Other paediatric musculoskeletal conditions

There are a number of paediatric-specific conditions, which are usually thought of as “growing pains and aches”. Out of a vast range, musculoskeletal conditions like the ones listed below are usually able to be treated conservatively with the right management plan prescribed by a physiotherapist. These conditions are sometimes overlooked, and with delayed diagnosis and management, can impact a child’s participation in activity at school, sport and social activities. A few examples of common paediatric growth related conditions are:

Hip: Development Dysplasia of Hip (DDH)

DDH is an umbrella term referring to the spectrum of abnormalities in the growth of the anatomical hip joint. DDH encompasses acetabular dysplasia, hip instability, subluxation and dislocation, and different ranges of severity. These abnormalities can be caused by development during infancy or be of congenital defect. Genetics, delivery and family history are known risk factors for DDH, whilst swaddling and carrying positions of babies have been seen as factors that contribute to the incidence of DDH. DDH is a condition that will require ongoing treatment even outside the newborn period. The condition can impact functional outcomes into the child’s growth and if missed, can lead to lifelong ramifications to hip development and therefore to motor skills. Physiotherapy for DDH will include thorough physical examination, referral to appropriate diagnostic tools (radiographs), and a thorough plan of management.

Knee: Osgood-Schlatter’s disease and Sinding-Larsen-Johansen’s disease

Osgood-Schlatter’s and Sinding-Larsen-Johansen’s disease are two common knee conditions in growing children. These are usually of irritation and inflammation of the growth plate in origin, and symptoms of pain are well managed with correct education, manual therapy and a guided exercise program prescribed by a physiotherapist.

Foot: Sever’s disease

This refers to heel pain, where the tendon pulls on the heel. This is also referred to as calcaneal apophysitis, inflammation of the growth plate at the heel. It is a common cause of heel pain in growing children, especially those that participate in sports and physical activity. Correct assessment by a physiotherapist, education towards activity modification and guidance through a thorough exercise program will often help reduce pain.

Spinal & Joint: Juvenile Idiopathic Arthritis, Scoliosis

Juvenile Idiopathic Arthritis (JIA) is inflammation of the joints in children, defined more specifically as swelling in the joint and two or more of: restrictions in motion, pain with movement, tenderness, redness or joint warmth. Like arthritic conditions in adults such as rheumatoid arthritis, JIA is diagnosed by a paediatric rheumatologist. Pain is a core factor of JIA that can significantly impact a child’s wellbeing and mental health. Primary management of JIA is pharmacological intervention which is usually effective and has been able to achieve clinical remission or “inactivity of the disease”. The role of physiotherapy is to assist in assessment and treatment of ongoing musculoskeletal issues including but not limited to active and passive range of motion, postural alignment and muscle strength tests, review of current interventions, prescription of an appropriate home exercise program and education of the condition.