Paediatric Physiotherapy

There's no single trigger, and most parents arrive having noticed something over weeks or months rather than in one moment. The things worth an assessment^2,3:

• Your child isn't rolling, sitting, crawling or walking around the time you'd expect, or has stopped doing something they'd already started.
• Your baby strongly prefers turning their head one way, or has developed a flat spot. We've written about this separately: see torticollis in babies.
• Your child walks on their toes, or their feet turn inwards when they walk or run. There's a full explanation of both in toe walking and in-toeing.
• They fall more than other kids their age, or seem generally clumsy or unsteady.
• They're limping, or have pain after sport that isn't settling with rest.
• They avoid physical activity, tire much faster than their friends, or have started opting out of things they used to enjoy.

None of these automatically means something is wrong. Children develop at different rates, and plenty of what parents worry about resolves on its own. What an assessment gives you is the difference between hoping it'll sort itself out and knowing whether it will.

Most of a first paediatric appointment is watching and listening. We'll ask about your pregnancy and birth if your child is a baby, about what you've noticed and when, and about what your child is finding hard day to day.

Then we watch them move. With little ones that means play, because a two-year-old won't perform movements on request but will absolutely chase a ball across a room. With older kids and teenagers it looks more like the sport or activity that's causing the problem: running, hopping, landing, squatting.

From there you get a plain-English explanation of what we've found, what we think is driving it, and what we'd suggest doing about it. If that's a course of treatment, we'll say how many sessions we'd expect and what progress should look like. If it's monitoring and a few things to do at home, we'll say that instead.

You'll be in the room for all of it. Paediatric physiotherapy works best when parents are part of the sessions and part of planning the treatment, and you'll generally be given activities to do with your child at home between appointments². That's not us outsourcing the work: it's that a handful of minutes several times a week, at home, with you, does more than a weekly appointment on its own ever will.

Children aren't small adults, and a plan that ignores that doesn't get followed. A few things we work around rather than against:

Attention spans are what they are. A session that holds a four-year-old's interest looks like play with a purpose, not a set of prescribed repetitions. The clinical reasoning behind it is the same; the delivery isn't.

Growing bodies get a specific kind of injury. Active kids and teenagers are prone to problems at the growth plates rather than the tendon and ligament injuries adults get from the same sport: Osgood-Schlatter disease at the knee and Sever's disease at the heel are the two we see most in South-West Sydney's junior sport seasons. Managing load matters more than complete rest for these, which is usually the opposite of the advice parents arrive with.

Some things are structural, not something a child will grow out of. Conditions like hip dysplasia need a proper assessment rather than reassurance, and we'd rather flag that early than be relaxed about it.

Your child has a life outside the clinic. School, sport, swimming lessons, a sibling's schedule. A home program that assumes you have forty spare minutes a day isn't a program: it's homework you'll quietly abandon by week two. We'd rather give you three things you'll do.

Paediatric appointments run from our Engadine, Mount Annan, Narellan and Appin clinics, so most families across the Sutherland Shire, Macarthur and Wollondilly can get to one without a long drive with a tired child in the back seat. You'll find our full range of services on the services page.