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A Day in the Life of a Private Care Pediatric Physiotherapist

Are you wondering why your kid might need therapy? Or what kind of therapy does your child need for a specific problem? Maybe this will help you. 

My name is Michelle. I’ve been a physiotherapist for over 10 years, and a physio specifically for kids (aka: pediatrics) for 6 of those years. In my former career I was a school teacher (kudos to all you teachers out there who have the patience for this…I didn’t make it past the “5 year mark”). AND I also have two children and a husband (which is sometimes like having another kid….am I right?). Needless to say, I know a thing or two about kids. 

Throughout my career as a physiotherapist, I’ve often been asked if I can help a kiddo with specific problems. I can! But it depends on the problems. And I’ve seen MANY in my days. Here is what a typical day looks like for me in the clinic. 

My first patient is a cute, squishy little baby who is 10 months old and not crawling yet (usually babies crawl at around 8 months old). I do my assessment and determine that there doesn’t really seem to be anything wrong – the baby just hasn’t figured out how to do this yet. I give the mother some homework to do with her baby which includes about 10-15 minutes of daily exercises and activities. Within a short period of time, Mom happily reports that her baby has now figured out how to crawl and won’t stop exploring. 

My second patient is a 7 year old with low tone (which means he seems a little “floppy” and weak). He’s been working with me for over a year now and has been making huge gains in his strength, balance, confidence and desire to participate in sports. He is slowly catching up to his peers in gym class and in the school yard. His parents are delighted with the changes he’s made this year and the child loves coming to “play” in the therapy gym. 

The third kiddo to come in today is “on the spectrum”. He began seeing me 2 years ago, when he was three years old, wasn’t talking yet, and did not look anyone in the eye. His balance was poor, he could not follow instructions well, and was easily overstimulated. With regular physiotherapy and occupational therapy the boy is now thriving! During his sessions, which used to be difficult for him from a physical and emotional standpoint, he plays with his therapists and does therapeutic exercises that are specifically chosen for him. He LOVES coming to therapy now, speaks just as well as his peers, and is almost caught up to his classmates at school. 

The kids just keep on coming! My next friend (as I like to call them) is a 9 year old girl with continence issues (still peeing her pants). She has always been anxious and quiet, and has always sat on the floor in  ‘w’ position (think knees in front and feet outside of the hips…I can’t do this – it hurts!). It’s her third session with me and her parents report that she is having fewer urinary accidents: than she was a few weeks ago. While they know that she is progressing, they also know that the journey to being dry will take more work. My young friend is very diligent about doing her physio homework and really wants to succeed because people at school are making fun of her, and she would really like to be able to have a sleepover with some friends soon. Because she is doing so well with her home exercise program, today I give her new exercises, and also do some hands-on therapy and some game based exercises. (Trust me, if you came to physio with me, you wouldn’t want to go back to your boring therapist to do your boring exercises. You would rather play “Floor is lava, Red-Light Green-Light and Stuck-in-the-Mud). 

Lunch time. Thank goodness! No one likes me when I’m hungry (ask my bestie receptionist…she keeps snacks behind her desk just for me for self-preservation. LOL).

The afternoon is filled with more fun. It’s really hard to call this a “job” on most days because I get to play with kids and see their smiling faces (or maybe just their eyes since they are wearing masks – can’t wait for this pandemic to end.)

My fifth visitor of the day is a sweet little 5 year old girl who toe walks. She has not “outgrown” this as she was told by her doctor, so her parents have decided to try physiotherapy. We begin with some manual work (ie: I use my hands to do some treatment on her legs and feet), and then we go to the gym to play some therapeutic games. As is very normal for many kids, she is having so much fun during her session that she does not want to leave when it is done; this results in tears and her mother picking her up to take her out of the clinic. But first, I give her a sticker for her hard work and tell her how proud I am of her persistence with her home exercise program. 

Again a baby! My favourite. This time, the 4 week old is here for treatment due to a birth trauma that has caused torticollis (aka side tilted head). She can’t turn her head all the way in both directions, which is affecting her ability to nurse and making tummy time very difficult. And, if you didn’t know: tummy time is a baby’s way of getting exercise. (And this PT is VERY serious about exercise.) It turns out that the treatment I’ve been doing has also been helping to reduce the baby’s reflux…bonus! After sneaking in some baby cuddles masked as treatment (just kidding, it’s really treatment), I teach the mother a new stretch for her to do at home to continue progressing the baby’s range of motion and to prevent the baby from getting a flat spot on her precious little noggin. The mother tells me that she is so glad she got started with physio now and didn’t wait, since she has learned that early intervention is better.

Patient #7 of the day comes racing down the hall to give me a hug. I haven’t seen her in a while because she’s been going to CHEO for pre-school and getting treatment there. I have missed her so much and am grateful for the hug. I’ve been working with this little one since she was just 6 months old, after getting diagnosed with CP. She is persistent and charismatic, which makes treatment a challenge for me; but I never baulk at a challenge. I put her on the swing and ask her about her friends at school. She hasn’t forgotten me, because she tells me that I’m her best friend (melt my heart). And so we go on with our hour-long session where we practice different balancing activities, walking with minimal assistance (she usually needs help), and playing lots of games (but really they’re exercises disguised as games). You have no idea how much psychology goes into treating kids…you have to outsmart the sneakiest and wisest kids. 

The second last patient of the day is an 18 month old girl who is not yet walking. In the medical world, a child gets “red flagged” if s/he is not walking by 15 months old. That means, we really need to investigate the issue because it’s not normal. Her parents have given me a list of concerns that their doctor has pretty much dismissed, but they are still concerned. One beautiful thing about physiotherapy is that we get to spend lots of time with our clients. In order to figure out what is going on, I ask the parents loads of questions, and do as many “Special Tests” and screening tests as I can that will help to rule out some problems, and narrow down the child’s difficulties. In the end, I am also concerned that there is more going on that warrants further investigation, so I write a letter to the child’s doctor with my concerns to hopefully push things along and help the family find some answers. Before they leave, I create a plan with the family so they can start doing things at home that will help their child begin to make progress (even without knowing the causes of some of the problems). Again, they are so relieved that they have chosen to get an assessment. 

My last patient for today is here for a soccer injury. He is 12 years old, plays soccer 5 times per week, and has Achilles pain. While this injury is pretty standard for many athletes of all ages, we need to be particularly careful because we want to avoid him getting Sever’s disease (specialty pediatric knowledge coming in handy here). He has a tournament coming up in a few weeks, so we need to rehab him in a hurry. We do some manual therapy, some exercises, and some special taping and send him on his way. 

What a day. It’s so satisfying to know that I have helped so many youngsters and their families. After finishing up my charting, I look ahead to tomorrow to mentaly prepare myself for what I need to do. It looks like I will be seeing a 7 year old with ADHD, a 4 year old who just had surgery on her hips, a 3 year old with balance problems, a 17 month old with a yet-to-be-determined rare genetic condition, a 10 year old with Autism and Developmental Coordination Disorder, a clumsy 6 year old, and an 11 year old who isn’t sure what’s causing his groin pain. I look forward to helping more kids and their families become more functional and make progress toward their goals.