Children are NOT Small Adults – They Need Specialized Paediatric Physiotherapy

It seemed straightforward. The twelve year old in front of me was complaining of right knee pain. It was not surprising given that he trains almost every single day between doing competitive football and a sport study programme at school. 

What drew my attention right away, however, was not his knee. It was the fact that he was very crooked. He was bent to the left side like a banana and was also experiencing neck pain. Mom had brought him specifically to see me because of a blog I wrote about torticollis. What’s that got to do with his knee you ask? I know it sounds crazy, but everything.

Torticollis is a condition seen in babies where there is tightness in the body that leads to the head always being turned to one side. The traditional approach to treatment is just to force the head to the side where it doesn’t want to go, and this was the approach used on this particular boy. The problem is, this condition involves tightness throughout the entire body and this is often missed. 

So here he was twelve years later still with significant tightness in the left side of his body, which by the way, mom had been addressing forever with health care professionals only to be told it was no big deal. This shortness (think the short side of a banana) through one side was pulling his left leg up and effectively making it shorter than the right. This in turn was putting undue strain on his right leg and with all of the activity he does it was producing pain in his right knee. 

Our main goal then became to deal with the tightness in the left side of his body in order to improve his symmetry and thus spread the load more evenly through both of his legs. In addition, this boy had grown extremely rapidly in the past two years and so we were dealing with tightness related to that, and some growing pains (which by the way are treatable) thrown into the mix as well. 

Further examination of his right knee revealed a likely diagnosis of Osgood-Schlatter disease. This is a paediatric specific condition affecting the growth plate of the bone. It produces pain in a specific area of the knee and requires rest and monitoring. The no pain no gain approach doesn’t work here for sure. 

So this case of “simple” knee pain in fact involved three very specific paediatric issues all rolled into one big ball of complicated interaction. Of course not all kids with sports injuries will have multiple issues as the underlying cause. However, the point is, as a layperson how do you know? 

The fact is, you don’t. And that is precisely why you should always bring your child to a physiotherapist with paediatric experience. 


Note: Marie (physiotherapist and owner of MAP Physiotherapy) worked the first ten years of her career at the Children’s Hospital of Eastern Ontario (CHEO) and has continued to treat infants and children throughout her decades of practice.

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