--- slug: pediatric-physical-therapy metatitle: Pediatric Physical Therapy: Care for Children metadescription: Discover how physical therapy helps children aged 0 to 18 with motor delays, growing pains, and sports injuries. headline: Pediatric physical therapy: care for children and adolescents collection: Complete Guide diagnosis-and-treatment---types-of-pain: [] # Population-focused, not pain-specific authors: [] reviewers: [] date_created: 2026-01-19 date_modified: 2026-01-19 status: ready_for_upload phase: phase_11_populations content_type: OUTER strategy_phase: BREADTH word_count: 3308 qa_score: 100 ---

# Pediatric physical therapy: care for children

Pediatric physical therapy helps children from birth to age 18 improve their motor development, manage pain, and recover from injury. Here's the good news: as physical therapists specializing in caring for children and families, we understand that every child develops at their own pace and that parents need support and clear answers.

What is pediatric physical therapy?

Pediatric physical therapy is a specialty of physical therapy that focuses on the assessment and treatment of children, from newborns to adolescents, with movement difficulties, developmental delays, or musculoskeletal injuries.^Unlike physical therapy for adults, it adapts to the child's stages of growth and uses playful approaches to engage young patients in their treatment.

Pediatric physical therapists assess muscle strength, coordination, balance, posture, and the child's ability to perform age-appropriate functional movements^.2 They work collaboratively with parents to create personalized treatment programs that integrate into the daily lives of the child and family.

Family-centered approach

Pediatric physical therapy recognizes that parents are the experts on their children. Sessions consistently include parent education and exercises to do at home to maximize progress between appointments. This collaborative approach ensures that treatment fits naturally into family routines.

What conditions does pediatric physical therapy treat?

Pediatric physical therapy treats a wide range of conditions, from developmental disorders to sports injuries, neurological and musculoskeletal conditions.³ Each condition requires an approach tailored to the child's age and specific needs.

Motor development delays

Motor development delays occur when a child reaches motor milestones (such as rolling over, sitting up, crawling, or walking) later than the average child of the same age^. Physical therapy helps strengthen muscles, improve coordination, and develop the motor skills needed to catch up.

Physical therapists use structured play activities to encourage gross motor skill development. For example, for a baby who is not yet crawling, tummy time exercises strengthen the neck, shoulder, and core muscles needed to progress to crawling.

Growth disorders

Growth-related conditions are painful conditions that affect active children and adolescents during periods of rapid growth. The two most common are Osgood-Schlatter disease and Sever's disease.

Osgood-Schlatter disease

Osgood-Schlatter disease causes knee pain in children aged 8 to 15, particularly those who participate in sports involving jumping or running.⁵ It results from repeated pulling of the patellar tendon on the growth plate of the tibia, causing inflammation and a painful bump under the kneecap.

Conservative treatment with physical therapy is the first-line approach, involving quadriceps and hamstring stretching exercises, pain management, and gradual modification of activities.⁶ A recent study demonstrated the effectiveness of a personalized physical therapy program in a teenage volleyball player, resulting in complete recovery and a return to sport.⁷

Sever's disease

Sever's disease affects the heel in children aged 8 to 14, caused by excessive traction of the Achilles tendon on the growth plate of the calcaneus.⁸ It is common in young athletes who participate in running, soccer, or gymnastics.

Physical therapy for Sever's disease includes calf stretches, strengthening exercises, pain management techniques, and recommendations on proper footwear. Managing training load is essential to allow healing while maintaining fitness.

Congenital torticollis

Congenital torticollis manifests as an inclination or rotation of the infant's head caused by a shortening or tightening of a neck muscle (the sternocleidomastoid).⁹ Without treatment, it can lead to skull asymmetry (plagiocephaly) and delays in motor development.

