Treating teenagers comes with a set of unique challenges, from navigating maturity (or lack thereof), communication and disinterest to dealing with parents and adapting treatments for their rapidly changing bodies!

Sports and exercise physiotherapist, Steph Woodhouse, says the key to success is finding out what motivates your teenage client.

“Unlike older clients, teenagers have often been dragged by a parent, and they are also usually not paying, so this can lead to even less motivation or interest to participate in the session.”

When dealing with parents, keep in mind that they’re not the client.

“You want to direct the conversation at the teenager as you would any other patient.

“You will often get parents that completely take over, but it is important to keep interacting with the patient as much as possible.

“Getting them involved and speaking to them clearly about goals can be really important.

“As they are under 18, it is the parent’s right to be informed about everything within the session, but find a balance to ensure the focus of the appointment is the teenager.”

Another distinct challenge of working with the teenage client is their changing bodies and shifting needs.

“What is a problem one week may be gone the next, and then a new one has appeared.

“More thorough and regular assessments need to be done with growing bodies as they change a lot quicker.”

Injuries sustained during sport and early diagnosis and management of problems in later life, such as scoliosis, Scheuermann’s disease, hypermobility and instability, are also essential factors to consider.

“Some of these may not be causing issues during the teen years, and not that you want to catastrophise anything, but giving some guidance on these can help a lot.”

As for engaging teenagers in treatment, it’s crucial to develop a good rapport early on and to explain the benefits of health and movement.
  
“You need more time with them to explain and educate – they need to know why they are doing things and actually want the outcome.

“If they don’t care about it, you become nothing more than another adult telling them what to do and then treatment goes nowhere.”

Engagement is best achieved by actively involving young people in their treatment and management plan.

“It may mean that your management isn’t exactly what you would usually do, nor one that is considered ‘gold standard.’

“But if they are excited about it, and it’s safe, then it is a great place to start.”

Goals setting is essential in treating the teenager, but it needs to be on their terms.

“Teenagers need to choose their own goals. If mum is telling them they’re here to improve their posture because they don’t sit up straight, they’re very unlikely to get involved.”

When it comes to the most common complaints, sporting injuries and posture are top of the list.

“Postural problems are a big one, due to people not wanting to be as tall as they are, or in girls developing breasts.”

Tips for engaging and communicating with a teen

• Don’t make the talk too clinical
• Ask a lot of questions
• Talk with them, not at them
• Ensure that they don’t feel like they are simply being told what to do
• Work together to make a treatment plan
• Talk to them, not to their parents

Teenage mental health and treatment.

The role of physiotherapy, including exercise and massage, in the management of anxiety disorders, is becoming increasingly recognised.

Considering one in four young people are affected by mental health problems and disorders, and those aged 18 to 24 have the highest prevalence of mental disorders of any age group, education on mental health is vital for physiotherapists.

“Physiotherapists are given minimal training in mental health management. Usually, it’s just enough that we can identify issues and refer when required.

“Nearly all physiotherapists will attest to the fact that our patients will tell us nearly anything.

“This has meant that a lot of physios are motivated to go on and do a little more research and study into mental health and how we can help people more in our role.”

The medical model based on dividing problems into specific areas is at odds with a growing body of evidence that connects for a more holistic approach to health, explains Ms Woodhouse.

“All of a sudden gut, musculoskeletal and mental health may all be part of one issue.

“There is growing support for lifestyle changes rather than pharmacological management of many issues, which is encouraging people to seek alternative approaches to a lot of different conditions.

“This is also a powerful argument for why physiotherapists can be involved in managing many different conditions, not just the traditional musculoskeletal issues connected to private practice.”

The comfort that develops during physiotherapy sessions, which often involves touch, is unique and encourages clients to share more openly, says Ms Woodhouse.

“There are very few health professions that have the same setup.”

While exercise assists in anxiety management, not everyone can develop a routine independently.

“You can treat exercise for anxiety similar to exercise for an injury, building a program to suit the patient’s needs.

“There is also emerging evidence showing the benefits of massage on anxiety.

“I have read that some of this can be due to the meditative effect – so having similar chemical effects to meditation.

“It can be more down the path of ‘embodiment,’ allowing people to connect more with their body and be less in their head. 

“There may be chemicals released when muscles are massaged.

“Regardless of the exact mechanism, it is a promising approach to anxiety management.”

Young people who feel anxious about seeing a therapist may benefit most from physiotherapy, explains Ms Woodhouse.

“Teenagers may struggle with talking to a therapist, so this can be a great start.

“A combination of exercise and massage, along with the natural talking and communication that occurs during a session can have significant effects for the patient.

“It will often make the patient more open and ready to see a therapist or seek additional help if that is deemed necessary.

“I think that physiotherapists can be a bit of a middle-man for this process.”