Physiotherapy (children's)

  • We are a team of qualified physiotherapists and therapy assistants who have specialist knowledge and experience in child development. We specialise in assessment and treatment of physical development in children and young people. We aim to improve the quality of life for children and young people in Coventry by helping them to develop their functional ability and mobility to achieve their full potential.

  • Base: Wayside House, Coventry
  • Directorate: Children's
  • Service Manager Lead: Aimee Strang
  • Age: 0-18 years (19 in special schools)
  • Referral Criteria: We accept referrals for children and young people age 0-18 years old with a Coventry GP. Referrals must be made by a healthcare professional. Inclusion and exclusion criteria, and our referral forms can be found under 'for professionals'
  • Address: 4th Floor City of Coventry Health Centre 2 Stoney Stanton Road CV1 4FS, Coventry, CV6 6NY
  • Hours: 08:30am to 5:00pm Monday to Friday
  • Telephone number: 02476 961 455
  • Service hours: 08:30am to 4:30pm Monday to Friday

Keeping active advice

Appointments at City of Coventry Health Centre

About us

We assess and treat children and young people with physical difficulties, as well as providing support to their families and carers. We cover a variety of specialist areas, including:

  •        early years
  •        special schools
  •        long-term neurological conditions
  •        neuromuscular conditions
  •        musculoskeletal
  •        respiratory  

Our physiotherapists assess and treat children and young people in their own homes, nursery or school (mainstream and special) and clinics, including City of Coventry Health Centre. The input that is required from our service will determine the best environment to see the child/young person.

Following the initial assessment, if ongoing physiotherapy input is required, goals are agreed and an appropriate treatment plan will be devised in collaboration with the child/ young person and their family/carer. Treatment is often incorporated into simple, everyday activities. Advice and training are provided so the family can help and encourage the child/ young person to practice their physiotherapy programmes. Direct treatment may also be offered to work towards a specific goal, either on a 1:1 or group basis.

Both qualified physiotherapists and physiotherapy assistants work within the service. All qualified physiotherapists are registered with the Health and Care Professions Council. 

We are dedicated to supporting the education of students. As part of this commitment, students may be involved in the care of children and young people. You will be informed of any such involvement.

Early years (0 to 5 years)

The early years physiotherapy service supports babies and young children aged from birth up to starting school. We help with a wide range of conditions. Some of these require short-term support, while others require long-term support. 

We may help short-term with:

  • concerns about head shape (plagiocephaly)
  • concerns about the way your child moves
  • mild delay in developing movement and coordination
  • balance difficulties

Some conditions may need longer term support, such as:

  • neurological conditions such as cerebral palsy
  • neuromuscular conditions
  • global developmental delay
  • brachial plexus injuries
  • down syndrome
  • monitoring under the neonatal pathway (for preterm babies)

The aim of physiotherapy is to help you support your child's physical development.

Where will the appointment be? 

Depending on your child's needs, we will arrange to see them either at home or in clinic on the 4th floor of City of Coventry Health Centre. After the initial assessment we will discuss where the next session, if needed, should take place. This could be at home, in clinic or in a nursery.

What will happen when we see the physiotherapist?

Assessments

We complete a variety of assessments including developmental, coordination and balance assessments. We will also look at the way the child walks or moves.

Treatment

We discuss your concerns about your child's development and physiotherapy needs and treat in a variety of ways. This can include one-to-one sessions and may be at your home, in clinic visits, at a nursery, or in a group environment at the City of Coventry Health Centre. We work in partnership with the educational services and other health professionals.

Further information and support 

Safety and advice 

  • Prolonged use of baby walkers is not recommended by physiotherapists as they encourage babies to walk on their toes, and forward walkers are not safe for your child to lean on.
  • Baby bouncers do not allow children to fully experience their crawling ability. They can also encourage children to stand or walk before they are ready, which could lead to walking on their toes. This can lead to problems with their walking at a later age.
  • Leaving your child in a car seat for long periods of time when they are not in the car is not recommended. It can encourage curling up and does not allow your child to stretch out into different positions. It does not allow them to explore their environment. Your child could develop breathing problems if left in this position for long periods.

