Orthopaedic Physiotherapy.
Orthopaedic physiotherapy for children focuses on the prevention, diagnosis, and treatment of disorders related to the skeletal system, muscles, joints, and associated structures like tendons and ligaments. Orthopaedic Physiotherapy addresses conditions ranging from congenital abnormalities and growth-related issues to injuries and post-surgical rehabilitation. The ultimate goal is to enhance and restore functional ability and quality of life to the greatest extent possible.
How we can help
Paediatric orthopaedic physiotherapy assesses, treats, and rehabilitates children with musculoskeletal conditions, including congenital, developmental, and acquired disorders. It aims to improve movement, strength, and function while managing pain or injury in infants to adolescents. Paediatric orthopaedic physiotherapy differs from adult care due to children’s ongoing growth and unique developmental conditions. Their musculoskeletal systems are more flexible but also more vulnerable to certain injuries. Paediatric Physiotherapists must consider growth-related changes and their impact on mobility and function.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists specialize in both congenital and growth-related orthopaedic conditions, ensuring comprehensive care for children.
Treatments we offer
Paediatric orthopaedic physiotherapy supports developmental milestones, mobility, and physical potential while preventing long-term disabilities from growth abnormalities. Our Expert Physiotherapists assess and treat conditions like hip dysplasia, clubfoot, limb deficiencies, Osgood-Schlatter, arthrogryposis, and scoliosis. With a strong track record, we help children, including those with special needs, exceed expectations and engage in social activities.
Schroth 3D Scoliosis Therapy
Schroth 3D Scoliosis Therapy is a specialized, evidence-based physiotherapy approach that uses individualized exercises to treat Adolescent Idiopathic Scoliosis. It targets spinal curvature in three dimensions, enhances postural awareness, and strengthens spinal muscles to reduce pain and prevent curve progression. Developed by German physiotherapist Katharina Schroth in the 1920s, it is widely recognized as an effective non-surgical treatment for scoliosis, particularly in children and adolescents.
At Sydney Kids Physio, our Expert Paediatric Physiotherapist is a certified Schroth Therapist to provide assessment and treatment of scoliosis using the Schroth Method.
Orthotic Garment Systems
Orthotic garment systems are dynamic orthoses that provide sensorimotor input to improve postural alignment and stability while allowing active movement training. They are used effectively with physiotherapy to treat conditions such as low muscle tone, decreased core strength, poor trunk control, flexible scoliosis, excessive hip rotation, and knee hyperextension. These garments are worn discreetly under clothing, with wear time gradually increased.
At Sydney Kids Physio, our expert paediatric physiotherapists have over 18 years of experience working with orthotic garment companies to prescribe these systems. We can help you find the best option to improve your child’s posture and function.
Orthotic Prescription
Orthotic prescription refers to the process of designing and providing orthotic devices which are custom-made or pre-fabricated devices used to support, align, or correct the function of a body part, particularly the feet, legs, or spine. The goal of an orthotic prescription is to address musculoskeletal issues, improve function, reduce pain, and prevent further damage to joints, bones, or soft tissues.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists collaborate with Orthotists to prescribe customised in-sole orthotics including UCBLs and SMOs to correct foot posture and prevent foot bone deformities from developing; as well as prescription of AFOs, KAFOs, HKAFOs for neurological conditions and Thoracolumbar braces to correct scoliosis. We also work with Prosthetists to design and provide feedback on Prosthetic limbs for children with limb deficiencies or post traumatic amputation.
Shoe Modification
Children with leg length difference, or congenital limb deficiencies will require customised shoe modifications to allow them to walk with a more natural pattern. Children who are not tolerant to removable in-sole orthotics would benefit from customised shoes with inbuilt orthotics.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists collaborate with Pedorthists to modify existing shoes to improve foot alignment, correct leg length difference to distribute weight evenly, and alleviate pain as well as prevent secondary complications in the spine from imbalanced weight bearing.
Serial Casting
Serial casting is a non-surgical treatment used to address toe walking in children, whether idiopathic or related to neurological conditions like cerebral palsy or muscular dystrophy. The process involves gradually lengthening the lower leg muscles and tendons, particularly the Achilles tendon, to improve ankle flexibility and encourage a heel-to-toe walking pattern.