The American Physical Therapy Association's 2024 clinical guidelines recommend early treatment including gentle stretching, specific positioning, and muscle strengthening exercises.¹⁰ Recent data also supports the use of microcurrent therapy for certain cases of torticollis.¹¹

Cerebral palsy

Cerebral palsy affects movement and muscle coordination due to brain damage that occurs before, during, or shortly after birth.¹² Physical therapy plays a central role in managing this condition by improving mobility, reducing spasticity, and maximizing functional independence.

Interventions may include therapeutic exercises, manual techniques, gait training, and the prescription of adaptive equipment. A recent approach combines modified sports interventions with contextual therapies to improve outcomes in children with cerebral palsy^.

Musculoskeletal injuries

Musculoskeletal injuries in children include sprains, strains, fractures, and sports-related injuries. Physical therapy helps restore strength, flexibility, and function after these injuries, while preventing recurrence.

Rehabilitation programs are tailored to the child's developmental level and include progressive exercises, manual techniques to reduce pain and stiffness, and advice on safely returning to sports activities.

Respiratory conditions

In premature infants, chest physiotherapy can treat lung problems and improve respiratory function.¹⁴ Techniques include positioning, postural drainage, and age-appropriate breathing exercises.

Brachial plexus injuries

Brachial plexus injuries occur during childbirth and affect the nerves in the arm, causing weakness or paralysis.¹⁵ Physical therapy is essential for improving range of motion, strength, and functional recovery in the affected arm.

How is a pediatric physical therapy evaluation conducted?

A pediatric physical therapy evaluation begins with an in-depth discussion with the parents about the child's pregnancy, birth, and developmental history, followed by an age-appropriate physical assessment that examines the child's strength, motor skills, and interaction with the physical therapist^.

The physical therapist observes the child in different positions and activities to assess:

- Posture and body alignment - Muscle strength (ability to sit, stand) - Functional movements (rolling, crawling, walking) - Flexibility and range of motion - Balance and coordination - Sensory processing

Motor development milestones

The assessment compares the child's skills to the motor development milestones expected for their age. These milestones include:

- 0-3 months: Head control, arm and leg movements - 4-6 months: Rolling over, sitting with support, holding objects - 7-9 months: Sitting without support, crawling, standing with help - 10-12 months: Standing up, cruising (moving around while holding onto furniture), first steps - 12-18 months: Walking independently, climbing stairs with assistance - 18-24 months: Running, jumping with both feet, climbing/descending stairs

^The diagnosis of developmental delay involves a detailed assessment by specialized health professionals, including a complete history and a physical evaluation tailored to the child's age.

After the evaluation

Following the assessment, the physical therapist discusses the results with the parents and develops a personalized treatment plan. This plan includes specific, measurable, and realistic goals, as well as a home exercise program for the parents.

What treatments are used in pediatric physical therapy?

Pediatric physical therapy treatments combine therapeutic exercises to improve strength and coordination, manual techniques to reduce pain and stiffness, balance and gait training, and the use of specialized equipment or assistive devices^.

Fun and age-appropriate approach

The key to pediatric physical therapy lies in the use of play. Therapy sessions incorporate fun, age-appropriate activities to engage children in treatment while achieving therapeutic goals^. For example, an obstacle course can work on balance, coordination, and strength while entertaining the child.

For infants, activities include tummy time, sensory play, and parent-assisted movement exercises. For preschoolers, physical therapists use imaginative play, songs, and toys to encourage therapeutic movement.

Therapeutic exercises

Therapeutic exercises are designed to strengthen specific muscles, improve coordination, and develop functional motor skills. They are progressive, starting with simple movements and gradually increasing in complexity as the child progresses.

Exercises may include: - Strength training (squats, lunges, resistance exercises) - Stretching to improve flexibility - Balance and proprioception exercises - Bilateral coordination activities (using both sides of the body together) - Functional training (climbing stairs, jumping, running)

Manual therapy

Manual therapy involves gentle massage, joint mobilization, and stretching techniques applied by the physical therapist to improve mobility, reduce muscle tension, and relieve pain. In children, these techniques are always adapted to be comfortable and non-invasive.

