childrens physio Berkshire

How to help your child ride a bike



My latest blog, with some ideas of how to help your child master riding a bike...

Spring is here and a long hot summer is just around the corner (we live in hope..) It’s a great time for families to get out on their bikes. Children can generally learn to ride between 3-6 years; younger for a child on a balance bike. As with all skills, children’s ability to ride bikes are very varied, some pick it up within a few hours and some take much longer. Additionally, some children have extra needs that may further complicate the issue. I see children in clinic with hypermobility, motor planning problems or learning difficulties to name a few that makes learning to ride more difficult.

Also a note on helmets; please use one and put it on correctly. It should sit 1-2 fingers above the eyebrows, the child should be able to see it when they look up. The side straps should form a Y just below their ear and the strap should be tight enough to only allow a finger underneath.

The best way to learn to ride is mastering each skill separately:

1.       It’s all about the balance

90% of learning to ride is about balance so work on this first. Your child needs to learn to scoot and coast along.

·         Don’t buy a bike too big that they will ‘grow into’.

·         Lower the seat so that your child can place their feet flat on the floor.

·         Remove stabilisers, they won’t help to teach balance. You can also remove the pedals if they are in the way. Or you can use a balance bike.

·         Choose the terrain; a grassy area cut short will provide a softer landing but not create drag; a gentle downhill slope that flattens out is perfect.

·         Encourage them to sit with their bottom on the seat and scoot along with their feet. Move onto lifting up both feet from the ground for increasingly longer times; try playing counting games to encourage this.

·         Once they have mastered scooting and coasting along in a straight line try work on turning; steering through cones that are placed nearer to each other.


2.       Move to pedalling!

·      When they are confident with balancing – and don’t be tempted to rush this, you can pop the pedals back on.

·         Keep the seat low initially so they can still stop still.

·         Place the pedal at 2 o’clock in relation to the handlebars and encourage them to press down on the pedal to move forward. Place the ball of the foot on the spindle.

·         You can hold onto their shoulders when they first start off but don’t keep a hold; it won’t help their balance or your back! Remember to tell them you are going to let go and when.


3. Stopping

·         While the seat is in its lowered position try practising braking – remembering to squeeze both brakes at the same time – you can play stopping games like ‘green lights, red lights’. When they can achieve this, pop the seat up. To get the correct height, with their bottom on the seat there should be a slight bend in the knee at the bottom of the pedal stroke.


4.       Consolidation

·         Now the basic skills are mastered and your child can ride in a straight line, try playing games practising turning and stopping; make the turning circles progressively tighter. You could use a figure of 8, weave between cones and around an obstacle course. Remember to encourage your child to keep their eyes looking forward.

A little aside with regards to stabilisers, there is sometimes a place for them, for example in children who have known balance or motor problems. It enables children to pedal a bike they might otherwise not be able to do and it helps to work on pedal power. Another option for some children is a trike,recumbent or tandem.

Most importantly try to have fun, keep positive with encouragements rather than screaming instructions in half panic ( I speak from experience!) and teach your child how to be safe on their bike.

If your child is really struggling to ride a bike and also has difficulties in other areas of physical development a children’s physiotherapist will be able to offer a full assessment and advice.


Growing Pains??

growing pains

I wanted to write about growing pains as there is often much confusion amongst parents. It is a popular and often wrongly used term by parents, teachers and even health professionals as a ‘one size fits all' diagnosis in the growing child. This blog will look at the typical signs of 'growing pains' as opposed to what may be a specific joint or muscle condition that needs prompt assessment and treatment.

True ‘growing pains’ are actually a misnomer but an easier one to remember than their other name 'benign nocturnal limb pains of childhood'! As this name suggests the cause is unknown and it does not appear to be directly related to growth but is more often found in a physically active child and children with hypermobility of their joints. It is really important to ascertain what may be growing pains, as listed below rather than other pains that could be a sign of something more serious, such as arthritis, vitamin D deficiency and even leukemia.

Signs of growing pains:

Usually affects children ages 3-12. It doesn't affect teenagers

Pain in both legs which develops in the evening, but is never there on waking. Pain usually in shins, calves and ankles

There is no change in daytime physical activities

Pain can be very distressing for all the family and is often described as crampy and intense muscle pains

They can come and go but they may be there for months. They do eventually settle with time

Pain is often worse after a very active day

There is no swelling or bruising

The child is healthy and well

There is no limping


When should I seek further advice from the doctor ?

Any joint swelling

Pain in a single leg rather than both

Waking every night with pain

Fever, weight loss, lack of appetite

Limping or reluctance to walk

Unable to continue to play sports or join activities because of pain

Pains affecting other parts of the body rather than just legs


What can I do to help?

Growing pains can cause much distress to the child, disturb sleep and generally be a miserable time for all the family.

You can try firm massage and/ or give painkillers such as paracetemol or ibuprofen before bed. Sometimes heat help.

Reassure your child that the pain is not serious but that you do understand it exist.

Keeping a diary may help to ascertain when the pain comes on e.g. After a physically active day.

Check your child’s footwear is supportive and fits well.

Don’t stop your child continuing with their usual activities.


Pain that does not fit the very specific criteria above should never be dismissed as ‘just a growing pain’, although it may be a problem due to the maturing skeleton. Most children who come to see me with growing pains do not fit this criteria and actually have a specific musculoskeletal condition that can be treated successfully.

Children and parents are often told they 'will grow out of it' , but in fact recent research has found that children diagnosed with ‘growing pains’ in their knees as teenagers are significantly more at risk of osteoarthritis as adults.

Correct assessment and treatment by a children’s physiotherapist will help children who are in pain and get them back into their chosen activities.