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Pediatric Physical Therapy

Improving ability and reaching milestones

Boy on balance beam

The rewards of effort and achievement

Not being able to function at full capacity can be a daily struggle and the cause of much frustration. At Trestle, our physical therapists provide relief for patients by helping them achieve skills they have never done or relearn ones they’ve lost. At the first session, goals are created based on developing or restoring function. Pediatric physical therapy is mostly about gross motor skill development. For example, physical therapy (PT) can help a child who is not yet walking strengthen their muscles and achieve those motor skills in a timely and symmetrical fashion. It’s all about building skills and the confidence that follows.

Signs & Symptoms

Knowing when physical therapy is needed

While pediatric physical therapy can be needed as part of the rehabilitation after an injury or procedure, it is usually about meeting developmental milestones and working on specific functions. Often pediatric patients are seen for neurological issues related to certain diagnoses such as cerebral palsy, Down syndrome, and spina bifida. At each one-on-one session, we make learning fun with play and games as the main components. It is typical for a session to include blowing bubbles, coloring, or putting together a puzzle. Exercise balls are used to help with core strength and overall stability.
Symptoms for children
  • Pain
  • Decreased strength
  • Problems with balance or posture
  • Decreased range of motion
  • Persistent tiptoeing
  • Issues with gross motor skills
  • Developmental delays, such as not sitting, crawling, or walking
  • Sleeping issues

Possible diagnoses

Getting to the root of the symptoms

Most of our patients do not have a condition or diagnosis, but rather are struggling in certain areas where they need help. However, the need for physical therapy can be associated with the conditions listed below.
Diagnoses for children
  • Torticollis (neck muscle issues that cause the head to tilt down)
  • Plagiocephaly
  • Delayed motor skills
  • Developmental delays
  • Coordination disorders
  • Toe walking
  • Core weakness
  • Infant prematurity
  • Childhood leukemia
  • Autism spectrum disorder
  • Hypotonicity
  • Spina bifida
  • Down syndrome
  • Cerebral palsy
Father throwing daughter in the air

The supportive path forward

Our treatment plans are based on a hierarchy, and once a foundation is laid, we continually advance goals to target more complex skills. It’s a fluid and flexible process, working together to improve function and your overall quality of life. Parents frequently report that their kids feel more rested, perform better in school, and have fewer behavioral concerns.
Working together to reach and celebrate your achievements
Customized plan
1-on-1 sessions
Home assignments
Goals reached
Our feedback speaks volumes
“Could not be happier with the therapists, office staff, and my son’s progress since starting therapy at Trestle. Everyone is helpful, knowledgeable and approachable. My son looks forward to his sessions and loves going to 'play'.”
We know you’re looking for answers, and we’re here to help
See our FAQs

Frequently asked questions related to speech therapy

What is physical therapy?

Physical therapy is the evaluation and treatment of various impairments and functional limitations like pain, decreased range of motion, decreased strength, poor balance, and decreased functional mobility.

What is pediatric physical therapy and how is it different?

Pediatric PT is the evaluation and treatment of patients who are less than 18 years old. It is different, as it is provided in a one-on-one situation where play is a main component of the sessions. Pediatric PT is often more habilitative, meaning it is used to help children master skills that they have never had before. Compare that to rehabilitation, which helps people to remaster a skill that they have already acquired in the past.

What do physical therapists do?

Physical therapists use exercises to help patient achieve functional skills. An example is a baby that is not yet able to crawl. A PT will use a combination of strengthening and mobility work to help the baby achieve the skill.

How can physical therapy help?

Physical therapy can help with strength and overall mobility independence for patients.

What’s the difference between physical therapy and occupational therapy?

Physical therapy works more with gross motor skill development, while occupational therapy works with the sensory system and fine motor skills. PTs and OTs often work together to co-manage patients who have needs in multiple areas. A co-treat is a session in which an OT and a PT can see the patient at the same time, each tapping into the other clinician for assistance to facilitate a well-rounded session for the patient.

What are some signs/symptoms that physical therapy is needed?

Pain, decreased strength, decreased balance, and delayed motor skill development.

What are some conditions/diagnoses related to physical therapy?

Back pain, hip pain, decreased balance, shoulder pain, sport injuries, along with spina bifida, cerebral palsy, Down syndrome, infant prematurity, toe walking, torticollis, and poor movement patterns.

What does PT/treatment look like at Trestle?

A typical PT session is a one-on-one experience with the PT and the patient. It can be anywhere from 45 to 60 minutes, often depending on the stamina and motivation of the child. Play and games are a main component of each session to gain rapport and allow the child to have fun. It is typical for a session to include blowing bubbles, coloring, or putting together a puzzle.

What treatments does a physical therapist provide?