For infants with torticollis, for example, gentle stretches of the sternocleidomastoid muscle are performed several times a day to increase the range of motion in the neck.

Walking and balance training

Walking training helps children develop or improve their walking pattern. This may include exercises on varied surfaces, the use of parallel bars for support, and activities that strengthen the muscles needed for effective walking.

Balance exercises progress from stable positions (sitting, crawling) to more difficult positions (standing on one foot, walking along a line). These activities are essential for preventing falls and improving children's confidence in their movements.

Prescription of equipment and technical aids

Depending on the child's needs, the physical therapist may recommend adaptive equipment such as orthotics (braces), orthopedic shoes, walking aids (walkers, canes), or positioning equipment (adapted seats, cushions).

This equipment is carefully selected and adjusted to support the child's development while maximizing their functional independence.

Home exercise program

An essential part of treatment is the home exercise program. Physical therapists teach parents specific activities and exercises to do with their child between therapy sessions. This regular practice accelerates progress and reinforces the skills learned.

Home programs are designed to fit easily into daily routines, such as incorporating stretches during diaper changes or balance exercises during playtime.

When should you consult a pediatric physical therapist?

You should consult a pediatric physical therapist if your child shows signs of delayed motor milestones, suffers from persistent pain related to growth or sports activities, exhibits postural asymmetry or movement difficulties, or has suffered an injury requiring rehabilitation^.

Warning signs in infants

For infants (0-12 months), consult a doctor if you notice: - Lack of head control at 3 months - Inability to roll over at 6 months - Inability to sit without support at 9 months - No crawling or moving at 12 months - Marked preference for one side of the body - Excessive muscle stiffness or flaccidity - Constant tilting or turning of the head (torticollis)

Warning signs in young children

For children aged 1 to 5, seek medical advice if you observe any of the following: - Inability to walk independently at 18 months - Frequent falls or difficulty maintaining balance - Persistent walking on tiptoes - Difficulty going up or down stairs - Asymmetry in movements or posture - Delayed motor skills (running, jumping, throwing) - Avoidance of physical activities or active play

Warning signs in school-aged children and adolescents

For older children and adolescents, consult a doctor if: - Knee or heel pain persists despite rest (possible growth-related conditions) - Sports injury requiring rehabilitation - Pain limits participation in activities - Posture or gait problems - Coordination difficulties or unusual clumsiness - Slow recovery after an injury

Early detection and intervention

Early identification of developmental delays allows for more effective treatment during the preschool years, and early intervention can reduce the need for costly special education services later on.²¹ The earlier treatment begins, the better the outcomes tend to be, as the child's brain is more plastic and receptive to new skills.

Don't wait and see if you have concerns. Pediatric physical therapists can evaluate your child and determine whether treatment is necessary or simply reassure parents that their child's development is within the normal range.

What is the role of parents in pediatric physical therapy?

Parents play a central role in pediatric physical therapy: they are active partners in treatment, participating in sessions, learning exercise techniques at home, and integrating therapeutic activities into daily routines to maximize their child's progress.

Active participation in sessions

During physical therapy sessions, parents are encouraged to observe, ask questions, and learn the techniques used by the physical therapist. This participation allows parents to understand the goals of treatment and feel confident in their ability to support their child.

The physical therapist may ask parents to assist with certain exercises or positions, thereby creating a collaborative treatment team.

Home exercise program

Regular practice at home is essential for successful treatment. Physical therapists provide clear instructions, often with video demonstrations or illustrated handouts, so that parents can repeat the exercises correctly.

Consistency is important. Even 10 to 15 minutes of daily exercises can make a big difference in a child's progress. Physical therapists work with families to find times of day that work best and to integrate exercises naturally into existing activities.

Encouragement and motivation

Parents play a crucial role in motivating their child. Celebrating small victories, using age-appropriate reward systems, and maintaining a positive attitude help the child stay engaged in their treatment.

For older children, explaining why the exercises are important (for example, "It will help you play soccer better") can increase their cooperation.

