Why your child might see a physiotherapist

Beyond “Growing Pains”: A Parent’s Guide to Pediatric Physiotherapy

The most dangerous phrase in parenting is “they’ll grow out of it.”

While many children do outgrow awkward phases, the “wait and see” approach can sometimes lead to missed windows of opportunity. A child’s brain forms over a million neural connections every second in the first few years of life. This is the era of neuroplasticity.

If a movement pattern—like toe walking or a crooked neck—isn’t corrected early, the brain “hardwires” it. Pediatric physiotherapy isn’t just about fixing injuries; it’s about architectural correction for your child’s developing body.

1. The Red Flags: When to Call a Pro

You don’t need a medical degree to spot issues. You just need to know what to look for. “Clumsiness” is often a code word for an underlying motor skill deficit.

The “Big Three” Warning Signs

The “W” Sit: Does your child sit on the floor with their knees together and feet splayed out to the side (forming a “W”)?
- The Risk: While stable for the child, this position can compromise core strength and cause long-term hip and knee alignment issues.
Toe Walking: If your child is constantly on their tiptoes past age two, it’s not just “cute.”
- The Risk: It can shorten the Achilles tendon and indicate sensory processing issues. Idiopathic Toe Walking (ITW) affects roughly 5% to 24% of children referred for gait abnormalities.
The Head Tilt (Torticollis): Does your baby constantly look to one side or tilt their head?
- The Risk: This tightens the neck muscles and often leads to Plagiocephaly (flat head syndrome), which might require a helmet to correct if not treated early.

2. Who Actually Needs a Physio? (The Spectrum of Care)

Pediatric physiotherapists (PTs) are not just “mini-adult” therapists. They specialize in development. Their patients usually fall into three categories:

A. The Developmental Delays

These are children who are missing milestones. They aren’t rolling, sitting, or walking within the standard windows.

Stat: According to the CDC, approximately 1 in 6 children aged 3–17 years have one or more developmental disabilities. Early intervention is the single biggest factor in long-term independence.

B. The Neurological & Congenital

Children with diagnoses that affect muscle tone and coordination.

Cerebral Palsy (CP): The most common motor disability in childhood. PT focuses on normalizing muscle tone and maximizing mobility.
Spina Bifida & Muscular Dystrophy: Managing muscle degeneration and prescribing adaptive equipment (wheelchairs, walkers).
Down Syndrome: Addressing hypotonia (low muscle tone) to improve stability.

C. The Orthopedic & Sports Injuries

Modern kids are specializing in sports earlier, leading to “adult” injuries in kid bodies.

- Osgood-Schlatter Disease: Knee pain caused by growth spurts.
- Scoliosis: A sideways curvature of the spine that often appears during the pre-teen growth spike. *

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3. The “Stealth” Therapy: What a Session Looks Like

If you watch a pediatric PT session, it looks like playtime. That is by design.

A child will not do 3 sets of 10 squats. But they will squat to pick up a toy and stand up to put it in a bucket.

The Method: The PT engineers the environment (“The Obstacle Course”) to force the child to perform specific movements.
The Goal: To trick the brain into learning a new motor pattern through play.
Parent Involvement: You are not a spectator. The PT will teach you how to handle your child so that therapy continues at home 24/7.

4. The Logistics: Referrals, Costs, and Waiting Lists

Navigating the healthcare system can be harder than the therapy itself. Here is the breakdown for Canadian parents (and applicable elsewhere):

Public vs. Private

Public (OHIP/Government Funded):
- Pros: Free.
- Cons: The Waitlists. In many provinces, waiting lists for non-urgent pediatric PT can stretch 6 to 18 months. By the time you get an appointment, the developmental window may have closed.
Private Clinics:
- Pros: Immediate access (usually within a week). You do not need a doctor’s referral to see a private physiotherapist in Canada (this is called “Direct Access”).
- Cons: Cost. Expect to pay $100 – $150 per session.

The Insurance Game

Check your employee benefits package. Most cover between $500 and $2,000 per year for physiotherapy.

Tip: Ask your insurer if they require a GP referral for reimbursement. Even if the clinic doesn’t require one, the insurance company might.

5. The Vetting Checklist: Questions to Ask

Do not just book the first clinic that pops up on Google. Ask these specific questions to ensure they are qualified to treat children.

“What is your caseload mix?”
- Good Answer: “I treat 80-100% pediatric patients.”
- Bad Answer: “I mostly treat back pain in adults, but I see kids sometimes.”
“How do you handle ‘home programs’?”
- Good Answer: “I will email you videos/photos of 2-3 exercises to do daily.”
- Bad Answer: “Just come back next week and we’ll work on it then.” (This is a money grab).
“Are you Rostered?” (Ontario specific)
- Ensure they are registered with the College of Physiotherapists. Unlicensed practitioners are illegal.

Your Next Step

If your gut tells you something “looks off” with how your child moves, record a 30-second video of them walking or playing today. Show it to your GP or book a 15-minute screen with a private physio. It is better to pay for one session and be told “they’re fine” than to wait two years and wish you had started sooner.