Conditions Treated

We see children with a range of different conditions.

We’re here for you

Our Children’s Physiotherapy team help people with a broad range of neurological, neuromuscular, orthopaedic and developmental disorders and diseases. Some of the most common difficulties that we see are listed below, but if you are seeking treatment for a child with a condition that isn’t listed, please contact us to see how we can help.

Neurological Conditions

What is Cerebral Palsy?

Cerebral Palsy is a group of movement disorders caused by an injury to the brain, either before the baby is born, during the birthing process or occurring soon after birth. It results in a wide spectrum of difficulties which can affect a single limb or the whole body including issues with muscle control, muscle tone, posture, and balance. The symptoms may not be obvious at birth but become more apparent as the baby develops.

Signs to look out for include:

We know the importance of finding the right Physio to work with you and your child, and will discuss their needs before making a recommendation of the most suitable member of the team. If we don’t feel that we’re the best people to help, we’ll help you find the right person.

Delayed motor development
Poor coordination of movement
Looking to one side only or moving one arm and leg more than the other
Always kicking both legs together
Lack of varied movements
Stiffness or floppiness when being held, moved, dressed, or at nappy changes
Difficulties with feeding
Poor head control

How PaedsPhysio helps children with Cerebral Palsy

Thorough physical assessment and identification of needs.
Hands on treatment to guide movement, motor development, muscle strength and motor control.
Management of abnormal muscle tone – intensive intervention following a period of serial casting, botulinum toxin injections or surgery (bone surgery, muscle lengthening surgery or selective dorsal rhizotomy surgery).
Provision of a daily home programme for parents and care givers to integrate into their child’s routine to optimise outcomes.
Recommendation of specialist equipment to promote function and postural alignment. This may include walkers, standing frames, specialist seating and sleep systems.
Monitor orthopaedic changes and liaise with specialist services and the multidisciplinary team to ensure holistic care provided.

Neurological Conditions

What is an Acquired Brain Injury?

Brain injuries in children result in a sudden disruption to the usual developmental process, often resulting in lifelong difficulties. The age of the child at the time of injury impacts on the recovery process due to the effect of the damage to the developing brain, with younger children often having a more significant impairment.

Some of the acquired brain injury conditions that we regularly see include:

Traumatic Brain Injury
Stroke
Brain Haemorrhage
Non-Accidental Injury

Children’s Physiotherapy following Brain Injury

Our Paediatric physiotherapists provide treatment for clients with mild to severe brain injury, tailored to the child’s age and developmental stage. Brain Injuries can result in complex physical, cognitive and psychological difficulties requiring a coordinated interdisciplinary approach. At PaedsPhysio, we work with the child, care givers and other professionals involved to provide targeted, meaningful therapy, support and interventions including:

Comprehensive assessment and identification of needs, with particular focus on activity and participation at home and school.
Family centred goal setting.
Hands on treatment to promote balance, coordination, muscle strength and motor control.
Management of abnormal muscle tone and / or loss of range of motion– intensive intervention following a period of serial casting, botulinum toxin injections or surgery.
Management of fatigue.
Provision of a daily home programme for parents and care givers to continue with advice to optimise outcomes.
Promotion of physical activity and return to school.
Sign posting to local sport’s groups and / or disability sports.
Recommendation of specialist equipment to promote function and postural alignment. This may include walkers, standing frames, seating, and sleep systems.
Monitoring and treatment of secondary orthopaedic changes.

Neurological Conditions

Spinal Injury

At PaedsPhysio, we offer bespoke intervention to children and young people who have suffered from spinal cord injury, whether this is traumatic (i.e. following injury) or non-traumatic (i.e. transverse myelitis, spinal tumour, spinal infarct). As Paediatric Physiotherapists, we have a key role in enabling our clients to lead a fulfilling life, facilitating their experience in all aspects of life, focusing on their function and participation.

Physiotherapy intervention will include the following:

Comprehensive subjective and objective assessment.
Identification of needs and formulation of specific, targeted goals.
Management of skin integrity and sensory loss.
Management of joint ranges of movement and muscle length.
Support and facilitation of participation in physical activities.
Recommendation for specialist equipment for mobility, transfers, postural management, bone density.
Recommendation for orthotics for function and maintenance of joint range.
Advice on respiratory management / use of specialist equipment for airway clearance.
Treatment options may include hydrotherapy or land-based sessions as appropriate.