Communication with the healthcare team

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

How long does pediatric physical therapy treatment last?

The duration of pediatric physical therapy treatment varies considerably depending on the condition being treated, the severity of symptoms, the child's age, and how regularly exercises are practiced at home, ranging from a few weeks for minor injuries to several months or years for chronic conditions or significant developmental delays.

Frequency of sessions

The typical frequency of sessions varies from once a week to several times a week, depending on individual needs. For acute conditions such as growth disorders, one to two sessions per week for 4 to 8 weeks may be sufficient. For developmental delays or neurological conditions, longer treatment with one to two sessions per week for several months may be necessary.

As progress is made, the frequency of sessions generally decreases, with maintenance visits spaced out to monitor progress and adjust the home program.

Factors influencing duration

Several factors affect the duration of treatment: - Severity of the condition: Mild cases respond more quickly than severe cases - Age of the child: Young children generally have better neurological plasticity - Adherence to the home program: Regular practice accelerates progress - Coexisting conditions: Other health problems may prolong treatment - Family goals: More ambitious goals require more time

Measuring progress

Physical therapists use standardized assessments and functional measures to track the child's progress. These regular assessments allow them to adjust the treatment plan and determine when goals have been achieved.

Parents receive regular updates on progress, often with concrete demonstrations of improvements (e.g., "Your child can now balance on one foot for 10 seconds, compared to 3 seconds a month ago").

Is pediatric physical therapy painful?

Pediatric physical therapy is generally not painful: the techniques used are gentle and adapted to the child's comfort, although slight discomfort may occur during stretching or strengthening exercises, similar to the feeling experienced after a new physical activity.

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

For painful conditions such as growth-related disorders, physical therapy aims to reduce pain through pain management techniques, gentle stretching, and appropriate activity management.

Welcoming environment

Pediatric physical therapy clinics create a welcoming and non-threatening environment with colorful play areas, toys, and equipment suitable for children. This approach helps reduce anxiety and makes physical therapy a positive experience.

Is pediatric physical therapy covered by insurance?

Pediatric physical therapy is generally covered by private insurance plans in Quebec, although coverage varies depending on the plan and may include annual limits on the number of sessions or the amount reimbursable.

It is recommended that you check your specific coverage with your insurer before beginning treatment. Most group insurance plans offer coverage for pediatric physical therapy, often similar to that for adults.

For children with recognized specific conditions, certain government programs or community organizations may offer additional financial support. Talk to your physical therapist or doctor about available funding options.

References

1. A Brief Overview of Recent Pediatric Physical Therapy Practices and TheirImportance 2. Physical Therapy Guide to DevelopmentalDelay 3. Principles of Pediatric Physiotherapy -Physiopedia 4. Physical Therapy Guide to Developmental Delay - ChoosePT 5. Osgood-Schlatter Disease: Appearance, Diagnosis andTreatment 6. A systematic review on conservative treatment options for Osgood-Schlatter disease 7. Role of Physiotherapy in Osgood-Schlatter's Disease in Adolescent VolleyballSmasher 8. The Role of Physio for Osgood-Schlatter and Sever'sDisease 9. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline 10. A Brief Overview of Recent Pediatric Physical TherapyPractices 11. A Brief Overview of Recent Pediatric Physical TherapyPractices 12. Principles of Pediatric Physiotherapy -Physiopedia 13. Modified Sports Intervention Combined with Context-Focused Intervention for Children with CerebralPalsy 14. Principles of Pediatric Physiotherapy -Physiopedia 15. Principles of Pediatric Physiotherapy - Physiopedia 16. Physical Therapy Guide to Developmental Delay - ChoosePT 17. Physical Therapy Guide to Developmental Delay - ChoosePT 18. What Is Pediatric Physical Therapy? - ChoosePT 19. A Brief Overview of Recent Pediatric Physical TherapyPractices 20. Physical Therapy Guide to Developmental Delay - ChoosePT 21. Physical Therapy Guide to Developmental Delay - Choose PT