More information:

If you have any concerns about your child's development, or any questions, please see your health visitor. This website may also give you more information if you have any concerns about your child's development .

Specific conditions

The Association of Paediatric Chartered Physiotherapists have a range of information leaflets for parents and carers on specific conditions, including:

 

Neurological conditions

We work with children and young people with neurological conditions at home, school or in clinic. 

What is a neurological condition?

These are conditions affecting the brain that the child will have throughout their lives. This may impact on their movement and physical ability, learning and communication. Sometimes these children and young people will have a diagnosis of cerebral palsy, and this can be their only diagnosis or may be one of multiple.

Children and young people with a neurological condition will usually have had an MRI scan of their head after birth or during childhood which showed differences in a certain area of their brain. These differences can be caused by genetic changes or following birth complications such as prematurity and/or a birth related injury. 

Conditions are sometimes called 'long term' as they will always be present, and the brain cannot be physically repaired. Our teams can support you with discussing your child's individual condition as every child is different.

What is muscle tone and how is it managed?

When a child or young person has changes to how their brain is made up, it is likely to affect their muscle tone. It may be higher than usual (meaning their muscles are tight and stiff) or lower than usual (meaning their muscles are weaker and floppy). This can make it difficult for the child or young person to do daily tasks, for example, roll, sit, stand, walk, feed themselves or brush their teeth. Muscle tone can also affect how easy it is for carers to change or transfer a child or young person. Muscle tone can be managed with medication, and regular stretching can help relieve symptoms.

On your child's clinic letters, you may see a GMFCS number. This directly refers to their current ability but please speak to the named physiotherapist if you have any queries relating to this.

Children with these conditions need to be encouraged to be physically active. The ability to be active will vary. Some people may aim to move themselves in their wheelchair or experience floating in water, whilst others may want to be involved in a sport. Sometimes this can be challenging but please speak to your physiotherapist for advice if needed.  

How will the physiotherapist work with me and my child?

A physiotherapist will work to: 

  • improve or maintain functional ability (how well a young person is able to manage everyday tasks)
  • support your child's individual goals, which will be set by the young person and their family, supported by their named physiotherapist and reviewed as required
  • improve or maintain the joint's range of movement and muscle length (how much the muscle can stretch)
  • manage posture
  • manage impact of growth 

What is postural management?

Children and young people who find it hard to move are most at risk of developing body shape changes. Postural management is important to protect a child's body shape.

Please select the postural management tab on this page for more information.

Charities and further support 

Neuromuscular conditions

What is a neuromuscular condition?

Neuromuscular conditions affect the muscles and can make them weaker.  This can make it harder to walk, move around, use strength and do everyday tasks like playing or feeding. These conditions can happen where there is a problem with the muscles, the nerves that send messages to the muscles, or the place where the nerves and muscles connect. 

There are many different neuromuscular conditions. These include:

  • Duchenne muscular dystrophy (DMD)
  • Becker muscular dystrophy (BMD)
  • limb girdle muscular dystrophy (LGMD)
  • spinal muscular atrophy (SMA)
  • peripheral neuropathies such as Charcot-Marie-Tooth (CMT)

How will the physiotherapist work with me and my child?

A physiotherapist will help children and young people to: 

  • improve how well they can do everyday tasks, such as getting dressed, eating, playing and moving around
  • be as independent as possible
  • keep moving and stay active
  • maintain their strength
  • prevent or reduce pain
  • encourage them to take part in everyday activities, like play, school and hobbies  

The physiotherapist will also monitor changes and other complications such as muscle tightness and curvature of the spine (scoliosis).

As well as seeing our team, most children or young people with a neuromuscular condition will be seen at a specialist centre such as Heartlands Hospital or Great Ormond Street Hospital.

What is postural management?

Children and young people who find it hard to move are most at risk of developing body shape changes. Postural management is important to protect a child's body shape.

Please select the postural management tab for more information. This includes information about specialist equipment.

Further information and support 

Musculoskeletal

What is the musculoskeletal system?

The musculoskeletal system is made up of bones, joints, muscles and all the bits that connect them together.