Neuromuscular Conditions

PaedsPhysio is able to support children and young people with a wide variety of neuromuscular conditions. The most common conditions seen are Duchenne and Becker Muscular Dystrophy and Spinal Muscular Atrophy. A Neuromuscular condition is a disorder that affects muscles and causes the muscles to become weak and tight and affects the individual’s function.

Neuromuscular conditions stem from a problem with the muscle, the nerves that supply the muscles or the junction between the muscles and nerves. This results in the child having functional difficulties, muscle weakness, fatigue and pain. Long term there can also be issues with loss of joint range, muscle length and spinal curvature.

How Can Physiotherapy Help?

A Paediatric Physiotherapist can help to monitor changes in function, muscle strength and joint ranges of movement over time, managing these with equipment and interventions to facilitate optimal outcomes for the child.
This may include pain management, walking practice / mobility assistance, orthotic recommendation, integration of sports / physical activity into weekly routines and stretching exercise programmes to maintain independence and skills.
Some children may have difficulties with their breathing. This will require respiratory support and management from their specialist centre.

Neuromuscular Conditions

Duchenne Muscular Dystrophy

Duchenne Muscular Dystrophy (DMD) is a muscle wasting condition caused by the lack of a protein called dystrophin. It usually affects only boys. It is a serious condition that causes progressive muscle weakness. Owing to the lack of the dystrophin protein, muscle fibres break down and are replaced by fibrous and or fatty tissue causing the muscle to weaken gradually.

In the early stages, boys with DMD show signs of muscle weakness, such as difficulties running, jumping, climbing stairs and getting up from the floor. They can develop a waddling gait (walking style) with their walking speed reducing as weakness progresses.

Steroids help to maintain muscle strength and function over a certain period of time and can delay the time when a wheelchair will be needed. Once needing a wheelchair full time the maintenance of good posture is increasingly difficult and complications are more likely.

Neuromuscular Conditions

Spinal Muscular Atrophy

Spinal Muscular Atrophy (SMA) is a rare, genetically inherited neuromuscular condition that causes progressive muscle weakness and loss of movement due to muscle wasting (atrophy). This may affect crawling and walking ability, arm, hand, head and neck movement, breathing and swallowing.

There are different forms of SMA and a wide spectrum of how severely children, young people and adults are affected. It can be classified as Types 1, 2, 3 and 4, with type 1 being the most severe.

Muscle & Joint Problems (Musculoskeletal)

At PaedsPhysio we regularly help children with a variety of conditions that affect their muscles and joints. These include neonatal conditions such as Torticollis / head turning preference, Obstetric Brachial Plexus Palsy, and Positional Talipes. In older children, we provide assessment and treatment for abnormalities of gait, symptoms associated with hypermobility, orthopaedic conditions such as Perthes Disease and rheumatological conditions such as Juvenile Idiopathic Arthritis.

We understand the complexities of child development and can offer our expert advice and support to help parents and carers support their children’s physical health.

Our assessment will cover discussion and testing of the following:

Cause for concern.
Pregnancy and birth history.
Family History.
Joint ranges of movement.
Muscle tone.
Muscle strength.
Gross motor skills assessment appropriate to the age of the child.

Muscle & Joint Problems (Musculoskeletal)

Torticollis and Head Turning Preference

Most babies have a preferred head turn. Congenital muscular torticollis is a postural deformity that is apparent shortly after birth. The baby tilts their head to one side and turns their head to the opposite side due to a tightness of the sternocleidomastoid muscle. Management includes positioning advice, stretches, active movement and environmental adaptations.

Muscle & Joint Problems (Musculoskeletal)

Plagiocephaly (Cranial Asymmetry)

This is a physiological moulding of the head that occurs in response to pressure on the back and side of the head, relating to the head turn preference. The head assumes a parallelogram shape with flattening at the back and bossing of the forehead, which can impact head control. Physiotherapy management includes targeting neck range of movement with stretches, positioning and environmental adaptations of activities to promote alignment and symmetry.

Muscle & Joint Problems (Musculoskeletal)

Obstetric Brachial Plexus Palsy

This is sometimes referred to as Erb’s Palsy. It is a traction injury to the upper nerves in the neck causing a peripheral nerve injury with a spectrum of severity, from transient weakness to permanent paralysis. It can also be associated with a fractured clavicle, humerus and diaphragm.

