At Ready Steady Therapy, we see many children who have had a musculoskeletal injury or have acquired a childhood MSK condition. These injuries and conditions can be painful and prevent participation in sport and school activities.
We offer a thorough physical assessment of your child’s main concerns, as well as a general physical assessment of their walking, running, balance, coordination, motor planning and strength. We will then speak in depth with you and your child about the outcomes of their assessment; providing exercises and activity suggestions to help your child heal and recover fully. A treatment plan and goals are created with you and your child, which encourages home-based exercises that will support your child to achieve their physical goals.
Where appropriate, we may liaise with your child’s school to support their access to all areas of the school and for a return to school sport.
Below are typical MSK conditions that can occur in childhood:
Traction Apophysitis is inflammation of bone that usually occurs in early adolescents. As children develop, their growth plates mature quicker than the muscle and tendons around them, which can lead to a mismatch in muscle and bone length. This mismatch means that the muscle is short and the tendon is tightly pulling over the longer bone, leading to pain and inflammation. If left untreated, avulsion fractures can occur. This is where tiny bits of bone can pull away from the main bone.
3 common areas for this to occur in children are:
- The heel (Sever’s Disease)
- The tibial tuberosity just below the kneecap (Osgood Schlatters)
- The bottom of the knee cap (Sinding-Larsen Johansson Syndrome)
It’s more common in very active children and those who have experienced a rapid growth spurt, typically between 8-14 years of age.
Typical treatment for Traction Apophysitis is:
- Modifying activities
- Icing painful areas
- Stretching stiff muscles
- Slow progressive strengthening exercises for muscles and tendons
Adolescents who have a slipped upper femoral epiphysis (SUFE) will complain of pain in their groin, hip, thigh and/or knee. It’s common to have no pain in the hip and have referral of pain in the groin or knee. You may notice your child starts to limp, one leg is shorter than the other or they hold their leg in awkward positions.
Treatment often involves surgery to secure the head of the femur in a good position. Weight-bearing on the effected leg is not allowed until the hip has fully healed. Teenagers routinely do not need to see a Physiotherapist, but some do as they may need help regaining mobility, strength and confidence through the effected side.
This is a condition that effects the developing hip joint in early adolescents. There is a growth plate between the head of the thigh bone (femur) and the body of the femur. A SUFE occurs when there is a fracture in this growth plate which leads to the head of the femur slipping out of it’s normal position.
Adolescents who have a SUFE will complain of pain in their groin, hip, thigh and/or knee. It’s common to have no pain in the hip and have referral of pain in the groin or knee. You may notice your child starts to limp, one leg is shorter than the other or they hold their leg in awkward positions.
Treatment often involves surgery to secure the head of the femur in a good position. Weightbearing on the effected leg is not allowed until the hip has fully healed. Routinely teenagers do not need to see a Physiotherapist but some do as they may need help regaining mobility, strength and confidence through the effected side.
This is a condition which affects one or both hips in growing children, it is also more common in boys than in girls and typically occurs between the ages of 4 and 10 years old. Changes to the hip joint occurs over the course of 18-24 months. Firstly the femoral head (top of the thigh bone) has disruptions to its blood supply causing bone cells to reduce, then the effected bone starts to soften and collapse and finally the blood supply returns and the bone starts to repair itself.
Children will often complain of groin or knee pain, not pain in the hip! You may also notice your child start to limp or avoid putting weight through one leg.
Your child will need to have regular reviews with an orthopaedic surgeon through the duration of the disease. Surgery is not frequently performed and Perthes can be actively managed with modification to activity and encouragement of pain free movement.
Some children and adolescents acquire specific conditions of the spine as they grow and develop. Common spinal conditions are idiopathic scoliosis (curving of the spine), spondylolisthesis (slipping of the bone in the lowest part of the spine) and Scheuermann’s kyphosis (rounding of the upper spine).
Physiotherapy is advised for these spinal conditions to improve range of movement and posture, to provide advice on activities and to strengthen weakened muscles.
Sometimes children and adolescents have increased flexibility in multiple joints of the body. Joint flexibility can occasionally lead to pain and fatigue as well as cause muscle tears or joint subluxations or dislocations (partial or full slipping of a joint). It is common for increased flexibility to lead to minor muscle injuries such as sprains and strains as the muscle and ligaments lack control of the joint increasing the risk for damage.
Ongoing joint pain, injury or fatigue should be reviewed by a Physiotherapist. Children with joint hypermobility may need to complete strength-based activities to improve their muscle control and postures. Activity suggestions and advice on limiting fatigue should be discussed with a Physiotherapist.
If your child has any of the above conditions, a review with a Physiotherapist could help them fully recover and get back to being an active young person! Book in a pre-consultation call if you need help to decide whether physiotherapy would be beneficial for your child.
