• Leong Mei Hong

Get To Know More About Physiotherapy and How It Can Help Your Child Before It Is Too Late

Updated: May 4


First of all, what do know about physiotherapy? Most people don’t understand the key role physiotherapy can play in maximizing a child’s health. Here is everything you need to know about physiotherapy and how it can help with your child.


Table of Contents

1. What is Physiotherapy?

2. Why your child might see a physiotherapist

3. Gross Motor Developmental Milestones

4. Gross Motor Developmental Red Flags




A physiotherapist is a health professional who treats pain caused by joint, muscle and nerve problems. Paediatric physiotherapists are physiotherapists who specialise in working with children from birth to late adolescence.

#physiotherapy


Physiotherapy helps with the development, rehabilitation, and improvement of movement, flexibility, strength and endurance. Therapy program will focus on improving the child’s functional or educational skills.


Therapy sessions may include:

  • Initial assessment to find out about the child’s needs

  • Regularly scheduled treatment to work on mobility, strengthening, flexibility exercises or stretching exercises

  • Home programs given to parents or families to practice at home


The goal of physiotherapy is to help a child function at their maximum capabilities. Physiotherapy can give a disabled child a priceless sense of independence through comprehensive therapy sessions.

Physiotherapy often works together with other therapies, such as occupational therapy or speech therapy. For example, if a child is learning how to write and is slouching at the table, it may be a sign of poor core strength—physiotherapy can help with the core strength while occupational therapy teaches writing.





1. Developmental delay

Child displays a significant delay in meeting milestones (rolling, sitting, crawling or walking)


2. Unusual posture

Child develops unusual walk, gait, foot or spinal posture. Child frequently sits in the W- sitting pose


3. Persistent pain

Child presents ongoing pain, stiffness or inflammation of joints.


4. Recent injury or surgery

The child is recovering from a recent injury or surgery where their movements became stiff or unsmooth


5. Low-tone/floppy

Child is floppy when picked up, unable to hold up their own head whilst lying on their tummy or when supported in the sitting position


6. High-tone/spasticity

The child’s elbow or knee cannot be straightened or always in bending position. Their foot cannot fully step onto the ground due to tightness


7. Reduced sensation

Child experiences reduced sensation in the hands, legs or feet.


A physiotherapist can help your child with:

  • Gross motor delay

  • Autism Spectrum Disorder

  • Global Developmental Delay

  • Cerebral Palsy

  • Down Syndrome

  • Spina Bifida

  • Brain Injury

  • Hypotonia/hypertonia

  • Muscular Dystrophy or other neuromuscular challenges

  • Torticollis

  • Other genetic disorders



Children develop at different speeds with developmental milestones such as sitting, crawling, climbing, walking and jumping. All these can be measured on a broad scale to give parents some guidelines.

#developmentalmilestones


What are gross motor skills?


Gross motor skills are those which involve whole body movements and require the large muscles of the body to carry out everyday functions, such as standing and walking, running and jumping, go up and down stairs, and sitting upright at the table. In addition, eye-hand coordination skills are also included such as throwing, catching, and kicking balls as well as riding a bike or a scooter and swimming.


The ultimate goal of gross motor development is to gain independent movement.

#grossmotor


Why are gross motor skills important?


To perform activities of daily living

· Walking and running

· Playground skills (climbing, jumping, grabbing)

· Sporting skills (catching, kicking, throwing and hitting a ball with a bat)

· Swimming and cycling


To carry out everyday self care skills

· Dressing (when you wear your pants, you need to be able to stand on one leg to put your leg into the pant leg without falling over)

· Climbing stairs to get into a room, at the mall or in class

· Getting into and out of bed


How gross motor skills affect child’s life?


Gross motor abilities have an influence on everyday tasks. For example, without proper upper body support (core strength), a child cannot sustain appropriate table posture. This will indirectly affect their ability to write, draw and cut. When their core strength is weak, they cannot sit for a long time while maintaining an upright posture in class which negatively impacts their academic learning.


Besides that, without proper gross motor skills, a child can easily get hurt while playing with their friends. They will frequently fall down while walking, running and going down hills which all require a fair amount of upper and lower body strength and balance.


Also, gross motor skills have an impact on your stamina to cope with a full day of school which includes moving between classrooms, walking around classroom desks, carrying heavy books, playing on the playground and sitting upright at a desk.

A child will struggle with many day to day functions such as a eating, keeping their toys, and getting on and off the toilet if they do not have fair gross motor skills.

