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At the completion of this chapter, the reader will be able to:

  1. Discuss the physical therapy role with a variety of orthopaedic subtypes and the challenges each present.

  2. Describe the various pathologies for these populations in terms of the presentation and the role that physical therapy plays.

  3. Outline the differences between a congenital condition and an acquired condition.

  4. Describe the normal aging process as it relates to orthopaedics.

  5. Outline the various theories of aging.

  6. Describe the common pathological conditions and functional limitations associated with the geriatric population.

  7. Describe some of the conditions that can affect women’s health.

  8. Describe the physiologic changes that occur during pregnancy within the various bodily systems.

  9. Describe the physical therapy interventions for pregnancy-related dysfunctions.

  10. Describe the complications related to breast-cancer–related lymphedema.

  11. Describe the common pathological conditions associated with a number of popular sports including swimming, rowing, throwing, tennis, and running.


There are a number of population subtypes that require special consideration in terms of the orthopaedic examination and intervention. These include pediatrics and geriatrics, and the whole spectrum of women’s health, in addition to the problems associated with a number of sports.

The Pediatric Athlete

The term pediatric refers to the 0- to 21-year age range, during which an individual undergoes many changes while aging, evolving, and maturing. During the preschool years, physical growth, neurologic growth, and maturation are quite rapid and apparent, with new skills being acquired at a quick pace.1 This process continues throughout the middle years (ages 6–11) at a somewhat slower pace. As a child enters puberty, the rapid development of physical and sexual characteristics become more apparent and is accompanied by important psychosocial development. It is important to remember that chronologic age does not necessarily correlate well with many physiologic and somatic changes.


A typical adult has a smaller surface area-to-mass ratio and a lower metabolic rate than a child. These discrepancies result in a greater transfer of heat and a greater challenge to the thermoregulatory system, respectively, in the pediatric population.

The major characteristics of somatic and skeletal growth and maturation during adolescence are outlined in Table 30-1. In addition, the following differences exist between the adult and the pediatric patient2:

TABLE 30-1Somatic and Skeletal Growth and Maturation During Adolescence

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