The baby may have muscle weakness or paralysis in the shoulder, elbow and wrist. Physiotherapy management includes assessment to understand the severity of the problem followed by a variety of possible treatments including:

Advice regarding handling, positioning and passive movements.
Ongoing assessment and monitoring of joint ranges of movement and muscle length.
Exercises and activity to improve functional ability.
Treatments to improve sensation.

Muscle & Joint Problems (Musculoskeletal)

Hypermobility

Hypermobility describes the movement within joints and relates to the amount of movement beyond that which is expected. It is normal to have joint hypermobility in children, but it can lead to pain, muscle weakness and increased risk of sprains and strains in some cases. Joint hypermobility decreases with age but in a small percentage of the population, persists into adulthood.

Physiotherapy cannot change the underlying flexibility in the joints, but strengthening the muscles that control joints, can lead to a significant reduction in symptoms.

Muscle & Joint Problems (Musculoskeletal)

Gait Abnormalities

There are a range of normal variations of walking pattern that occur and change as children grow and develop. It is very common to see children who walk with ‘in-toeing’ (feet turned inwards) and ‘out-toeing’ (feet turned out to the sides) walking patterns. These can often resolve on their own but a children’s physiotherapist can assess your child and provide advice on whether this is part of the developmental process or if there is anything that can be done to improve their walking more quickly.

Muscle & Joint Problems (Musculoskeletal)

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children and teenagers, causing swelling, pain and inflammation in the joints. It typically affects the hands, knees, ankles, elbows and/or wrists. But, it may affect other body parts too.

It is not clear why children develop JIA but it is likely to relate to genetic causes. There is currently no cure for JIA but symptoms, pain, function and quality of life can be improved with medication and Physiotherapy intervention.

Physiotherapy management of JIA involves muscle strengthening, maintaining joint ranges of movement, balance and developing motor skills. Advice and referral for orthotics can be facilitated.

Muscle & Joint Problems (Musculoskeletal)

Perthes Disease

Perthes Disease is a rare condition that affects the hip joint in children between the ages of 4 and 10 years of age. The blood supply to the head of the femur becomes disrupted and this can cause the ball shape of the bone to become misshapen. Children may present with a limp, pain in the groin and stiffness in the affected hip.

Physiotherapy treatment involves managing the pain with rest and modified activity, strengthening and stretching exercises to maintain muscle strength and hip joint mobility, to minimise long term problems. In a small number of more severe cases, surgery may be needed.

Muscle & Joint Problems (Musculoskeletal)

Positional Talipes Equinovarus

This describes the position of one or both feet of the baby (foot pointing down and turned inward) and is present from birth. This condition relates to in-utero positioning and resolves over time. The foot / feet can be moved into a neutral position passively without any structural restrictions.

Physiotherapy management includes a thorough examination of the baby including checking the hips, spine and assessment of the foot to ensure there is no structural element to the posture. If the foot will not fully correct, this condition is known as congenital talipes equinovarus and may require management via a specialist orthopaedic centre with a series of casts, boots and braces.

Orthopaedic Trauma & Amputation

PaedsPhysio provides expert rehabilitation to children who have suffered orthopaedic trauma including complex fractures, ligamentous injury and amputation. We adopt a holistic approach to treatment and will liaise with other specialist services involved in the child’s care to ensure that the best possible outcomes are achieved.

As specialist Children’s Physiotherapists, we can work with children at any stage of their rehabilitation, supporting them to achieve goals at any point in their rehabilitation journey. Where possible, we can meet the child and their family and provide physiotherapy support prior to planned surgery, offering intervention in their home, school or other appropriate setting. We support all adults involved in the child’s care to enable everyone to feel confident in their skills to support the child’s physical progress.

Physiotherapy intervention will vary according to the needs of each individual child / young person but may include the following:

Thorough physical assessment and identification of needs, with particular focus on activity and participation at home and school.
Family centred goal setting.
Hands on treatment to promote balance, coordination, and muscle strength.
Management of loss of range of motion.

Conditions Treated

What is Cerebral Palsy?

What is an Acquired Brain Injury?

Spinal Injury

Duchenne Muscular Dystrophy

Spinal Muscular Atrophy

Torticollis and Head Turning Preference

Plagiocephaly (Cranial Asymmetry)

Obstetric Brachial Plexus Palsy

Hypermobility

Gait Abnormalities

Juvenile Idiopathic Arthritis

Perthes Disease

Positional Talipes Equinovarus

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