Ключевые выводы
- Developmental milestones have ranges, not deadlines — but consistent delays across multiple areas warrant assessment
- Torticollis (head tilt) in newborns responds best to physiotherapy started before 3 months of age
- Flat feet in children under 6 are usually normal — the arch develops gradually and only needs treatment if painful or persistent
- Pediatric physiotherapy uses play-based exercises rather than adult repetition-based programmes
- Scoliosis screening should happen during growth spurts, particularly between ages 10–14
- School-aged children increasingly present with postural problems from prolonged screen use and heavy backpacks
- Early intervention produces the best outcomes — if you are concerned about your child's movement, get an assessment sooner rather than later
- Sports injuries in children require different management than in adults because growth plates are still open
Your toddler is 15 months old and not walking yet. Your 8-year-old complains about leg pain after football. Your teenager slouches so badly their shoulders are rounded forward. Are these normal phases, or signs that your child needs professional help? Knowing when to seek a physiotherapy assessment can prevent small problems from becoming lasting ones.
Pediatric physiotherapy is not simply adult physiotherapy with shorter treatment beds. Children's bodies are still developing, their conditions are often different from adults', and the treatment approach must be adapted to their age, attention span, and emotional needs. At DCDC's Paediatrics department in Dubai Healthcare City, we work with our physiotherapy team to assess and treat children from infancy through adolescence.
When Should You Worry About Developmental Milestones?
Every child develops at their own pace, and milestone ranges are broader than most parents realise. However, there are patterns that suggest a child may benefit from physiotherapy assessment. The concern is not usually about a single delayed milestone, but about a pattern of delays or asymmetries in movement.
| Age | Expected Motor Milestones | When to Seek Assessment |
|---|---|---|
| 0–3 months | Lifts head during tummy time, moves arms and legs equally | Strong head tilt to one side, does not lift head at all, one arm moves less than the other |
| 4–6 months | Rolls over, reaches for objects, supports weight on forearms | Cannot hold head steady, does not roll by 6 months, marked preference for one side |
| 7–9 months | Sits independently, crawls or commando crawls, pulls to stand | Cannot sit unsupported by 9 months, does not bear weight on legs, asymmetric crawling |
| 10–14 months | Cruises along furniture, stands briefly, first steps | Not pulling to stand by 12 months, no attempt at walking by 15 months, walks on toes persistently |
| 15–24 months | Walks independently, begins to run, kicks a ball | Not walking by 18 months, falls excessively, significant in-toeing or out-toeing |
| 2–5 years | Jumps, climbs stairs, pedals tricycle, balances on one foot | Cannot jump by 3, cannot climb stairs alternating feet by 4, frequent tripping and falling |
What Conditions Does Pediatric Physiotherapy Treat?
Pediatric physiotherapy covers a wide range of conditions from birth through adolescence. Some conditions require early intervention in the first weeks of life, while others present later as a child grows and becomes more active. Here are the most common reasons children are referred to our physiotherapy team.
Infant Conditions
- Torticollis: Tightness in the neck muscles causing the head to tilt to one side. Affects 3–16% of newborns. Early physiotherapy (before 3 months) has a 98% success rate without surgery
- Plagiocephaly (flat head): Often occurs alongside torticollis. Positioning guidance and neck stretches help resolve both conditions
- Developmental delay: When a baby is not meeting motor milestones within expected ranges, targeted exercises can help bridge the gap
- Hypotonia (low muscle tone): Floppy babies who struggle to hold their head up or sit independently benefit from strengthening programmes
Childhood Conditions
- Flat feet (pes planus): Normal in children under 6 as the arch develops. Assessment is needed if feet remain flat after age 6, cause pain, or affect walking pattern
- In-toeing and out-toeing: Walking with feet turned inward or outward. Usually corrects with growth, but persistent or severe cases need monitoring
- Growing pains: Common between ages 3–12, typically in the legs at night. Physiotherapy can help with stretching programmes and rule out other causes
- Coordination difficulties: Children who are notably clumsier than peers may have developmental coordination disorder (DCD), which responds well to targeted therapy
Adolescent Conditions
- Scoliosis: Abnormal lateral curvature of the spine, most commonly detected during growth spurts between ages 10–14. Screening involves the Adams forward bend test
- Sports injuries: Growth plate injuries, ligament sprains, and overuse injuries from specialising in one sport too early
- Postural problems: Rounded shoulders, forward head posture, and upper back pain from prolonged device use and heavy school bags
- Osgood-Schlatter disease: Knee pain at the tibial tuberosity common in active adolescents during growth spurts
How Does Pediatric Physiotherapy Differ from Adult Physiotherapy?
The biggest difference is approach. You cannot hand a 3-year-old a set of resistance bands and ask them to do three sets of ten. Pediatric physiotherapy uses play, games, and activities that achieve therapeutic goals while keeping the child engaged. A session might look like an obstacle course, a ball game, or imaginative play — but every activity is designed to target specific muscle groups, coordination patterns, or balance skills.
