From Leg Pain to Confident Running: A Six-Week Paediatric Physiotherapy Case Study

How individualised physiotherapy helped a 10-year-old boy clear recurring pain and helped him so much more…

When running becomes uncomfortable

For children who enjoy football and Gaelic games, running, jumping and changing direction are a big part of everyday life. When leg pain or stiffness begins to interfere with these activities, it can affect not only performance but also a child’s confidence in movement.

At BodyRight Physiotherapy Drogheda, we look beyond the area of pain to understand how a child’s movement patterns, strength, flexibility, balance and their nervous system including coordination may be influencing their symptoms.

This case study follows a 10-year-old boy  who presented with leg pain and stiffness during running. Over six weeks of individualised physiotherapy, we worked on improving his movement control, strength, balance and flexibility, with fantastic results. He also learned a lot about himself, including I would say a lot of self belief.

The initial assessment: looking at the bigger picture identified several areas that could be addressed as part of his rehabilitation:

● Leg pain and stiffness during running, affecting his comfort and confidence with sport.

● Reduced hamstring flexibility, and tight neurodynamics, this tight were really affecting his running mechanics.

● Reduced single-leg balance, initially maintained for approximately seven seconds.

● Joint hypermobility, with a Beighton score of 5/9.

● Difficulties with body awareness and movement control, particularly during more complex movements requiring coordination and stability.

These findings helped guide the treatment plan. Rather than focusing solely on the painful area, we aimed to develop the physical skills needed for comfortable, controlled movement during running and sport.

A key part of paediatric physiotherapy is recognising that children are still developing their strength, coordination and movement skills. But treatment needs to be appropriate to their individual presentation, and it really needs to be enjoyable and relevant to the activities they want to return to. Higher proprioceptive input will mean a more satisfying sensation and help regulate their ability to focus on the movement.  For this reason weightbearing, resistance and balance exercise games work really well. 

The six-week physiotherapy programme

After initial assessment and some hands on treatment we used short, focused 20-minute weekly sessions to work on balance, strength, proprioception, flexibility and coordination.

Exercises were selected to challenge his control gradually while keeping the sessions engaging. Sessions were recorded and emailed to patient so he could watch back to practice the new exercises each week. 

1. Balance and body awareness

Single-leg balance activities, helped develop balance, postural control and awareness of body position.

2. Strength and stability

Body weight strengthening exercises targeted the muscles needed to support controlled lower-limb movement. We also incorporated exercises that challenged core stability and control in a fun and satisfying way for a 10 year old. It was great to see the movements waking up the core and postural awareness so well. 

3. Coordination and movement control

Running-man exercises and ball activities helped practise coordination and control in more dynamic positions.

4. Jumping and lateral movement

We made jumping exercises progressively more challenging as the weeks went on, helping develop control during take-off, landing and changes of direction.

Exercises were progressed according to his ability, with an emphasis on quality of movement rather than simply completing repetitions.

The aim was to build the foundations for comfortable, confident movement that he could transfer into running and sport.

The results after six weeks showed improvements in a range of important measures including hamstring  length by 25 degrees, Single-leg balance improved from 7 seconds to  over 30 seconds even with additional challenges like adding arm movements.

And just as importantly, his leg pain during running had totally  resolved, his running form sharpened and his confidence with running and sporting movement had improved.

These changes were measurable to us his physio team, he could feel the differences and his football coaches and parents remarked on how improved his running and game was. 

What can we learn from this case?

It highlights several important principles of paediatric physiotherapy….

Look beyond the site of pain. An assessment of flexibility, strength, balance, coordination and movement control can help identify additional areas to address alongside the presenting symptoms.

Making rehabilitation relevant to the individual child, fun and satisfying. Games, ball activities and movement challenges can make exercises more engaging while developing the skills needed for sport.

Measuring progress is key!  Reassessing flexibility and balance shows how a child is progressing in a measurable way. Equally, improvements in pain and confidence are essential parts of the overall outcome.

Every child is different, and one case study cannot predict how another child will respond to treatment. However, this case shows how a targeted, progressive physiotherapy programme can address several areas of movement and support a positive return to activity.

How can paediatric physiotherapy help your child?

If your child experiences recurring leg pain, stiffness, difficulty with running or challenges with sporting movements, a physiotherapy assessment can help explore the possible contributing factors and identify an appropriate management plan to help them reach and exceed their goals. 

At BodyRight Physiotherapy Drogheda, our paediatric physiotherapy service provides individualised assessment and treatment to support children’s movement, physical development and participation in the activities they enjoy.

To enquire about a paediatric physiotherapy assessment, contact BodyRight Physiotherapy Drogheda.