Serial casting involves applying weekly casts from the foot to just below the knee over 8–12 weeks. Each cast progressively increases ankle dorsiflexion, stretching the calf muscles and Achilles tendon to improve walking patterns. When combined with physiotherapy, this method can yield significant results.
At Sydney Kids Physio, experienced paediatric physiotherapists provide expert serial casting and second opinions, often helping families avoid surgery after unsuccessful prior treatments.
Fracture Management
Fracture management involves a combination of diagnosis, pain control, immobilization, and realignment of the bone to ensure proper healing. Depending on the severity and complexity of the fracture, it may require surgical intervention, physiotherapy, and regular follow-up care to restore function and prevent complications.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists are skilled in plaster casts, fibreglass casts, customised splints and braces for management of acute fractures of the arms and legs. We also provide mobility assessments and post fracture rehabilitation to support children returning to active living after a fracture.
Exos Braces
The Exos brace is a modern alternative to traditional casts and braces, offering a combination of comfort, adjustability, and effective support for a range of orthopedic conditions. Its key benefits include lightweight construction, breathability, water resistance, and the ability to be customized for each individual. It is commonly used for fractures, post-surgical recovery, soft tissue injuries, and chronic conditions.
Exos Braces are available at Sydney Kids Physio.
Conditions we support
Paediatric orthopedic conditions involve musculoskeletal issues in children, affecting bones, joints, muscles, ligaments, and tendons. These conditions can be congenital, developmental, or acquired due to injury or infection. Early diagnosis and treatment are essential to ensure proper bone and joint development, as delaying intervention can lead to lifelong physical impairments. At Sydney Kids Physio, our paediatric physiotherapists work with children as young as one week old to correct congenital deformities, helping each child reach their full physical potential.
Adolescent Idiopathic Scoliosis
Adolescent Idiopathic Scoliosis is a condition characterized by an abnormal lateral curvature of the spine that develops in children aged 10 to 18 years, without a known cause. It is the most common type of scoliosis and typically occurs during the rapid growth phase of adolescence. Treatment depends on the severity of the curve, risk of progression, and the child’’s age and growth stage. Early diagnosis and tailored treatment can effectively manage the condition, minimize complications, and ensure good outcomes.
At Sydney Kids Physio, Expert Paediatric Physiotherapists assess, diagnose and effectively manage AIS using a variety of strategies including, soft tissue muscle release, Radial Shockwave Therapy and, Schroth 3D Scoliosis Therapy.
Arthrogryposis
Arthrogryposis, or Arthrogryposis Multiplex Congenita (AMC), is a rare, non-progressive condition characterized by congenital joint contractures in multiple areas of the body due to decreased fetal movement during development. It leads to stiff joints usually in the wrists, elbows, knees, hips, and ankles. Surrounding muscles are often underdeveloped or absent while affected hands or feet may have abnormal positions like clenched hands or clubfeet. AMC does not affect intelligence or brain function.
Early Intervention Paediatric Physiotherapy is essential for improving mobility, function, and independence for children with AMC. At Sydney Kids Physio, Expert Paediatric Physiotherapists use a multimodal approach to help manage the musculoskeletal and functional issues children experience as a direct result of AMC.
Developmental Dysplasia of the Hips
Developmental Dysplasia of the Hip (DDH) is a condition in which the hip joint does not develop properly in babies and young children. It can range from mild instability to complete dislocation of the hip. Risk factors include family history, breech position, and swaddling. Early diagnosis and treatment with a Pavlik harness is crucial for ensuring normal hip development and function. Delayed or untreated cases can lead to complications like pain, osteoarthritis, or a limp.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists are trained in the use of Pavlik Harness to effectively correct DDH in babies. The best outcomes are achieved when babies are treated as young as 1 week old. The goal is to help babies achieve optimal hip health for life.
Club Foot
Clubfoot, or Congenital Talipes Equinovarus, is a congenital condition where one or both feet are twisted out of their normal position. It is a common birth defect affecting the bones, muscles, tendons, and blood vessels of the foot, leading to a characteristic inward and downward turning of the foot. Early treatment using the Ponseti Method, is highly effective in correcting the deformity, enabling normal mobility and function.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists carry out baby checks to assess Clubfeet and are trained to carry out serial casting as per the Ponseti Method, reducing the impact of the clubfeet deformity on baby’s gross motor function. Left untreated, clubfoot can result in lifelong disability, pain, and difficulty walking.
