Children's Musculoskeletal Physiotherapy

Children’s Musculoskeletal Physiotherapy addresses problems relating to bones, joints, muscles and ligaments following injury or operation; as well as issues related to growth and development in children and young adults.

Our aim is to support the return to normal function and sporting activities.

Physical activity guidelines for children

Children between the ages of 5 and 18 years should be doing regular physical activity in order to maintain their health. If your child is not physically active this may be the cause of the issues they are experiencing. Children aged 5 to 18 should:

  • Aim to do at least 60 minutes of moderate to vigorous physical activity every day.
  • Take part in a variety of different physical activities across the week.
  • Limit prolonged periods of sitting or lying down during the day.

'Moderate physical activity' would be anything that raises a child's heart rate, causes them to breathe faster, and makes them feel warmer. Further information is available by clicking the links below.


Common conditions we see as part of our service

Flat feet

What is a flat foot?

The inside arch of the foot is ‘flat’ to the floor.

Is it a problem?

Children under the age of 5 often have flat feet; this is considered part of normal development and most children grow out of it. Those with a persistent flat-foot, rarely develop symptoms or pain and participate in physical activity and sports without any problems.

It is often ‘flexible’ in nature, and an inside arch can be formed when stood on your tiptoes. In a few cases there is an underlying problem that may require further investigation and treatment. This can be assessed by a clinician and they will then discuss appropriate treatment.

Download information about Flat Feet in children for parents and carers (opens in new window) >


Some children and adults walk with their toes pointing inward and parents or carers often report their child to be clumsy and falling over frequently.

There are a few reasons that contribute to in-toeing:

  • Femoral Anteversion
  • Internal Tibial Torsion
  • Metatarsus Adductus

Download information about Intoeing Gait in children (opens in new window) >

Osgood Schlatters

Osgood Schlatters is a common cause of anterior knee pain in late childhood and early adolescence and can affect one or both knees. The patella tendon inserts into the tibial tuberosity. Reoccurring pulling from the quadriceps can cause repetitive injury to the growth plate and can lead to pain and swelling in the region of the tuberosity.

It often occurs in children who are sporty, particularly sports involving running and jumping.

What are the risk factors?

  • Rapid growth, typically girls 8-12 years and boys 10-14 years
  • Regular high impact, repetitive activities e.g. running & jumping

Download information about Osgood Schlatters disease (opens in new window) >

Sever's disease

Sever’s disease is a common cause of heel pain (opens in new window) > in late childhood and early adolescence. Pain is usually experienced at the back of the foot, with or without swelling. It is often aggravated by increased physical activity such as walking, or playing sport.

Tip-toe walking

Tip-toe walking is a common parental concern seen by children’s physiotherapists. Usually there is no underlying problem with the structure of the legs and feet and it is simply a habit that the child has picked up. Tip-toe walking can lead to children experiencing pain in the calf muscles, particularly on increased activity or walking up hill.

Vitamin D deficiency

Vitamin D (NHS) (opens in new window) > is an important part of a child’s diet because it supports the absorption of calcium, which is needed for their bones to grow and to stay strong. Inadequate vitamin D can lead to softer, weakened bones, that can be painful and are more vulnerable to injury.

If your child is struggling with weakness, tiredness, frequent falls, and fractures, it may be because they are deficient in vitamin D. Bowing of the legs is also a symptom of vitamin D deficiency.

Knee ligament reconstruction

There are different types of knee ligament reconstruction protocols, and each has a specifically designed post-operative process that has been put together by our orthopaedic surgeons and specialist physiotherapists. You will be supported by the Physiotherapy team in following these procedures after your operation.

Patients can find the protocols for a specific operation, and further advice on expectations for the rehabilitation process by visiting our knee protocols > page.