Does my child need to see a physio? 6 reasons kids under 12 may require a visit

Whether you're navigating common concerns or seeking guidance on a more complex issue, Tom Hunter and Monique Miller, physiotherapists at HBF Physio Rockingham explain when it may be necessary for your child to visit a physio, and what they can do to help.

1. Growing pains

Presentation: “Growing pains, typically experienced by children between the ages of three and five, and eight to 11, are characterised by recurrent episodes of limb pain, usually in the evenings or at night,” says Hunter.

While the exact cause of growing pains is not fully understood, they are believed to be related to the imbalance between bone length and muscle strength that occurs during times of rapid grown.¹ Growing pains, also known as benign nocturnal limb pains (BNLP)¹, often occur in the calves, thighs, or behind the knees².

When to see a physio: While it can be distressing to see your child in pain, Hunter assures that growing pains have no long-term effects and can usually be settled by strategies like activity modification, heat packs, warm baths and massage.

“However, if growing pains are causing significantly stress to your child, and are getting in the way of normal activities, such as school, sleep and sport, it may be worth visiting a physiotherapist.”

Treatment(s): Hunter explains, “A physiotherapist can provide strategies to modify painful activity and give age-appropriate strengthening and stretching exercises to prevent and reduce the effect of growing pains. It’s also the physio’s role to determine whether imaging or further testing is required to assess for more serious conditions.”

2. Gait (walking) abnormalities

Presentation: “Gait abnormalities can present in a number of ways,” says Hunter. “Including flat feet; intoeing or pigeon-toed gait; bow legs; knock knees; and antalgic gait, where a child walks with a limp due to pain.”

When to see a physio: It can be challenging for parents to know when to seek medical attention with many children outgrowing gait issues as they age. However, if your child’s gait shows no improvement with age, or if they experience persistent pain, increased trips, an inability to participate in age-appropriate activities, a physio can help, even if it’s just to provide reassurance.

Treatment(s): “A physiotherapist trained in paediatric conditions and gait analysis can expertly assess your child’s gait to see if there’s cause for concern,” says Hunter. “Treatments and interventions can include strengthening and stretching muscles and improving balance and endurance through play-based exercises.”

3. Sports injuries

Presentation: Sports injuries in children range from everything from sprains, to overuse injuries and concussions. “The most common overuse injuries in children include Osgood-Schlatter disease, which causes pain and swelling below the knee joint, and Sever's disease, which causes heel pain,” Hunter explains.

When to see a physio: “If your child experiences a sporting injury which does not resolve within three to four days, a trip to the physio can be beneficial in diagnosing any issues, as well as beginning injury rehabilitation, if required,” says Hunter.

If you suspect your child has suffered a concussion, or any other serious injury, such as a broken bone, you should present to your nearest emergency department (ED) as soon as possible.

Treatment(s): “After diagnosing any present injuries, a physiotherapist can combine hands on treatment with fun, game-based exercises to stretch and strengthen injured joints and muscles,” says Hunter.

With Sports Medicine Australian estimating that 50% of injuries are preventable³, prevention is always better than cure. Keep your child safe by ensuring they participate in varied sports, attend appropriate training sessions, wear appropriate safety protection and warm up properly.

4. Gross motor delay

Presentation: Motor development occurs during infancy and throughout childhood and encompasses both gross motor skills, which involve large muscle groups and whole-body movements like walking, running, and jumping, and fine motor skills, which involve smaller muscle groups and precise movements like grasping objects, writing, and buttoning clothes.

When to see a physio: While all children develop at different rates, if your child is exhibiting signs of gross motor delay, such as difficulty sitting, crawling, standing, walking, or other age-appropriate movements, a paediatric physiotherapist may be able to assist.

“Early intervention is key in addressing motor delays and promoting optimal development in children,” says Miller.

Treatment(s): “A paediatric speciality physiotherapist can identify if and why a child’s gross motor skills are delayed,” says Miller. “And, if required, develop a tailored treatment plan to address your child’s specific needs.”

This treatment plan can include targeted exercises, activities, and interventions to help your child improve their muscle strength, coordination, balance, and mobility, as well as advice and strategies to facilitate your child's motor development at home.

5. Lack of coordination

Presentation: As children get taller and heavier, they need to recalculate and coordinate how much movement and power is required for a task. This can make them appear clumsy or uncoordinated.

“This can occur to factors such as lack of practice, developing muscle strength, developing body awareness and balance, attention deficits, and vision or visual perception issues,” says Miller.

Clumsiness is a normal part of development, but when does it cross over to something more serious, like developmental coordination disorder (DCD)?

When to see a physio: “Lack of general coordination becomes something to worry about when it affects the child’s education and performance of everyday tasks,” explains Miller.

“There are four criteria used to make a diagnosis for CDC: that your child’s movement skills are below what is expected; it interferes with their daily activities; it was evident in their early development; and that it cannot be explained by another development condition, such as cerebral palsy.

Treatment(s): “If you’re concerned your child has DCD, a paediatric-trained physiotherapist can help with diagnosis, and then if required, create an individualised treatment plan that will encompass strengthening and sensory exercises, as well as task-specific training,” says Miller.

6. Weight management and fitness

Presentation: A report by the Australian Institute of Health and Welfare found that 74% of children are not exercising for the recommended 60 minutes a day, and one in four are overweight or obese⁴.

“While the most visible sign of obesity is obviously excess body fat, it’s not always easy to tell if your child is or isn’t overweight. A BMI calculator designed for children and teenagers, such as the one found on the NSW government website, can be a good place to start,” says Hunter.

When to see a physio: “If your child experiences persistent musculoskeletal discomfort or difficulty in performing daily activities due to their weight, consulting a physiotherapist or exercise physiologist specialising in paediatric care could be beneficial,” says Hunter.

Treatment(s): A paediatric physio can help your child by promoting physical activity, improving mobility and flexibility, and managing any musculoskeletal issues that may arise due to excess weight. Additionally, they can provide guidance on safe and effective exercise strategies, lifestyle modifications, and behaviour change techniques to help your child adopt healthier habits and achieve their weight management goals.

“Preventative measures for weight gain in children include reducing screen time, adjusting diets, and increasing daily physical activity,” explains Hunter.