Osgood-Schlatter Disease
Osgood-Schlatter Disease is a common condition in children aged 9–14 years, especially during growth spurts, caused by irritation of the growth plate in this area, often due to repetitive stress or overuse during periods of rapid growth. It is characterized by pain and swelling at the tibial tuberosity, the bony prominence just below the kneecap.
Most cases resolve on their own as the growth plate closes after adolescence. However, for some children the pain and swelling around the knee can persist, especially if they continue to participate in high impact sports like basketball, soccer or netball. Physiotherapy intervention will be required and treatment focuses on symptom relief and preventing further irritation.
At Sydney Kids Physio, our expert paediatric physiotherapists use a combination of Low Intensity Pulsed Ultrasound, Radial Shockwave Therapy, kinesiotaping, and targeted strengthening programs to help children with Osgood–Schlatter Disease reduce pain, maintain function, and safely return to sport.
Sever’s Disease
Sever’s Disease, or Calcaneal Apophysitis, is a common condition in children aged 8–14 years, coinciding with growth spurts, characterized by pain and inflammation at the growth plate in the heel. It is caused by repetitive stress on the heel during periods of rapid growth, often exacerbated by physical activity. Pain is localized to the back or bottom of the heel and worsens during or after physical activity, especially activities involving running or jumping.
If left untreated, Sever’s disease doesn’t usually cause permanent damage but can lead to ongoing heel pain, reduced activity, and altered movement patterns that place stress on other joints. It may also cause muscle tightness and prolong recovery, with symptoms persisting or recurring during growth spurts.
At Sydney Kids Physio, our expert paediatric physiotherapists support children with Sever’s disease by focusing on reducing pain and inflammation while minimising stress on the growth plate. Treatment includes tailored rest, stretching, supportive footwear, and activity modification to maintain function. With appropriate management, symptoms typically resolve as the growth plate matures, allowing a safe return to normal activities.
Legg-Calvé-Perthes Disease
Legg-Calvé-Perthes Disease is a rare condition in children where a temporary loss of blood supply to the hip joint leads to bone cell death in the femoral head (thigh bone of the hip joint). Although the bone eventually heals, it may result in deformity and joint issues if not correctly managed. The exact cause is unknown but may involve trauma, genetic factors, or vascular abnormalities. Symptoms include hip pain, stiffness, and limping.
At Sydney Kids Physio, our expert paediatric physiotherapists support children with Legg–Calvé–Perthes disease through individualised management aimed at preserving the shape of the femoral head and preventing deformity. Treatment may include activity modification, physiotherapy, and collaboration with medical specialists for surgical management when required, depending on the child’s age and severity, to minimise long-term complications and optimise function.
Juvenile Idiopathic Arthritis
Juvenile Idiopathic Arthritis (JIA) is the most common type of arthritis in children under the age of 16. It is an autoimmune or autoinflammatory condition where the immune system mistakenly attacks the body’s own tissues, leading to chronic inflammation in the joints.
Symptoms include joint pain, swelling, stiffness, morning stiffness, and in severe cases, fever, fatigue, rash, or growth disturbances. JIA has various subtypes with differing severity. Early treatment with medications and therapy can manage inflammation, prevent joint damage, and improve quality of life, while untreated cases may lead to deformities, growth issues, and chronic pain.
At Sydney Kids Physio, our Expert Paediatric Physiotherapists help children with juvenile idiopathic arthritis by reducing pain and stiffness, maintaining joint movement, and strengthening muscles to support joint stability. Physiotherapy intervention also includes promoting safe participation in daily activities, teaching pacing strategies, monitoring posture and growth, and providing individualised programs and education to support long-term joint health and independence.
Slipped Capital Femoral Epiphysis
Slipped Capital Femoral Epiphysis (SCFE) is a hip condition in adolescents where the femoral head slips out of alignment with the neck during rapid growth. Symptoms include hip, groin, or knee pain and limping. Surgery is typically required to stabilize the femoral head, with early treatment improving outcomes. Left untreated, it can cause serious complications like avascular necrosis and arthritis.
At Sydney Kids Physio, our expert paediatric physiotherapists support post-surgical rehabilitation by restoring mobility, strengthening muscles, managing pain, and preventing complications—ensuring a smooth recovery and minimising long-term joint issues.
