Children’s Physiotherapy Service

A flat foot is when the inside of the foot (the arch) appears reduced or absent in standing. The arch often ‘reappears’ when sitting with the weight off the foot.

Before the age of 3 years, most children naturally have flat feet. The arch only starts to develop around this age.

Children’s feet grow very quickly and it’s important that the bones grow straight. Therefore, choosing the correct fitting footwear is essential during this stage of development.

There is no need to put your child in shoes until they can walk. You may wish to buy soft shoes. These help to protect the feet and keep them warm when outside.

APCP leaflet here>

Bow legs is the term used to describe outward curving of the legs. Most children have some bowing of the legs when they start to walk. It is common from birth and usually straightens by itself by the time the child reaches 3 years old. This bend in the leg often causes children to walk with their feet turned in (in-toeing).

It is normal for infants to be born with bow legs. Bow legs are a normal part of a child’s growth and may become more obvious in toddlers as they begin to walk. When a child with bow legs stands with their feet and ankles together, the knees stay apart. In most children bow legs disappear without treatment by the time they are two or three years old.

A child with knock knees has a large gap between their feet when they’re standing with their knees together. Many young children have knocked knees, which tend to be most obvious at around the age of 4. It’s almost always just a normal part of their development, and their legs will normally straighten by the age of 6 or 7.

Gait is the technical term for walking pattern. When children learn how to walk it is normal for them to stretch out their arms and to step with their feet apart to maintain their balance.

As children practice walking, they can walk really fast and may trip or fall down more frequently, especially before 3 years old.

As toddlers grow, the length of the steps tends to increase and they start to walk slower. As the young children grow and develop, there are various changes that may concern parents, but are usually part of normal development.

Heel pain is a common growth-related issue in children, and can be due to the calf muscle pulling on the heel bone. It is usually irritated by walking and running, and settles with rest. It can be self-managed and you do not necessarily need to see a physiotherapist.

Osgood Schlatters is a growth-related condition of the knee which is caused by an irritation of where the thigh muscle attaches to the shin bone. This is one of the most common causes of knee pain in young people aged between 10–15 who are growing rapidly.

Hypermobility describes joints that are particularly flexible. This can affect just one joint or many joints. It is not an illness or disease and is a normal variation. Hypermobility is commonly seen in young children, who are naturally more bendy.

Most children are flexible but some more so than others. Between 25-50% of children under 10 are considered hypermobile. Most children will get less flexible as they get older and any difficulties should improve as the child’s strength and co-ordination develop.

Back pain is common in children and young people and studies have shown that back pain affects over half of all children in primary and secondary school at some time. Back pain can be frightening for children and you may worry that it is something serious. The good news is that the back is very strong and by making small changes in posture and lifestyle, you can often improve back pain.

We all experience painful or uncomfortable feelings in our body at some time in our lives. Common examples are headaches, stomach aches and ‘growing pains’. Often these symptoms get better on their own and do not need any treatment.

Click here for more information about our Persistent Physical Symptom Service.

Read the full range of the Association of Paediatric Chartered Physiotherapist’s parent information leaflets here>

If you are concerned about your child’s health or development you may find the links to external resources below useful. These will give you helpful advice to help you manage their needs and enhance their skills.

Baby Buddy: Advice about early child development.

BBC Tiny Happy People: Explore their simple activities, videos and play ideas and find out about your child’s early development.

NHS Healthier Families: Information about healthy eating, useful recipes, activities in your local area to get involved in, getting children active and lots more.

These websites may also be of use to you if your child has specific needs or conditions:

• Dyspraxia Foundation
• Hypermobility Syndromes Association
• Down’s Syndrome Association
• National Autistic Society
• Children’s Hemiplegia and Stroke Association
• Cerebra, children with brain conditions
• Movement Matters

Speech and language:

• I can, talking
• Words for life
• Selective mutism
• Cleft Lip and Palate Association
• National Deaf Children’s society 

Equipment:

• Disabled Living
• Whizz-kids, help with mobility aids

Charity Funding:

• New Life, the charity for disabled children
• Family Fund, helping disabled children

Physio Direct is a telephone advice line for parents and carers. It is open in the mornings from 9am to 12pm daily. Leave a message on 0300 421 6980 and a qualified physiotherapist will return your call as soon as possible.

Our physiotherapists work in specials schools across the county to support children and young people at school and at home.

We work with children with a variety of presentations and conditions including cerebral palsy, neuromuscular conditions, Down’s syndrome and developmental delay. We work with children, their families and carers and educational staff to improve a child’s access to the curriculum. This may include providing a physiotherapy programme that is carried out in school, specialist equipment, postural management ideas and working alongside other healthcare professionals to encourage function, movement and posture.

Our therapists can be contacted Mon-Fri on our main number: 0300 421 6195 – leave a message on this number and we’ll get back to you as soon as possible.