Kids Health Info

Burns and physiotherapy

  • Children who have had a significant burn usually start having physiotherapy (often called physio) early in their treatment. The main reasons for having physio are to:

    • Keep the joints moving (joints include elbows, knees, etc).
    • Reduce or prevent the joint tightening up (called a 'joint contracture').
    • Keep the muscles working for normal movement.
    • Prevent or reduce scars.

    As an inpatient (when in hospital)

    Positioning

    Physiotherapists may use splints, pillows and and custom made wedges to position your childs joints whilst in bed. The purpose of careful positioning is to prevent or reduce the joints from becoming stiff or contracting. Orthotists are also involved in providing some of the wedges, splints and braces to maintain these positions. The physiotherapist will provide you with a regimen/program of the correct resting positions and, together with the nursing staff, assist you with following the program.

    Breathing exercises

    If your child has sustained an inhalation burn or remains resting in bed for a long time the physiotherapist may teach your child deep breathing exercises or blowing games. These will help to prevent respiratory complications.

    Stretches

    It is essential your child regularly stretches the affected joints. This is often done with splints and positioning in the beginning. If your child has had skin grafts, the stretching exercises may not start until the grafts have healed.

    Active exercises

    Bed exercises are important in the early days and weeks of recovery to keep your child's muscles working. The effects of pain and any surgery will be considered by the physiotherapist when planning exercises. 

    Functional exercises

    Your child will be helped to start moving and walking as soon as possible. This depends on which areas of the body have been burned. If your child has had skin grafts, these exercises may not start until the grafts have started to heal. 

    As an outpatient (after going home)

    Scar management

    The aim is to have a scar which is as flat, supple (ie able to stretch) and as soft as possible. It can take one to two years for a scar to mature. This depends on:

    • How deep the burn is (deeper burns means scars are more likely).
    • Time taken for the burn to heal (the longer it takes to heal, the higher the risk of scarring).
    • Skin colour (darker skin colour is more likely to have problem scarring).
    • The part of the body (areas over joints are usually more likely to have problem scarring).

    There are some special dressings that are often used to help reduce the development of scars:

    • Tubigrip (tube bandage) or compression garments made especially to fit your child.
    • Adhesive tape - to provide compression.
    • Silicone products - gel sheets and moulds.

    The physiotherapist will assess your child's burns and scars and provide the best treatment.

    Ongoing rehabilitation

    Your child may need ongoing physiotherapy (physio) and rehabilitation (often called rehab). This can be done at the RCH or somewhere closer to your home.

    At home care / care after procedure

    Your child's physiotherapist will give you information and instructions for ongoing care at home including exercises, positioning, stretches and bandages or garments to wear. Talk to the physiotherapist and ask about anything you want to know or don't quite understand.

    For more information

    • Outpatient Burns Nurse 
      T:  (03) 9345 6564 or (03) 9345 5522 pager 6844
      Monday-Friday 8.30am - 4.30pm
    • After hours, contact Platypus ward T: (03) 9345 3653

    See additional Kids Health Info factsheets

    Developed by the RCH Burns Unit. First published in October 2007. Updated November 2010.

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Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.