretches may be part of the treatment plan if limited range of motion warrants it; however, their isolated effect on this pain remains uncertain²⁷. A 2026 Cochrane review concluded, with moderate certainty, that orthotics and heel lifts make little or no difference in pain or the ability to perform activities in the short term among children with Sever’s disease. It did not compare these two interventions to no treatment. Most other comparisons are based on evidence of low or very low certainty²⁸. A 2013 review reported limited findings favoring orthotics over heel cups for short-term pain. The small number of studies and their differences prevented a reliable synthesis²⁹.

Options to discuss with your healthcare provider:

• Temporary adjustments to certain activities, depending on symptoms and what activities are possible
• Ice is sometimes used to provide temporary relief, but its effect on the course of the condition has not been demonstrated
• Heel lifts, which raise the heel inside the shoe, or other supports appropriate for the situation
• Exercises selected based on the child's strength, mobility, activities, and response
• Resuming activities is discussed based on symptoms, abilities, and the demands of the sport

To learn more about managing heel and ankle pain in young people, consult our guide on foot and ankle pain.

What are the growth challenges for young athletes?

Bone growth exposes young athletes to specific injuries in areas where the bone is lengthening or is under tension from a tendon. Injuries to these attachments remain less common than sports injuries overall among adolescents. A review highlights that their risk factors and prevention remain poorly understood; they rarely interfere with long-term growth³⁰. A growth spurt alone, therefore, does not predict an injury.

Growth plates and injury risk:

Growth plates are areas of cartilage located near the ends of long bones. They play a role in bone growth in length. A review describes growth plates as the primary site of bone elongation in children³¹. Pain following a fall, a blow, or repetitive stress should be evaluated with these areas in mind.

Types of growth-related injuries:

• Traction apophysitis: Irritation of a growth plate where a tendon attaches, as in Osgood-Schlatter and Sever’s diseases. The cartilage in this area gradually transforms into bone during growth³²
• Growth plate fractures: Injuries that require evaluation following a blow, a fall, or repetitive stress. The growth plate is the most fragile structure in the still-developing skeleton. An injury to this area can disrupt ossification—the process of bone formation—and impair growth³³
• Osteochondrosis: A term that encompasses various conditions that can affect bone growth plates
• Apophyseal avulsions: The tearing away of a fragment of bone at the site where a muscle attaches via its tendon. A review of pelvic avulsions describes an injury that primarily affects young athletes. It occurs during a forceful muscle contraction while the growth plates are still open³⁴

Contextual elements to describe:

• Sports Practiced During the Year
• Recent changes in training volume or intensity
• Strength, Mobility, and Exercise Tolerance
• Physical activities and situations that trigger symptoms
• Equipment Used and Practice Areas

Growth spurts:

Apophysitis occurs during growth, but there is no single mechanism that explains its onset in young people. Recent growth and changes in training are part of the context that must be evaluated.

Activity Management:

• A warm-up tailored to the demands of the activity
• Stretches are included only when they meet an evaluated objective
• Gradual progression tailored to goals and tolerance
• Recovery tailored to symptoms, activities, and the sports schedule
• Selecting activities based on the young person's interests, goals, and circumstances
• Monitoring symptoms to guide adjustments to activities

Role of the physiotherapist:

Physical therapists can assess symptoms, activities, and functional abilities relevant to the situation. They can also discuss temporary adjustments and a gradual return to activity with the family and the sports team. To learn more about our approach to manual therapy, check out our comprehensive guide.

To learn more about managing knee pain in young athletes, check out our physical therapy guide for knee pain.

How does the play-based approach work in pediatric physiotherapy?

The game allows the physical therapist to suggest movements for the child to practice as part of an activity that interests them.³⁵ A consensus document is a text in which experts in the field agree on a course of action. Such a document describes the frequent use of play in pediatric physical therapy. It recommends tailoring the activity to the child, their condition, their own suggestions, their social environment, and their family³⁵. It outlines a proposed approach without comparing its effectiveness to other approaches. Play provides opportunities for motivation, participation, exploration, repetition of movements, and experimentation with variations³⁶.

Principles of the play-based approach:

Play can serve as a context for offering activities tailored to the child's interests, needs, and development³⁷. The physical therapist can follow the child’s lead or suggest a more structured activity. The therapist tailors their approach to the child’s goals and response.

