To think that a thirteen year old boy who needs physio should be seen by a paediatric physio

[ReallyTired]

When my son was a little boy he had a lot of physio because he could only walk on tip toe. He could only manage one or two steps at the age of two. We did a lot of stretching exercises and he wore orthorics. He was discharged from physio at three and half years olds.

Ds is now having a massive teenage growth spurt and his tendons are not growing as fast as his bones. It is causing him a lot of pain and he has had a dramatic loss in flexibilty. For example he he is finding hard to walk down stairs in the morning. Our GP has refered him to an adult physio because he is nearly fully grown. Apparently children over eight are referred to adult physios.

Am I being unreasonable to think that older children have different needs adults and need a paediatric physio? My son might be as big as the child physio, but he can be very immature at times. For example he took it as a personal insult that our (new) GP thinks he has an abnormal walking gait. (He walks with his feet turned out) Can adult physios cope with patients who are full of teenage hormones? What happens if the child and parent disagree with the treatment plan?

I saw adult physios through my teenage years. I don't see why it's an issue.

If the physio is used to being referred children and adults over 8 then they're probably used to dealing with teenagers. Is it osgood-schlatters? If so (or similar) the physio will have probably seen several that day and be very used to treating it.
Not sure why you've decided you might disagree with their treatment plan already before meeting them?

I expect that my son will be fine. I wish that he could have seen the child physio who treated him ten years ago because she was really good.

I had physio at the local hospital and I was the youngest in the waiting room by about twenty years. Even though I had several sessions, I never saw a child waiting to be treated. I am surprised that children as young as eight are refered to adult physio.

I think any physio should be able to deal with child patients. I'd have no problem with my DC seeing one. Is there a reason why you think that you might disagree with their treatment plan?

My DS is currently seeing an podiatrist who deals with both adults and children for his feet related issues. He also walked with his feet out because he has incredibly flat feet (he's now wearing orthorics) and it didn't become an issue until he started doing more sport.

My ds2 is going to physio tomorrow, he has joint issues and a permanent limp, we are not sure what is going on, gastro issues and a bit of hypermobility as well as joint pain and aching, anyway he is seeing a child physio for a full assessment.

I think children's muscles and skeletol system.is obviously different to an adult so can require different techniques, I assume an adult physio may well be trained to deal with both though, as long as they have the appropriate knowledge and bedside manner to treat kids and teens it's fine. So it just depends if the physio you see has those skills.

I still have the letters from when my son saw child physios and consultants as a small child. I have shown these letters to my son because he asked what treatment he had in the past. The consultant and physio discussed various options for treating him and we chose to treat him with stretches and orthorics, rather than a more agreesive treatment like botox and plaster casts. My son wishes that he had had botox and plaster casts as a small child.
I do not regret that the course of treatment we chose for my son.

"But are you actually worried that your son is just going to get stroppy regardless and will just disagree for the sake of it."

I hope that he has more sense, but he can be a bit defiant at times. At the moment I can understand why the upper classes send their thirteen year olds off the boarding school.

Oh yes, my son is convinced that its 100% my fault that he has problems now because I made the wrong treatment decisions when he was a tot. Ofcourse parents should consult their crystal ball before making any decisions about medical care.

It's about his physical treatment though, not psychological stuff.

Your son is the size of an adult, and needs to be treated as though he is one by a physio.

A children's physio will need to tailor treatment towards someone who is physically quite different.

If your son has issues apart from the physical ones dealt with by the physio, you need a psychologist - not a paediatric physio, who is still only equipped tot reat the physical problem.

Your son can be as defiant as he likes, but I hope he realises that the physio will be treating him with the best of intentions. It's up to him whether he co-operates or not and whether he gets better.

If you are that worried about his 'hormones' perhaps he should see a psychologist as well

Really I think your hoping a panda Physio will be a panacea to all your son's problems. I'm sure the Physio he had when a tot was lovely but even if he saw her now, she's not going to put up with bad behaviour so he'll either have to agree to treatment or not.

Personally with regards to options, I'd be very much getting him to decide what he wants to do. He can't then start the blame game if things don't turn out the way he wants.

A panda Physio?? Paeds physio

Your child's needs are probably a lot closer to those of an adult to those of a toddler or pre-schooler, who would be the mainstay of a paediatric physio. I'm quite sure he's not the first teenager the phyio will have seen and won't be a complete mystery to them.

Provided the physio is appropriately trained I don't see the issue at all. Your son is quite old enough for adult services.

Children are pysiologically different from adults because they are growing. My son is not fully grown yet. At the moment he is growing rapidly, which is something adults do not do. His problems are caused by his current growth spurt. He has never experienced an injury or has the problems of old age.

Lots of teenagers push boundaries and can be a pain in the neck at times. Its pychologically normal and very common. My impression is that ds' friends are very similar to him. They answer back, they don't like being told what to do, they have tantrums and think they know everything. I have worked in several secondary schools and met plenty of moody teenagers.

But he's growing into his adult body. His bones are not as soft as those of a young child (and he as more of them), so he's not more comparable to a 3 year old than a 23 year old.

And you don't become a physio by a 6 week correspondence course, so I'm sure the person knows what they're doing.

I said if the physio is appropriately trained. Do you think the physio will be incompetent?

Yes there are obvious differences between teenagers and adults but the range of problems and treatment are more comparable between adults and teens than teens and toddlers.

Trust me if they accept referrals for over 8s they are equipped to deal with them. Your sons growth issues are common and do not require specialist paeds Physio.

Physios also deal with a whole lot more than sports injuries and old people! The skills required to deal with your son are required for a whole range of other things that an adult musculoskeletal Physio will do.

I took my ds to my physio when he was 10. It was fine . I think what you're suggesting is a bit odd tbh. Just take him and see what the physio is like and if it helps.

I have joint issues and by the time I became a teenager I was pleased to be seeing adult rather than child services. I benefited from being spoken to as the primary patient, rather than my parent as would have been the case in paeds. Also it was easier to address my concerns re the effects of my condition into adulthood.
In terms of practicalities a children's department will have physio resources too small for an adult size child.
I am sure the physio you see will be as experienced with youths as they are with older people as growth problems and sports injuries are quite common in this age group.

A teenager will be expected to do their exercises / stretches / splints them self, a baby/ toodler has to be exercised / stretchef/ splinted by their parent. There is a world of difference between a paediatric physio consultation and one for a teen. Teen should be at an adult clinic.

Are you worried he'll have a strop with the physi?. I would expect a child of his age to behave and cooperate with anyone who was treating him unless he has specific needs.

Why are you worrying about disagreeing with the treatment plan before you have even seen the physio ?

Go with an open mind, do the exercises suggested and take it from there.

I think you've received a resounding YABU here. I feel sorry for the poor physio to be honest, you seem to have decided they are no good at their job before even meeting them. All the physios I work with treat adults and children and are fantastic at adapting their practice depending on their patient. Because that is their job which they've had a lot of training to do.