Connected Paediatrics Weekly: The Lost Boys

Hi Reader

Dad Joke: Why is Peter Pan always flying…because he neverlands!

Song of the Week: Lost Boy - Ruth B

They’re the ones who fall through the cracks.

Too old to be “cute and developmental”.
Too young to be taken seriously as adults.

The lost boys of neuromusculoskeletal care.

(And yes, I’m thinking Peter Pan.)

Older children sit in a strange no-man’s-land of healthcare. When we see babies, we instinctively respect development. We talk about milestones, reflexes, variability, and plasticity. We rightly assume function first and structure second.

But…

Somewhere along the line, something shifts. They start to look more adult…and so… we treat them like they are.

They come in with posture issues, neck pain, knee pain, headaches, back pain and all too often the response is:

“Nothing’s broken.”
“They’ll grow out of it.”
“Just posture.”
“They’re fine.”

Or worse, we apply adult logic to a developing system.

Here’s the problem. An older child is not a small adult (however big they look). Their neurology is still developing, morphology is still changing, and their motor strategies…well they are still being written.

If we don’t respect where they are developmentally, we miss the mark…

A 12-year-old with neck pain doesn’t just have a “tight neck”. They may have poor cervical endurance, noisy proprioception, and a control system that defaults to bracing.

A 10-year-old with knee pain doesn’t just have “bad alignment”. They may have delayed torsional change, altered force vectors, and a system running a messy map of where the limb is in space.

And when the input is messy…output looks clumsy.

These kids are clever, they have already learned workarounds. They have decided what feels “safe” and many have already been told, sometimes explicitly, that their pain isn’t real.

The lost boys don’t need to grow up faster.

They need us to slow down, respect their development, and meet them where their nervous system actually is…not where their height suggests they should be.

If we don’t, they don’t disappear…they just become adults who’ve been compensating for years.

Chat soon,
Mike

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