Benefits of the game:

Play can serve as a context for practicing movements, exploring, and participating in therapeutic activities. The cited studies do not measure the benefits attributable to play alone, independent of exercises and other forms of care.³⁵

Three examples of how games are used in therapy:

A physical therapist may use play for the following purposes:

1. Encouraging Participation: Offer a game that makes the child want to take part in the session
2. Practicing a movement: For example, reaching for a toy to work on balance while sitting
3. Learning to Play: Helping a Child Use a Toy or Participate in a Game with Others³⁸

New Motor Skills:

The game offers opportunities to practice and explore movements³⁶. In a study based on interviews and videos of sessions, 14 physical therapists working with children aged 0 to 3 described these opportunities to learn and try new ways of moving³⁶. This study describes their experience. It does not measure the effect of play alone on skill acquisition.

Examples of Therapeutic Play Activities:

• For balance: Games like "musical statues," obstacle courses
• For strength: Climbing on play structures, pulling/pushing toys
• For coordination: Throwing and catching colorful balls, chase games
• For fine motor skills: Playdough, crafts, construction games

Challenges during gameplay:

The physical therapists interviewed described times when it is difficult to engage the child or keep the play going³⁶. They may switch toys, allow more time, or adjust the difficulty based on the child’s reactions³⁶.

Factors to consider when choosing an activity:

• Comfort and Exploration: Choosing an activity isn't based on age alone
• The child's interests: An activity can be chosen based on what captures the child's attention
• Current Abilities: The difficulty can be adjusted based on observed skills
• Targeted Activities: The activities may be related to the sports the child wishes to participate in
• Observed response: The choice and difficulty are reassessed based on what happens during the activity

Parental Involvement:

Depending on the situation, the physical therapist may suggest activities for the family to do at home. Some of these may take the form of a game to make it easier to incorporate them into their daily routine. The frequency and goals are determined in consultation with the physical therapist, without attributing success solely to parental involvement.

When should you consult a physiotherapist for your child?

You should consult a physical therapist when movement difficulties, persistent pain, or the aftereffects of an injury limit a child’s activities or cause concern for the family. Certain signs also warrant medical attention. The following examples are intended to help prepare for the discussion; they are not sufficient to establish a diagnosis.

Examples of observations to describe in infants:

• Strong preference for one side (always turning the head to the same side)
• Little Progress in Head Control
• Little progress in position changes
• Persistent difficulty maintaining a sitting position appropriate for the child’s developmental stage
• Asymmetry in arm or leg movements
• Muscles that seem unusually stiff or loose at rest—a condition known as muscle tone

Signs to Watch For in Toddlers (1-3 years):

• Little progress toward independent walking
• Persistent tiptoeing that concerns the family or limits activities
• Frequent falls or excessive clumsiness
• Persistent difficulty climbing stairs compared to other motor skills
• Asymmetry in gait or movements

Examples of observations to describe in school-age children:

• Persistent pain in the knees, heels, or other joints
• Avoiding physical activities
• Decline in athletic performance
• Pain or fatigue that always recurs in the same area—for example, in the neck or shoulders—when the child sits for a long time
• Difficulties with balance or coordination compared to children of the same age

Examples of observations to describe in adolescents:

• Persistent or recurrent pain with no apparent cause
• Recent sports injury
• Recurring pain in the same area
• Difficulty performing daily activities or participating in sports

Situations that can be discussed with a professional:

• After an injury, such as a sprained ligament or a broken bone
• Delayed acquisition of certain motor skills
• A recognized health condition that requires exercises or activities to restore or develop abilities
• Questions About Returning to Sports After an Injury
• Persistent pain during growth
• Doctor's or pediatrician's recommendation

Milestones that warrant a medical evaluation: NICE recommends referral to developmental services if a baby cannot sit up without support by 8 months, if a girl cannot walk without support by 15 months, or if a boy cannot walk without support by 18 months. A clear preference for one hand before age one also warrants this referral. For a child born prematurely, corrected age—calculated based on the expected date of birth—is used. A loss of previously acquired motor skills requires a medical evaluation without waiting for the next physical therapy session.

