Pediatric Physiotherapy
Pediatric physiotherapy is a specialized area of physiotherapy in which we design the therapy according to the children’s age, abilities, and cognitive capacity. At the Budapest Musculoskeletal Private Outpatient Clinic, we welcome our patients from 0 to 18 years of age, meaning we treat children from newborns to teenagers.
How does pediatric physiotherapy work?
The therapy begins with a physical assessment, as with adult treatments. This starts with taking the child’s medical history: reviewing family planning, pregnancy, birth circumstances, analyzing infant and toddler movement patterns, and inquiring about motor development. For the most accurate medical history, please bring your child’s previous medical documentation. The assessment is conducted in a playful manner, examining various movement sequences, reflex testing, and basic movement patterns. For newborns, please bring a cloth diaper for the examination and subsequent treatments; for older children, a change of clothes (socks, shirt, pants) is required.
Why is it necessary/beneficial to start physiotherapy in childhood?
From birth until approximately 10–12 years of age, movement is the primary means of interacting with the outside world. Through movement, children experience, acquire stimuli, and develop their organs and organ systems. Movement is the primary stimulus for bone growth and muscle development; without it, this process is inhibited, development may slow down, or even stop completely, which can lead to deformities and postural defects in later life. Beyond the connection between bone and muscle, it is also closely related to nervous system development. The developing nervous system becomes capable of controlling increasingly complex movements, and practicing these movements in turn contributes to the refinement of the nervous system, enabling the acquisition of new movements. Thus, it plays an irreplaceable role in the functional development of the nervous system.
Motor development in childhood
Every child’s motor development is unique, reflecting the maturity of the nervous system and closely related to the development of other abilities. The most important thing is that the milestones of motor development—rolling, crawling, climbing, standing—occur in the proper sequence, that no movement pattern is skipped, and that movements are performed correctly and for an appropriate duration.
The most common problems include failure to lift the head while lying on the stomach around three months of age, as well as when the infant has difficulty tolerating the prone position, does not support on the forearms, and does not lift the chest. Around six months of age, another common problem is the absence of rolling, when the baby does not yet roll from back to stomach or from stomach to back.
Furthermore, postural asymmetry can occur at any age, most commonly caused by unilateral head positioning. This can often develop during fetal life; in such cases, asymmetry is visible in the newborn’s posture and skull shape.
What symptoms warrant consulting a pediatric physiotherapist?
- Soft and weak or tight, stiff muscles
- Asymmetric head and neck posture, limb positioning
- Does not like lying on the stomach, does not lift the head
- Unequal limb use
- Frequent head extension and trunk arching
- Delayed motor development
What complaints can you bring to us?
- Infants and young children with delayed motor development
- Torticollis or asymmetric trunk posture, asymmetric postures
- Muscle tone distribution disorders
- Movement coordination or balance disorders
- Central nervous system injuries: genetic abnormalities, cerebral palsy, slower development due to early nervous system immaturity
- Orthopedic conditions: poor posture, scoliosis, flat foot or other static foot deformities, hip problems, knock knees, bow legs
- Traumatology cases: rehabilitation after accident or surgery
- Other childhood musculoskeletal problems
Tímea Szentpétery
Physiotherapist
Poor posture
Poor posture is an increasingly common problem among older children, primary school students, and adolescents. Poor posture can be actively corrected and generally does not cause pain; however, without treatment, various musculoskeletal problems and pain may develop in later life. It is not a disease in itself, but most spinal conditions develop on this basis. Poor posture can develop as a result of sudden rapid growth that the child’s muscles cannot keep up with, or due to incorrect sitting, psychological factors, lack of willpower, or imbalance in trunk muscles. We distinguish four types of poor posture:
- Flat back, when the physiological curves straighten, meaning the thoracic spine curvature and the lumbar spine curvature are reduced. The trunk appears straightened in side view, the back is flat.
- Kypholordotic back, when the physiological curves are increased, meaning the thoracic curvature and lumbar curvature are more pronounced.
- Sway back refers to when the degree of thoracic curvature is normal, but the lumbar curvature is increased.
- In the case of round back, the thoracic curvature is greater than normal and extends to part of the lumbar spine as well; the trunk appears rounded in side view, the back is hunched.
Flat foot
Another very common problem in childhood, considered a widespread condition, is flat foot and other static foot deformities. The arch of the foot begins to develop around 3 years of age, and this process can continue until 10–12 years of age. The adult foot arch begins to appear at the earliest around 5–6 years of age. In flat foot, the longitudinal arch of the foot collapses. This is caused by weakening and elongation of the muscles and ligaments that support this arch.
This is often accompanied by collapse of the transverse arch, when the transverse arch running between the heads of the first and fifth metatarsal bones beneath the toes collapses. To promote the development of the foot arch and correct already developed flat foot, it is advisable to perform foot exercises. For children, foot exercises can be made colorful and varied with equipment, so they perform the tasks with greater enjoyment and perseverance.
Our pediatric physiotherapy treatments
- Active physiotherapy: strengthening muscles with playful, varied exercises, activating, practicing, and acquiring new functions. Restoring muscle balance, stretching tight muscles prone to contracture, and strengthening weaker muscles prone to elongation.
- Early intervention: correcting and initiating age-appropriate motor functions, normalizing abnormal muscle tone, mobilizing joints, reducing pathological reflexes, strengthening muscles, initiating and facilitating motor development, developing coordination and balance, and eliciting certain reactions.
- Posture correction exercises, spinal exercises
- Scoliosis treatment with Schroth 3D scoliosis therapy
- Manual techniques
Working together with parents
We try to make the sessions engaging with various exercises and diverse equipment. Communication with parents, setting common goals, and working together are very important. We also give parents tasks to do at home. With timely treatment and professional development, deficits can be addressed and eliminated.
Prevention is extremely important, but existing conditions can also be treated effectively, often conservatively. It is definitely advisable for children leading active lives to learn a personalized, easy-to-follow physiotherapy exercise routine, which is essential for avoiding pain and deformity and enhancing athletic performance.
Continuous development
Our physiotherapist therapists continuously develop themselves through specialized training to provide the most appropriate therapy and development for children. For example, training for Pediatric Rehabilitation Specialist Physiotherapist certification is currently underway, as well as learning the Dévény Special Manual Technique.
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