#activitydailyliving



Gross Motor Milestones

1 month

  • Chin up when lying on tummy

  • Turns head when lying on the back

2 months

  • Chest up when lying on tummy

  • Head bobs when held in sitting position

3 months

  • When lying on tummy, pushes up to elbows

  • Rolls to the side

4 months

  • No head lag when pulled to sitting position

  • When lying on tummy, pushes up on wrists

  • Rolls from front to back

5 months

  • Rolls from back to front

  • Sits with arms supporting the body

6 months

  • Sits momentarily propped on hands

  • Bears weight on one hand when lying on tummy

7 months

  • Bounces when held

  • Sits without support

  • Puts arms out to sides for balance

8 months

  • Commando crawls

  • Pulls to sitting/kneeling position

9 months

  • Walking on hands and feet with bottom in the air

  • Begins creeping

  • Pulls to stand

10 months

  • Creeps well

  • Moves around furniture using two hands

  • Stands with one hand held

  • Walks with two hands held

11 months

  • Turns body to a sitting position

  • Move around furniture using one hand

  • Stands for a few seconds

  • Walks with one hand held

12 months

  • Stands well with arms high and legs spread out

  • Independent steps

13 months

  • Walks with arms high and out

14 months

  • Stands without pulling up

  • Falls by collapse

  • Walks well

15 month

  • Stoops to pick up toy

  • Creeps up stairs

  • Walks carrying toys

  • Climbs on furniture

16 months

  • Stands on one foot with slight support

  • Walks backwards

  • Walks up stairs with one hand held

18 months

  • Creeps down stairs

  • Runs well

  • Seats self in small chair

  • Throws ball while standing

20 months

  • Squats in play

  • Carries large objects

  • Walks downstairs with one hand held

22 months

  • Walks up stairs holding rail, putting both feet on each step

  • Kicks ball with demonstration

  • Walks on one foot on walking board

24 months

  • Walks down stairs holding rail, both feet on each step

  • Kicks a ball without demonstration

  • Throws overhand

28 months

  • Jumps from bottom step with one foot leading

  • Walks on toe after demonstration

  • Walks backward 10 steps

30 months

  • Walks up stairs with rail, alternating feet

  • Jumps in place

  • Stands in both feet on a balance beam

  • Walks with one foot on a balance beam

33 months

  • Walks swinging arms opposite of legs

3 years

  • Balances on one foot for 3 seconds

  • Goes up stairs, alternating feet, no rail

  • Pedals tricycle

  • Walks heel to toe

  • Catches ball with stiff arms

4 years

  • Balances on one foot 4 to 8 seconds

  • Hops on one foot 2 to 3 times

  • Standing broad jump: 1 to 2 feet

  • Gallops

  • Throws ball overhand 10 feet

  • Catches bouncing ball

5 years

  • Walks down stairs with rail, alternating feet

  • Balances on one foot more than 8 seconds

  • Hops on one foot 15 times

  • Skips

  • Running broad jump 2 to 3 feet

  • Walks backward heel-toe

  • Jumps backward


The points below shows the warning signs of delayed gross motor skills and development. Once a condition is suspected or diagnosed, early intervention is extremely important. This is because the child’s brain is still growing hence is the best time to teach new skill or to change behaviour.

Late intervention can prevent the child from reaching their maximum capabilities due to a smaller window to implement changes or teach new skills.

#developmentalredflag #earlyintervention


Gross Motor Delay According to Age


6 months

  • Not rolling

  • Not holding head up when lying on tummy

9 months

  • Not sitting without support

  • Not creeping or crawling

  • Does not hold weight well on legs when held by an adult

12 months

  • Not crawling or bottom shuffling

  • Not pulling to stand

  • Not standing holding on to furniture

18 months

  • Not attempting to walk without support

  • Not standing independently

2 years

  • Unable to run

  • Unable to use stairs holding onto rail

  • Unable to throw a ball

3 years

  • Not running well

  • Cannot walk up and down stairs

  • Cannot kick a ball

  • Cannot jump well

4 years

  • Cannot pedal a tricycle

  • Cannot catch, throw or kick a ball

  • Not able to walk, run, climb, jump and use stairs confidently

5 years

  • Awkward when walking, running, climbing stairs

  • Ball skills are very different from peers

  • Unable to hop 5 times on each foot


Red Flags at any age

  • Not achieving indicated developmental milestones

  • Strong parental concerns

  • Significant loss of skills

  • Difference between right and left sides of body in strength, movement or tone

  • Loose and floppy movements (low tone) or stiff and tense movements (high tone)


If you have concerns about your child at any age or your child shows any signs of delays stated in the above, please feel free to contact us to speak to a professional.

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