Paediatric & Adolescent Physiotherapy

During growth spurts, bone lengthens faster than muscle and tendon adapt, so flexibility drops, mechanics change and the growth plates and apophyses become the weak link. That is why young athletes present with pain at very specific sites and why adult protocols do not transfer directly.

Common presentations include Osgood-Schlatter disease at the tibial tuberosity, Sever's disease at the heel, Sinding-Larsen-Johansson at the base of the kneecap, apophyseal injuries around the hip and pelvis, gymnast's and swimmer's shoulder, spondylolysis-type back pain in extension-heavy sports, ankle sprains, and general growth-related knee and heel pain.

We also see a lot of hypermobile adolescents whose joints move well beyond normal range, who fatigue easily, and who have usually been told to stretch when what they actually need is strength and control.

Assessment includes growth stage, sporting load across school, club and academy, training and competition schedule, footwear, sleep and general wellbeing. In most young athletes the biggest single driver is total weekly load and how quickly it increased, not a structural defect.

Treatment is education-led and activity-modifying rather than rest-by-default. Almost all growth-related conditions settle with load management, targeted strengthening and time, and we aim to keep the young person participating in a modified way rather than stopping entirely, because prolonged withdrawal from sport has real physical and social costs.

Parents are part of every plan. You get a clear explanation of what the condition is, what the expected timeline looks like, what is safe to continue, and what would justify a review or imaging. Where coaches or schools need to adjust load, we can put that in writing.

Dynamometry is age-appropriate and used to compare sides and track change over a growth period, which is far more informative in a growing athlete than a one-off measurement.

ForceDecks testing quantifies jump, landing and asymmetry in young athletes, useful both for return to sport after injury and for monitoring how a growth spurt is affecting control.

Diagnostic ultrasound is used selectively for soft tissue where it adds value, and we are explicit about when a growth-plate concern warrants X-ray or MRI through the appropriate medical route instead.