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?

My ds is 10, but on 99th centile for height - his issues sound v similar to your son's, however he saw a paediatric physio. He was shown exercises to do himself at home.
I do think that the exercises they give will be the same regardless, so hopefully should be ok?

It sounds like your son had quite definite opinions about his medical condition so don't you think he'll actually appreciate not being treated as a child?

As others have said, the reason he's been sent to an adult physio not a paeds one is his size. He is not child sized any more so he's better assessed by someone used to working with bigger bodies.

I'm sure if all children over 8 are referred to adult physios, then they are quite used to dealing with both adults and children, at least from a treatment/physical point of view.

I don't think I would expect any physio or member of medical staff to have to deal with 'teenage hormones'. That's surely your job? If I took my teenager to the dentist and he refused to open his mouth, I wouldn't expect the dentist to have to persuade him, I'd deal with it.

Why do you think you will disagree with the treatment? At least give it a chance before you dismiss it.

I do see that it may be difficult to get a teenager to do exercises at home if any are given. You'll just need to explain how important it is do them if he wants things to improve (bribe him if necessary ). After that, the ball is really in his court. He's old enough to understand.

I agree with pretty much everyone else. It seems like you think there's a missing specialism, so there should be paediatric physios, then ones for teenagers, then adults.

Nothing is missing - the physio your son will be seeing might fall under adult service, but the name is a misnomer - they will be trained appropriately to deal with teenagers as well.

I benefitted enormously from seeing an 'adult' physio when I was a teenager. I can only imagine the service has got better (I still see physios now and there are always teenagers in the waiting rooms, so it's not like it's a rare occurence).

Why are you already considering that you and your son might not agree with the physio's plans - do you think that you will know better than a medically trained professional. The physio will discuss an individualised treatment plan as required by the specific problem - it will be appropriate to your son and him only, so why would you know of 'different plans'.
When physios are training they deal with a very wide spectrum of people/illnesses covering all age groups and situations and the majority of NHS physions work on a 'rotation' basis so they are up to date in all areas of their service.

I saw physios throughout my teens (from 12 onwards, actually - but it still took me a further 25 years to get a diagnosis of Ehlers-Danlos Hypermobility )

I was always seen by an "adult" physio; the one I saw seemed to do lots with teenagers though (rather than proper adults and older people) so they definitely had the experience - almost like a mini-specialism within the department (ie "Bob is good with knees so we'll send people with knee issues to Bob. Suzie is really good at talking to older people and making them understand what needs to be done so she'll see all the ladies having had falls and hip replacements. Raj is great with teenagers, so he can see them). It could be that there should be more official specialism (paediatric, teenage, adult) but that isn't going to happen - and if it did, waiting lists may be longer.

The 'Adult' Physio will be used to dealing with growing teenagers. He needs to really think about things if he is stropping at being told he has an odd walking gait, especially if he does.

What makes you or him think he would get the same person he did 10 years ago or that, that person would be able to help you more?

Your son is a lot bigger than a toddler though!

I dont understand your logic - he thinks the treatement chosen as a toddler is the reason for his problems, and you want him to be treated by the same therapist? Why? To give your son a chance to argue that the physio was wrong??

YABU, you sound like you are looking for problems when the physio is highly likely to deal with the issue perfectly adequately. You might have a valid point if you'd seen the physio and experienced a problem, but you haven't.

I had that issue as a teen and saw adult physios having been referred there by paediatrics. They did it because of my height. Is he tall?

My son aged 13 and several of his friends all see adult physics for their growth related problems such as osgood schlatters and severs. These physics are well used to teens and their problems and generally the kids respond well as they are treated like adults by the physio (ie not spoken down to and physio asks them the questions not me) . YABU to call into question their professionalism.

Auto bloody correct puts physics instead of physios!!

My DD was seen by an adult physio when she was 12. He was utterly useless but I don't think that was anything to do with her being 12. We saw a private physio who had a lot of experience working with dancers, including teenage girls, and she was amazing. I think it is finding the right person.

Part of the HCPC registration rules are that if s person is referred that is outside the professionals competence then the professional will refer to someone who is competent. So don't worry!

Also in my team we divi the referrals based on competence (not physiotherapy).

My DD was seen, age 10, by a physio for feet issues. Until i saw this thread it never even occurred to me that there were paediatric physios. She was fab and was obviously well used to dealing with children.

At 13 your DS is a young man not a small child. Why would he throw a strop?

My dd was 14 when she first got referred to physio- at our local childrens hospital. They take referrals to age 18.

ReallyTired is your ds hypermobile?

You need to stop being so judgemental!

'child' physios have the exact same qualifications as 'adult' physios they just specialise in children. They will treat children every single day seeing the same problems day in day out!

My dd12 has seen two different physios regarding a similar problem, and both have been great with her and very understanding of her growth spurts and the impact of that on her joints etc