- Treatment is play-based: Exercises are disguised as games appropriate for the child's age and interests
- Growth plates must be protected: Children's bones are still developing, so exercises avoid heavy loading that could damage growth plates
- Parental involvement is essential: Parents learn techniques to continue at home, as daily practice between sessions drives results
- Sessions are shorter: Young children cannot concentrate for 45–60 minutes. Sessions are adapted to attention span, typically 30–45 minutes
- Goals are functional: The aim is not muscle strength in isolation but the ability to do what a child needs to do — run, play, sit at a desk, carry a bag
What Are Age-Appropriate Exercises for Children?
The exercises prescribed depend entirely on the child's age, condition, and developmental level. Here is a general guide to what physiotherapy exercises look like at different stages. All exercises should be prescribed by a physiotherapist after assessment — this list illustrates the approach, not a home programme.
| Age Group | Exercise Type | Examples |
|---|---|---|
| Infants (0–12 months) | Positioning, passive stretching, tummy time | Supervised tummy time sessions, gentle neck stretches for torticollis, reaching activities |
| Toddlers (1–3 years) | Active play, balance challenges, obstacle courses | Walking on uneven surfaces, stepping over objects, kicking and throwing balls, climbing |
| Pre-school (3–5 years) | Structured games, coordination tasks | Hopping and jumping games, balance beams, catching, pedalling, animal walks |
| School age (6–12 years) | Sport-specific training, strength exercises, stretching | Single-leg balance, core exercises as games, flexibility stretches, sport skill practice |
| Adolescents (13+ years) | Progressive strengthening, posture correction, sport rehab | Targeted strength training, postural exercises, return-to-sport protocols, stretching programmes |
How Are Sports Injuries Different in Children?
Children are not small adults. Their skeletons are still growing, which means their bones have open growth plates (physes) that are weaker than the surrounding ligaments and tendons. Where an adult would sprain a ligament, a child may fracture a growth plate instead. This is why children's sports injuries require assessment by practitioners who understand paediatric anatomy.
- Growth plate injuries: Can affect bone growth if not properly managed — always require medical assessment
- Apophysitis: Inflammation where tendons attach to growing bone (Osgood-Schlatter at the knee, Sever's disease at the heel)
- Overuse injuries: Increasingly common in children who specialise in one sport year-round. Rest and cross-training are essential
- Return to sport: Children heal faster than adults but should not return to full activity until cleared by a physiotherapist
Why Are School-Related Postural Problems Increasing?
We are seeing a significant increase in children presenting with postural problems, neck pain, and upper back discomfort. The causes are straightforward: children spend an average of 4–7 hours daily on screens outside of school, school bags frequently exceed the recommended 10% of body weight, and desks and chairs at school are often not adjusted for individual height. These issues are preventable with awareness and simple interventions.
- Ensure screens are at eye level — not in the lap or lying down
- Backpacks should not exceed 10–15% of the child's body weight
- Encourage movement breaks every 30 minutes during homework or screen time
- Sports and physical play counteract the effects of prolonged sitting
- If your child complains of regular neck, shoulder, or back pain, seek a physiotherapy assessment
Book a Pediatric Physiotherapy Assessment
Our physiotherapy team at DCDC in Dubai Healthcare City provides child-friendly assessments for developmental concerns, sports injuries, and postural problems. We make sessions fun while achieving real results.
Часто задаваемые вопросы
Trust Your Instincts, Seek Early Assessment
Parents often know when something is not quite right with their child's movement or development. If you have a concern, do not wait to see if it resolves on its own. Early assessment and intervention consistently produce better outcomes than a wait-and-see approach, whether for an infant with torticollis or a teenager with scoliosis.
A single assessment with our physiotherapy team can either reassure you that your child's development is on track or identify issues early enough for the most effective treatment. Either way, you will have clarity instead of worry.
Источники и ссылки
Эта статья проверена нашей медицинской командой и ссылается на следующие источники:
- American Academy of Pediatrics: Motor Delay Early Identification and Evaluation
- Kaplan et al: Physical Therapy Management of Congenital Muscular Torticollis (Pediatric Physical Therapy 2013)
- Scoliosis Research Society: Adolescent Idiopathic Scoliosis Screening Guidelines
- British Journal of Sports Medicine: Youth Sports Injury Prevention
- World Health Organization: Child Growth Standards
- Journal of Pediatric Orthopaedics: Flat Feet in Children
Медицинский контент на этом сайте проверяется врачами, лицензированными DHA. См. нашу редакционную политику для получения дополнительной информации.
Автор
Dr. Hadi Komshi
Specialist Internal Medicine
MD, DHA-Licensed
Dr. Hadi Komshi is a DHA-licensed Internal Medicine Specialist at Doctors Clinic Diagnostic Center in Dubai Healthcare City, with extensive experience in managing acute and chronic medical conditions including musculoskeletal pain and rehabilitation.
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