Chris Smith is a paediatric physiotherapist who runs a private children’s clinic in Essex. It offers specialist therapies to children from birth.
He says, ‘Many people think physiotherapy is something you receive after breaking an arm, but actually the profession has massive scope.
‘I started my career working in a hospital paediatric intensive care unit (ICU) where we helped babies on ventilators to breathe. In ICU, physiotherapists make sure babies get good oxygen to the lungs by checking their lying position.
‘I set up Kids Works in 2010 when I realised families were choosing to have more physiotherapy than the NHS offers. I employ six physiotherapists, who provide treatments you can’t get in other UK clinics.
‘We start at 10am. On a typical day a therapist sees five children aged from one or two years old upwards. I work predominantly with children with cerebral palsy who have had an operation called selective dorsal rhizotomy. This aims to improve muscle stiffness.
‘One treatment we offer to children with difficulties standing is spider cage therapy. We attach eight elastic bungees to a belt worn by the child. It helps them stand, move and strengthen their muscles.
‘Another is functional electrical stimulation. A bit like a TENS machine used by women in labour, it makes muscles contract, which helps strengthening for children with a predominant weakness.
‘We also use partial body-weight supported treadmills. These help children who are unable to walk to put a little weight through their legs and gradually build up confidence and strength. When the children do good stepping, the walker lights up and talks encouragingly.
‘We also see babies or younger children born with their feet in the wrong position. We treat babies with a misshapen head, known as flat head syndrome. Or help babies with muscle tightness on one side of their neck.
‘Up to the age of four years, you have to be clever about getting children on board with therapies. We make them think it’s a game. We choose toys and environmental opportunities for exercises the child will enjoy. For a child with poor leg strength, it could be as simple as stacking bricks.
‘To learn a new skill, the brain requires frequent practice. It takes much targeted repetition, but younger children don’t tolerate long treatment times. A typical one-year-old will work well for 30 minutes within an hour. We can work for two hours with children aged from four.
‘We also have to give the children exercises to practise at home, but there’s no point handing a family sheets of exercises they won’t do. We ensure these fit into family life. For example, if the child needs standing practice, they could do that with an assisted device next to mum when she’s making dinner.
‘Our clinic is not like a hospital – it’s in an open-plan barn decorated with cartoon characters so children don’t feel threatened. Often families come for blocks of therapy. They travel from all over the UK to receive one or two hours of therapy a day, five days a week, for one to three weeks. Most make it into a holiday.
‘After every appointment we write an account of the session in standardised language. We are bound by the Health and Care Professions Council (HCPC) to ensure note-keeping is up to date, as well as maintain continual professional development.
‘Our physiotherapists sometimes go into nurseries and provide advice to nursery nurses about making play meaningful for children with brain injuries, which we try to incorporate into the Early Years Foundation Stage.
‘No two days are the same. Every patient, even with the same condition, is completely different. It’s tough sometimes – you have to manage parents’ expectations. They might want their child to be walking, but that might not happen in the way they would like.
‘It’s also emotional spending the whole day with children who have physical difficulties. But it’s such a privilege that a family chooses you to help their child.’
TRAINING
All physiotherapists must complete a BSc degree in physiotherapy, which takes three years of full-time study. To qualify, applicants must have two or three A levels, including one in a biological science or physical education. People already holding a relevant BSc can take a two-year accelerated course. After qualifying, physiotherapists must register with the HCPC.
CV
Employment history
2004-2006: Junior rotations, West Middlesex University Hospital, London
2006-2007: Respiratory physiotherapist, St-Mary’s Hospital, London
2007-2008: Specialist paediatric physiotherapist, Northwick Park Hospital, London
2008-2010: Senior paediatric physiotherapist, North East Essex Primary Care Trust
2010-present: Lead paediatric physiotherapist, Kids Physio Works, Colchester
2010-present: Guest lecturer in paediatrics, University of Essex
Qualifications
BSc physiotherapy, Keele University, 2004
A range of training courses including spider cage therapy, kinesio tape and TheraSuit method.
Useful websites
Kids Physio Works, www.kidsphysioworks.co.uk
Chartered Society of Physiotherapy, www.csp.org.uk
National Careers Service, nationalcareersservice.direct.gov.uk/advice/planning/jobprofiles/Pages/physiotherapist.aspx
