Physiotherapy - Musculoskeletal (MSK)

Children's Musculoskeletal Physiotherapy (MSK)

Children’s Musculoskeletal Physiotherapy addresses problems that relate to joints, muscles, bones and ligaments following an injury or operation. It also addresses concerns related to children’s growth and development.

The MSK service is mainly advisory and signposting, but the physiotherapists can offer a treatment block or review if it is clinically indicated. We focus on self-management and expect children and families to follow advice independently at home.

Physical Activity Guidelines:

Physical Activity is extremely important for all children as it will help you stay healthy and reduce your risk of musculoskeletal pain or injury caused by inactivity.

The NHS advises children between the ages 5 – 18 to complete 60 minutes of moderate to vigorous to physical activity a day. Moderate activities are those will raise your heart rate and increase your work of breathing.

How to stay active?

NHS Physical Activity Guidelines

This website will give you more information on the guidelines and how to stay active.

Everybody Moves:

This is a website where you can search for your local sports groups/settings that cater for all abilities.

NHS Fitness Studio:

This website provides online resources and videos on exercises to target different muscle groups.

Common Conditions That We See:

These are a few common conditions that we may see. Please see the downloads for the associated leaflets.

Flat Feet:

This is a common condition where the arches of the foot/ feet are reduced or absent. It is normal for children to have flat feet until around the age of three years old. Many children have flat feet and this is part of normal.

Flat feet may cause some discomfort when walking or there may be no symptoms. Some presentations of flat feet may need no intervention. The treatment will be based on clinical assessment.

Tip toe Walking:

Tip toe walking is a normal variation of development. Usually there is no underlying structural issues but could be caused by habit or may link with sensory processing. Your physiotherapist will assess range of movement, check function and determine the best management approach. We will give advice on activities and footwear that may help the tip toe walking.

Bow Legs:

Bow legs is when the legs curve outward at the knees and the ankles are touching, children are often quite clumsy and can trip over easily.

Bow legs is a normal childhood variation that effects children under the age of three and can be linked with early walkers. It is common for children to have bow legs when they start walking and this should improve on its own by the age of three.

Knock knees:

Knock knees is a common childhood condition when the knees are touching and there is a gap between the ankles when they are standing or walking. This condition usually effects children between the ages of 3 to 6 years old and typically resolves on its own. Most children have knock-knees for a period of time when they are growing.

Out-toeing:

Out-toeing is when a child’s feet are in an outward position, this is more noticeable when they are walking or running and can affect one or both legs. Out-toeing is a normal variation and doesn’t require any ntervention and often corrects on its own.

Out-toeing will not affect your child’s function, but they could experience some falls therefore it is important that they remain active and work on their strength and balance.

In-toeing:

In-toeing is when a child’s feet point inward when they walk, this can affect one or both legs. It is common for children who walk with an in-toeing pattern to be quite clumsy. In-toeing can be caused by the position of the hip, knee or the foot.

In-toeing is a normal variation of development and often with natural growth and development will resolve on its own. In-toing will not affect your child’s function and your physiotherapist will give you advice on how to manage in-toeing and suggest different stretches or sitting positions.

Severs:

Severs is a condition that presents as heel pain and is linked with growth. The heel pain is caused by inflammation at the growth plate in the heel. The pain is usually worsened with high impact activity and worsens when the child has had a growth spurt. Severs is managed by activity modification and will usually will resolve on its own.

Osgood Schlatters:

This is a condition that presents as pain on the front of the knee, just below the knee cap. This is caused by inflammation of the tibial tuberosity and usually linked with growth and activity. You may notice a visible lump on the front of your knee and can worsen with high impact activities. Osgood Schlatters usually resolves on its own and is managed by modifying activity levels to help manage the pain.

Joint Pain:

We often assess children who complain of joint pain. During the appointment the physiotherapist will assess the joint, look at muscle strength, range of movement, complete structural assessment and assess functional abilities.

Pain can be caused by multiple factors that include – muscle weakness, bendy joints, instability of the joint, reduced activity levels, poor posture or injury. You will receive advice on how to manage this during the appointment.

Warning signs:

Your physiotherapist will screen for more serious conditions during the appointment. Some presentations/ symptoms will require further investigation or management.

Please refer to the Paediatrics MSK warning signs leaflet in the download section for further information and contact your GP if you are concerned.