Congenital Limb Deficiencies
Congenital Limb Deficiencies are birth conditions where a part of a limb (arm or leg) is missing, underdeveloped, or malformed due to disruptions in fetal development. These deficiencies can affect bones, joints, muscles, and soft tissues, leading to functional and structural differences.
Physiotherapy plays a vital role in supporting children with congenital limb deficiency by improving mobility, strength, coordination, and overall independence. The goal is to maximise function and enable active participation in daily activities and social interactions. At Sydney Kids Physio, our expert paediatric physiotherapists work closely with prosthetists to support the development and fitting of customised prostheses, enhancing mobility and functional outcomes.
Limb Amputation
Limb amputation is the surgical removal of a part or whole limb due to injury, disease, or congenital conditions. It can affect the upper limb (arm, hand, fingers) or lower limb (leg, foot, toes) and may be planned (surgical) or result from trauma. Physiotherapy intervention is crucial to helping children rehabilitate post limb amputation to regain strength, balance, mobility and function.
At Sydney Kids Physio, our expert paediatric physiotherapists provide comprehensive amputee rehabilitation, including desensitisation of the residual limb, scar tissue management, and gait retraining. We work closely with prosthetists to support the development and fitting of customised prostheses, helping children achieve optimal mobility and functional independence.
Common orthopaedic conditions by age groups
Have you noticed that your toddler is walking with a waddle or perhaps they seem to trip and fall over more often than their peers?
Or perhaps your child seems to have difficulty with mobility and physical activities that others their age can easily perform?
Orthopaedic conditions in babies and children can vary significantly depending on their age and developmental stage. Understanding these conditions and their age-specific prevalence can help in early identification, timely intervention, and appropriate management to ensure better physical health outcomes for children.
Early detection and intervention by a paediatric physiotherapist can significantly improve outcomes for these conditions.
Newborns may be diagnosed with orthopaedic conditions that require specialised care. Developmental Dysplasia of the Hips (DDH) is common, where the hip joint doesn’t develop properly, leading to instability. Club foot, a congenital deformity causing the foot to turn inward, is often identified at birth. Early intervention with orthopaedic physiotherapy is crucial to correct these conditions and promote normal development.
infants between 6 to 18 months old who have undiagnosed DDH may show signs of limited hip movement or leg length difference as they start to learn to transition from sitting to crawling to walking. Metatarsus Adductus the inward turning of the front part of the foot, or Tibial Torsion the inward or outward twisting of the shin bone may become more obvious as little one starts to walk. Physiotherapy Early intervention can effectively correct these conditions to prevent habitual sitting and walking patterns from impacting normal bone growth and development.
Toddlers who are not yet walking by themselves need to have their hip joints reviewed to rule out DDH. Infantile Scoliosis, a spinal curvature that develops before the age of 3 may present during this period. Children who have congenital limb deficiencies, where a part of their limb does not develop properly, will require specialised care and physiotherapy to adapt to prosthetic care and enhance mobility.
Preschoolers and early Primary Schoolers may present with persistent intoeing or outtoeing, causing frequent trips and falls as well as knee pain. Some children may be persistent toe walkers and begin to experience calf and foot pain. Physiotherapy aims to manage pain, correct bony alignment of the hip, knee, ankle and foot to prevent permanent bony deformations of the knee, ankle and foot joints.
School-aged children and pre-teens commonly experience growing pains and conditions such as Osgood–Schlatter disease (inflammation at the knee growth plate) and Sever’s disease (inflammation at the heel growth plate), often associated with increased participation in high-intensity sports and physical activity. The onset of adolescent idiopathic scoliosis can also occur during this stage, typically between 9–12 years of age. Physiotherapy plays a crucial role during these growth years to support optimal development of the spine, hips, knees, and feet.
Adolescents commonly experience orthopaedic conditions such as stress fractures related to sporting activities. Ongoing growth spurts and development can also increase the risk of progression in conditions like adolescent idiopathic scoliosis. Teenagers with congenital limb deficiencies or limb amputations require specialised care from paediatric physiotherapists to optimise functional outcomes, enhance quality of life, and support physical independence.