When to Seek Immediate Care: Sudden weakness—or weakness that worsens over a few hours or days—in an arm, leg, or face requires immediate evaluation. The same applies to a new abnormality in gait. An abnormal neck position following a head or neck injury requires evaluation in the emergency room. Weakness that progresses more slowly requires urgent medical attention. These situations are distinct from developmental milestones: consult the NICE guidelines for children.

What to Expect During the First Visit:

The initial assessment generally includes:

• Discussion on development, past and present health issues, and activities
• Observing the movements and activities a child can do
• Tests of strength, flexibility, balance, and coordination
• Assessment of posture and gait
• Setting goals with the child and parents
• Personalized Treatment Plan

Age-Appropriate Approach:

Physical therapists tailor their explanations and assessments to the child’s age. A systematic review compiles the published literature on a given topic. A 2024 review describes ways to involve the child in the assessment and goal-setting process, such as providing clear explanations and suggesting activities the child can successfully complete³⁹. A review on cerebral palsy also recommends care tailored to the child’s age and developmental level¹. With a young child, the physical therapist can observe movements during play. With a teenager, the therapist can discuss goals and expectations directly. The child’s level of communication also guides this adaptation.

What are the frequently asked questions about pediatric physiotherapy?

Frequently asked questions about pediatric physical therapy include age-appropriate treatment, parental involvement, the duration of treatment, discomfort, continuing to play sports, activities between sessions, and the age at which treatment begins.

What is the difference between pediatric physiotherapy and adult physiotherapy?

Pediatric physical therapy tailors assessments, explanations, and activities to the child’s development and needs. The family may participate in setting goals and in certain at-home activities, depending on the situation, although their involvement alone does not determine success.

Does my child need to be present at every session, or can parents come alone?

Whether the child or a parent is present depends on the purpose of the session, the child's age, level of independence, and the type of assessment required. The physical therapist works with the family to determine what is needed for each session.

How long do pediatric physiotherapy treatments last?

The duration depends on the condition being treated and the child’s progress. To provide a concrete example, a study of 45 infants with congenital muscular torticollis reported an average duration of 3.2 months. These children began treatment early; this result does not predict the duration for other children or other conditions. The physical therapist will work with you to set measurable goals and reassess progress to adjust the treatment plan accordingly.

Does physiotherapy hurt for children?

Tolerance varies depending on the condition, the activity, and the child. Some activities may be uncomfortable and should be adjusted based on the child’s response. Play can be incorporated when it aligns with the child’s interests and goals, though this does not guarantee that every session will be enjoyable. Report any significant, unusual, or persistent pain so that the approach can be reevaluated.

Can my child continue sports during physiotherapy treatment?

Whether a child can continue participating in a sport depends on the child’s symptoms, abilities, the condition being evaluated, and the demands of the activity. Certain activities may be modified, scaled back, or temporarily suspended depending on the child’s response; a different activity is considered on a case-by-case basis.

How can I help my child between physiotherapy sessions?

The physical therapist may suggest activities for you to do between sessions. How often you do them depends on the child’s condition, goals, tolerance, and family routine. Some activities can be turned into playtime to encourage participation. Recommendations regarding positioning, activities, or equipment are tailored to the situation.

At what age can physiotherapy begin?

Physical therapy can begin at birth if necessary. Early screening and treatment of congenital torticollis, for example, often begin in the first few weeks of life. The 2018 practice guideline describes a deformity visible shortly after birth. It recommends referring the child to physical therapy as soon as asymmetries are detected¹⁰. In a study of 45 infants followed over time, the first evaluation took place on average at 38.6 days of life⁴⁰. The timing of care should be tailored to the needs of each infant. An evaluation can be conducted as soon as a concern arises. The appropriateness and timing of an intervention depend on the child’s condition and circumstances. Never hesitate to seek medical advice if you have concerns about your child’s motor development, even if they are very young.

What to do if your child needs physiotherapy?

Parents can schedule an appointment for an evaluation, discuss their concerns, and work out a plan with the physical therapist. Persistent pain, difficulty moving, or a lack of progress that concerns you may warrant this step. The urgent signs described above require appropriate medical care first.

The plan is discussed with you and your child based on symptoms, abilities, limitations, and the targeted activities, without guaranteeing a specific outcome.

References

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