Children's musculoskeletal physiotherapy addresses problems relating to bones, joints, muscles and ligaments. When a referral is made to our service the referral is looked at by a physiotherapist, who decides which team it would be best for the child or young person to be seen by. 

The children's musculoskeletal physiotherapy service will often see children with:

  • soft tissue injuries or joint pains related to a known condition or caused by things like growing quickly or not being active enough
  • sports injuries, especially injuries caused by doing the same activity too much
  • children whose walking causes concern, or there are changes to the way they walk
  • children with rheumatological conditions such as juvenile idiopathic arthritis (JIA)

The aim of musculoskeletal physiotherapy is to help children and young people get back to their usual activities, including sports, and to teach families how to look after the condition and manage it themselves.

Who do we see? 

We see children and young people who have been referred to physiotherapy by a health professional, are in full-time education and have musculoskeletal difficulties that require short term rehabilitation. If the young person referred is over 17 1/2 years old, we may refer them to the adult musculoskeletal service if this is the most suitable service for their needs.

About your appointment

If you are under 16 years old, you must come to your appointment with a parent or another adult who is responsible for you.

Your physiotherapist will ask questions about your injury or problem, how you are feeling and how your symptoms affect your everyday life and the activities you enjoy. They will usually examine the part of your body that is causing the problem. 

After the assessment, you and the physiotherapist will agree on a treatment plan. If you need more physiotherapy, you will set goals together. These goals help everyone to know how well physiotherapy is working.

Your physiotherapist will tell you know if you need another appointment.

What to wear to the appointment

We may need your child to remove some of their clothing to carry out a complete assessment. We recommend that your child wears loose fitting and comfortable clothing. If they have been referred due to concerns about their back or arms, a vest top is recommended. Shorts are recommended for lower limb concerns.

Treatment

All children and young people who are referred to our service will receive helpful information and can use these webpages for help and support.

Treatment may include:

  • learning about your condition - it is important for you and your child to understand what is causing the problem and what you can do to help manage it
  • advice- some conditions do not need treatment. Instead, we can give advice on how to manage symptoms
  • exercise rehabilitation - exercises can help to improve strength, balance, movement and flexibility. These may take place in our clinic, either one-to-one with a member of the physiotherapy team, or in a group exercise class, depending on your child's needs
  • exercises to do at home - you will be given exercises to do with your child at home. These are an important part of treatment and help to support progress made during appointments
  • soft tissue techniques - we may use gentle hand-on techniques to help improve movement, reduce pain and support your child in doing everyday activities
  • taping- special tape may sometimes be used to support muscles or joints and help them work better

Physical activity guidelines for children

Children and young people aged 5 to 18 should be doing regular physical activity to keep their bodies healthy and strong. If your child is not active enough, 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. Moderate physical activity would be anything that raises a child's heart rate, causes them to breathe faster, and makes them feel warmer.
  • take part in a variety of different physical activities across the week, such as walking, cycling, playing sports, dancing, or active play. 
  • reduce the time spent sitting or lying down during the day and break up long periods of not moving with some activity.

Find out more in the NHS physical activity guidelines for children. 

What should I do if my child gets a minor injury?  

If your child has a minor injury, remember RICE (rest, ice, compression, elevation): 

  • Rest: let the injured area rest and try not to use it. 
  • Ice: put an ice pack on the injured area. Always wrap the ice in a tea towel, cloth or sock to protect the skin. Use it for a maximum of 5-10 minutes at a time, and no more than once every hour.
  • Compress: use a bandage or gentle pressure on the injured area to help reduce swelling.
  • Elevate: raise the injured area above the level of the chest where possible. This can help to reduce swelling.

If you are worried about your child's injury or symptoms, contact your GP, visit an urgent treatment or walk-in centre, or go to A&E if it's an emergency. 

Further information and advice

The Association of Paediatric Chartered Physiotherapists has a range of information leaflets for parents and carers. These include information on: 

They also provide information on specific conditions, including:

Find information about sleep in the Good Sleep Guide. 

 

 

 

 

Respiratory physiotherapy

Why would a child or young person need respiratory physiotherapy?