There are many treatments that can be provided by a PT. Some, to name a few, are stretching and range-of-motion work, either through exercise or through manual work by the therapist; strengthening with or without weights; balance training with mirrors for visual feedback; and coordination skills like jumping. Often PTs will use exercise balls to help with core strength and overall stability. Some physical therapists are trained in Kinesio® taping, which is used to help facilitate positions and movement patterns with application of tape in certain ways.

What education/training do physical therapists have?

Physical therapists require a bachelor’s degree as well as a Doctor of Physical Therapy (DPT) degree from a graduate school with an accredited PT program.

Do physical therapists have specialist certifications in areas of expertise?

Many therapists have certifications that allow them to perform certain interventions. These include but are not limited to Kinesio® taping, neurodevelopmental technique, and manual therapy.

How long do therapy sessions last?

Each session lasts anywhere from 45 to 60 minutes, depending on the goal that day and the stamina of the patient.

How many sessions will I have?

Some patients will only need six total sessions, while others may need physical therapy for many years. Each situation is different.

How is my progress measured?

Progress is measured by using goals. Goals are looked at each session and can be either not met, emerging, or met. In pediatrics, there are outcome measures that can be used to compare the skills of a child to same-aged peers to see if the patient is performing skills of a typically developing child. There are various tests that can be used depending on the age of the patient and/or the concerns.

Do I need to see my doctor to start physical therapy?

In Illinois there is something called direct access, in which you can see a PT for five visits without an order from the doctor. However, if you are using your insurance, the carrier may require that you have a doctor’s order for reimbursement purposes from the start. Trestle always recommends clear communication and encourages you to get an order from your doctor prior to treatment.

Do I need a referral or prescription for physical therapy?

A referral may be needed if you have certain insurance plans that require it. Your insurance company can verify this for you.

Why is physical therapy a good choice?

Physical therapy is an excellent choice because it is a non-invasive treatment option that is proven to be effective for many different patient groups.

Why should I choose a private practice physical therapist?

Choosing private practice is often a better financial option for patients. Billing and cost can be more at a hospital facility. Private clinics are able to create a culture of treatment that can be more creative and more autonomous.

Is physical therapy painful?

Physical therapy does require that you move your body. Sometimes, if those movements are new, there can be some soreness one to two days after treatment. If something that the therapist is having you do or doing to you is painful, you have every right to speak up. When
that happens, the activity is either stopped or decreased in complexity. It is important to
remember that you have the right to advocate for yourself. A main purpose of PT is to alleviate pain, not to cause more.

Is “no pain, no gain” true for physical therapy?

At Trestle, we do not believe physical therapy should hurt. If you ever feel pain during your protocol, stop and let us know so that we can address it. There is a difference between pain and muscle soreness. Often people are unfamiliar with muscle activation and can describe it as pain. If something hurts, that is the body’s way of trying to protect itself, and it should be reported to your PT.

Can a physical therapist help to alleviate pain?

There are many ways that physical therapists can help with pain. Manual work like soft tissue mobilization, joint mobilizations/manipulations, muscle activation, gentle stretching, and exercise are all ways we can decrease pain.

Can a physical therapist help me avoid surgery?

Yes, that can often be the case.

How do I know if physical therapy will help me?

It will help you! Patients who complete plans of care and do exercises that are recommended at home will make progress toward their goals.

Can my physical therapist provide me with a diagnosis?

We can provide a therapeutic diagnosis. An example would be a child who walks on their toes. The therapeutic diagnosis would be “abnormality of gait.” A physical therapist is not allowed to diagnose a patient with conditions like autism or cerebral palsy.

Why does physical therapy take longer than I had thought?

It can take longer if the patient is not following the recommendations that are put in place by the PT. Sometimes patients try to speed up the process by doing too many activities, and that can create injuries or other problems and increase their therapy time. On the other hand, if a patient cannot or does not perform the recommendations, that can also create more time in therapy. It’s a fine balance, which is why we encourage patients to follow the recommendations as given. As you’re building strength, it will help motor skills. However, there can also be relapses. Every patient moves at their own pace. No need to get discouraged as long as progress is moving forward.

How many times a week do you usually attend physical therapy?

It is up to the clinician, but a typical plan for a pediatric patient is once per week. If a patient is post-surgical, it can be two to three times per week.

Is physical therapy covered by my health insurance?

Each insurance plan is different in terms of the coverage for physical therapy, but it is covered in most cases. Some insurance plans require a referral from a primary care doctor, and some do not. Some plans have limitations on the number of visits allowed per year. All these things should be checked with your insurance carrier ahead of treatment.

What should I wear for physical therapy?

Clothes that are not restricting are best for physical therapy. A perfect outfit is a tee-shirt and comfortable shorts or pants and grippy socks.

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