When to Seek Physiotherapy Treatment for Children – The Cringe Test

It’s a beautiful Thursday evening and you are watching your son play soccer. The game is going well when suddenly he goes flying. A badly timed slide tackle has caught his foot while he was in full flight and he has gone down hard. You and the other parents suck in a collective gasp and hold your breath waiting to see if he will get up. He gradually peels himself off the ground and trots slowly back towards the play. Thank goodness he escaped that one unscathed. But did he really?

Kids, particularly those who play sports often, can sustain some pretty significant blows sometimes. Generally they bounce back and keep going, but are they really okay? Sometimes the injury prevents them from continuing and then as parents we wonder if we should take them to see someone. While we spend a few days sitting on the wait-and-see fence, they usually get back in the game, we breathe a sigh of relief, and life returns to normal……or so we think.

The reality is that kids do bounce back better than adults do, but that does not mean their bodies have absorbed less impact. When they crash into someone while running full tilt or get hit in the arm with a line drive, their bodies absorb the same kind of force that an adult’s does, and yet we usually don’t seek treatment for children because they carry on.

I often get asked how to decide when children need physiotherapy treatment for an injury. My simple response is the cringe test. If you or someone else witnessed the incident, simply ask yourself if you cringed and physically curled yourself into some sort of protective ball when it happened. You know what I mean – you suck in your breath sharply, pull your arms and legs up towards your torso, and say something like “Oooooh. That’s GOTTA hurt!” If that sort of reaction occurred then you should seek treatment for your child even if they get back to the game relatively quickly.

The problem with not seeking treatment when something like this happens is that these types of injuries have a cumulative effect. As the body absorbs the force of impact, it stores that energy in the tissues. The body will continue to do this until the tank is full and then something gives – i.e. serious injury occurs such as a blown out knee requiring surgery. If you would like to know more about this cumulative effect of injury, read this blog post.

So next time your child wipes out or gets hit with some flying object think about the cringe test. If you experienced a full-blown physical fetal position response when you witnessed the event, then physiotherapy treatment is probably recommended.


The Ontario government and the College of Physiotherapists of Ontario have given us the go-ahead to start seeing people in person. We are now taking online bookings for in person appointments on or after June 1st. We would like to assure you that we will be operating under strict guidelines in order to minimize the risk to everyone. We have the health and safety of our community at heart in every decision we make. We are so excited to welcome you back!