A respiratory physiotherapist helps to look after the lungs. It is normal for all of us to produce secretions (sometimes called phlegm or mucus) from our lungs. Normally secretions are loosened when we move around and breathe, and we get rid of them by coughing and clearing our throats. If a child or young person is unwell, tired or weak and not moving around, it can be harder for them to cough and clear their secretions. This makes it difficult for the lungs to work properly and so they become more at risk of getting a chest infection.  Respiratory physiotherapy helps your child to clear these secretions, to keep the lungs as healthy as possible.

Who may benefit from a respiratory physiotherapy assessment and treatment?

There are many groups of children who will benefit from respiratory physiotherapy support. This may include children who have the following conditions:

  • some chronic lung diseases
  • long term ventilation
  • upper airway obstruction
  • difficulties with swallowing, reflux or managing saliva or mucus
  • neuromuscular, for example muscular dystrophies
  • non-specific neurological, for example, complex cerebral palsy
  • traumatic or acquired brain injury
  • spinal cord injury that affects their ability to take a deep breath or cough
  • chronic cardiopulmonary disorders
  • skeletal deformities, for example kyphoscoliosis, thoracic wall deformities

Where and how often will a respiratory physiotherapist see a child/young person?

Once a child has been referred, a respiratory physiotherapist will do an assessment, and treatment will be carried out depending on the needs of the young person.

The child or young person may be seen in a variety of settings, this could include at home, a clinic, their school/nursery or a respite centre. Other professionals such as children's community nurse, physiotherapist or speech and language therapist may also attend the visit to support the young person's care and treatment.

Respiratory physiotherapy will stop once your child is getting better, able to cough and clear secretions and move around as they do normally.

Physiotherapists usually work between the hours of 8.30am and 4.30pm.

What might respiratory physiotherapy treatment involve?

We use different techniques to help clear secretions and keep the lungs full of air and as healthy as possible. The physiotherapist will work closely with family, carers and other professionals to ensure the treatment program meets the young person's needs and their current goals. 

Physiotherapy treatment may involve:

  • assessment and development of treatment plans and teaching packages
  • exercise therapy, which can include mobilising (rolling, sitting up, walking)
  • inhalation therapy such as inhalers or nebulisers
  • postural care advice
  • support and advice about treatment
  • information, training and support for the young person, parents and carers
  • a program for nursery/school or advice around activities within PE lessons

The physiotherapist may also conduct airway clearance assessment and treatment. This may include:

  • helping your child to sit or lie in different positions. This is called positioning and can help the lungs to work better and may encourage typical movement and development
  • putting their hands on your child's chest to use techniques called vibrations, shakes and percussion. These hand-on-techniques can help to help loosen secretions
  • suggesting breathing exercises and blowing games
  • using respiratory equipment 

Postural management

If you are looking for information about posture related to a short-term injury, pain, or discomfort, please visit the musculoskeletal section of this page.

Children and young people who find movement difficult are more likely to develop body shape changes. This is because they may spend a lot of time sitting or lying in the same positions. Good postural management helps to protect their body shape and keep them comfortable. Without the right support, they may develop problems such as scoliosis (curve of the spine), which can cause pain and make everyday activities more difficult. 

Postural management is a 24 hour approach to manage a child or young person in all positions, for example lying, sitting and standing. Your child's physiotherapist will check their posture and body position and may suggest ways to improve support or recommend equipment.

The specialist equipment may include: 

  • standing frames 
  • sleep systems
  • therapy wedges
  • floor sitters
  • walkers

Seating is also an important part of postural management. A child or young person with a long term neurological condition may be seen by wheelchair services to provide a wheelchair, and occupational therapy to consider whether they need specialist seating at home or in school. 

Further information and support

Equipment 

 

For professionals

We only accept referrals from professionals working with children and young people. This page will assist you in deciding whether a referral to physiotherapy is required. It will also provide information about training and support we offer. Please click on the appropriate service tab for more detailed information.

We can assist children with physical difficulties, motor delay or motor skill problems, difficulties with activities of daily living and musculoskeletal problems. We can offer advice, support, exercises, equipment and therapy intervention when it is appropriate. 