Information for parents
As parents, you know your child best. If you feel and see something happening in your child which makes you worry or concerns you, trust your gut instinct. Even if the medical professionals, friends, family and well wishers say to you that “you are overreacting and paranoid”, it doesn’t hurt to speak to a trained and experienced Paediatric Physiotherapist about your concerns for your child.
Here at Sydney Kids Physio, our Expert Paediatric Physiotherapists have been helping families and children since 2006. We see babies as young as 1 week old, including premature babies who might actually be 0 weeks old for corrected gestational age, to assess their gross motor skills development to make sure that babies hips and feet are well developed at birth. The most common orthopaedic conditions that present to a Paediatric Physiotherapist include club feet, Developmental Hip Dysplasia, turned in feet, turned out feet, flat feet, toe walking, limping walking patterns, uneven shoulders and poor spinal postures, as well as fractures from trips and falls. Early Intervention Paediatric Physiotherapy can effectively manage and treat these orthopaedic conditions to help babies achieve their best potential and prevent secondary complications such as hip, knee and ankle, foot bone deformities, scoliosis and loss of function following poor fracture healing.
The common misconceptions we see in the community are parents are told their child will grow out of toe walking, or intoeing or out toeing of the feet because it’s just a phase their child is going through. In reality, Paediatric Physiotherapy can help children improve their spinal posture and lower limb joint alignment to improve their walking pattern and prevent worsening scoliosis, back pain, hip pain, knee pain and foot pain.
If you are concerned about your child’s skeletal development, reach out to Sydney Kids Physio to speak to one of our Expert Paediatric Physiotherapists. You don’t need a doctor’s referral to see a Paediatric Physiotherapist in Australia. Take advantage of our 15 minute FREE PHONE CONSULTATION.
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Information for specialists
As Paediatric Physiotherapists, we are often working closely with General Practitioners, Paediatricians, Neurologists, Orthopaedic Specialists, Paediatric Occupational Therapists, Speech Pathologists, Dietitians, Feeding Therapists, Psychologists, Behavioural Therapists, Optometrists, Behavioural Optometrists, Orthotists and Podiatrists to help little ones achieve their best potentials.
Orthopaedic conditions such as Developmental Dysplasia of the Hips are best managed with Early intervention by an Experienced Expert Paediatric Physiotherapist rather than an Orthopaedic Surgeon. Common complaints of toe walking, pigeon toed, duck footed, are all conditions that can be corrected effectively with Early Intervention Paediatric Physiotherapy, as most of the times such walking patterns do not disappear over time. The common myth that children will just grow out of toe walking or abnormal walking patterns have actually resulted in long term permanent bony deformities of the knee, ankle and foot joints. Without timely management, abnormal movement can lead to poor biomechanics, joint stress, and potential long-term deformities. Paediatric physiotherapists are specifically trained to assess and treat these issues early, helping to optimise development and improve functional outcomes.
Pre-teens and adolescents who experience neck, shoulder and back pain might be developing Adolescent Idiopathic Scoliosis but are often waved off with advice for pain relief and warm baths instead of referring to Paediatric Physiotherapists for early assessment and management.
If you are a Medical Professionals seeing a baby with clicky hips, or a child who is often falling and tripping on themselves or a child who is tip toeing, or a child who complains of persistent back pain, it is worthwhile referring them for Orthopaedic Paediatric Physiotherapy for an assessment to help correct and improve their walking patterns and prevent secondary bony deformities.
Reach out to Sydney Kids Physio to speak to one of our Expert Paediatric Physiotherapists about your concerns about the child you are seeing to find out if we can help improve their posture and walking pattern to allow them to increase their social participation with their peers and family. Together we can help more children build great foundations for bright futures.
We're only ever a phone call away.
Welcome
The Dream Team
It takes a village to raise a child, and that saying is never more true when you have a child with Special Needs. At Sydney Kids Physio, you can be assured that our team is committed to helping you equip your child with the skills they need to achieve their best potential.
Our Team led by Neesha Gan, an Expert Paediatric Physiotherapist with over 26 years of Physiotherapy experience, lives by our core values to deliver Expert Knowledge with Empathy, Respect and Transparent Communication. We understand that the journey of parenting is a lifelong journey filled with the greatest joys and the deepest sorrows which can be overwhelming and daunting at times. We have walked that journey together with thousands of families, and we believe that working together, we can and must create great foundations for bright futures. We look forward to being a part of your family’s journey.