How to complete a referral

All referrals must be completed by a healthcare professional (such as a GP, consultant, allied health professional or nurse). Referrals not completed by a healthcare professional will not be accepted and will be returned to the referrer.

When making a referral, please: 

  • ensure the child or young person meets our acceptance criteria listed below before completing a referral. If you are unsure if the child or young person meets the criteria, please contact us to discuss
  • read the form carefully and fill in as much relevant information as you can
  • attach any relevant reports or clinic letters that provide further information to the referral form

We hope our referral form is easy to complete, however if you have any difficulties please contact us for further advice.

Please send the completed referral form to the address located at the end of the form.

 Children's physiotherapy referral form [docx] 72KB

 Children's respiratory physiotherapy referral form [docx] 1MB

Children's complex physical health MDT referral pathway

If you are referring a child or young person with complex physical health needs requiring input from multiple physical health services please read the attached document for inclusion/exclusion criteria then refer to the MDT Single Point of Access Pathway as appropriate by completing the referral form below. This includes children and young people who are new to the city or country with complex physical health needs.

This referral form can be completed by any agency working with the child or young person but it cannot be completed by a parent/carer.

 Children's complex physical health MDT information sheet [docx] 179KB

 Children's complex physical health MDT referral form [pdf] 318KB

Acceptance Criteria and Triage Process

Our acceptance criteria is as follows:

  • The child or young person must be registered with a Coventry GP. If the child or young person attends a specialist school within Coventry but their GP is out of area then they may still be seen if input in a school setting is deemed necessary, following consultation with the local team/ GP.
  • NB- A child or young person who is registered with a Coventry GP who lives and/or attends school outside the city boundaries will be offered treatment in our clinic setting only.
  • The child or young person must be between 0 and 18 (or 19 if attending a special school).
  • The child or young person must have a physical need that physiotherapy can help with. This is including (but not restricted to):a neurological impairment, such as Cerebral Palsy or acquired brain injury.
    • a neuro-muscular condition, such as Duchenne Muscular Dystrophy or Spinal Muscular Atrophy.
    • post surgical intervention.
    • a diagnosed syndrome, such as Down's Syndrome, where developmental delay is beyond expected norms.
    • Plagiocephaly and Torticollis.
    • Obstetric Brachial Plexus Palsy (OBPP).
    • babies born before 30 weeks gestation or babies with significant birth history/ trauma.
    • developmental delay (with no specific diagnosis) which is impacting on gross motor development, such as late walking.
    • gait abnormalities, including symptomatic intoe-ing and toe walking where the child or young person cannot get their heels to the floor.
    • musculoskeletal impairments including pain, loss of joint range, symptomatic hypermobility, inflammatory and rheumatological/arthritic disorders.
    • respiratory conditions excluding asthma and Cystic Fibrosis.

Referrals are triaged twice a week by clinical leads and prioritised according to the reason for referral.

We aim to see all priority 1 referrals within 2 weeks of receiving the referral, priority 2 referrals within 6 weeks and priority 3 within 18 weeks.

If the nature of the condition or the child/ young person's presentation changes whilst they are waiting to be seen, please contact us to discuss as the referral priority may need to be changed.

Exclusion Criteria

Our exclusion criteria is as follows:

  • referral not completed by a healthcare professional.
  • the child or young person is not registered with a Coventry GP, unless attending a specialist school.
  • young people over the age of 18.
  • Talipes is the primary reason for referral (please refer to University Hospital Coventry and Warwickshire instead).
  • Developmental Hip Dysplasia is the primary reason for referral (please refer to University Hospital Coventry and Warwickshire instead).
  • referrals where there is no evidence that Physiotherapy input is required, including (but not limited to):non symptomatic flat feet
  • non symptomatic in-toeing
  • varus knees (bow legged)
  • toe walking where there is no associated muscle tightness or gross motor difficulties
  • Clinodactyly - 'curly toes'
  • brachycephaly (symmetrical flattening of the back of the head in a baby/ infant), where there is no developmental delay
  • children or young people who have co-morbidities, including behavioural difficulties, where physical difficulties are not the main concern.

If you are uncertain if a child or young person meets the service's referral criteria, please contact us to discuss.

 

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