Why Is My Child Struggling to Progress in Swimming Lessons? A Paediatric Physiotherapy Case Study

This case study is part of a new series where one of our lovely paediatric physiotherapists shares learnings from real families we support.

This is a genuine clinical case involving a child seen through our mobile paediatric physiotherapy service in Ryde, NSW. To protect the family's privacy, identifying details have been changed or removed. The clinical themes and outcomes remain authentic.

Introduction

Many children attend swimming lessons for years but still struggle to progress to the next level.

While they may be comfortable in the water, they can find it difficult to develop efficient kicking, coordinated arm movements, or the endurance needed to keep up with their peers.

This case study explores how paediatric physiotherapy helped a child with developmental and coordination challenges improve the physical skills underpinning swimming performance.

Presenting Concern

A family sought physiotherapy because their child was finding several gross motor activities difficult, particularly swimming.

The child's parents reported challenges with:

  • Freestyle arm movements

  • Straight-leg kicking

  • Fatigue during swimming lessons

  • Coordination and balance

  • General sporting activities

Despite regular swimming lessons, progress had slowed and the child was finding it difficult to achieve the skills required to move up to the next swimming level.

Assessment Findings

Assessment suggested that the swimming difficulties were not simply a swimming problem.

Several contributing factors were identified:

Reduced Core Strength

The child demonstrated weakness in the postural muscles responsible for maintaining body position during movement.

Coordination Difficulties

Tasks requiring rhythmic or alternating movements were often challenging, affecting both swimming and land-based activities.

Muscle Tightness

Tightness through the legs was limiting the child's ability to maintain straight-leg kicking patterns.

Reduced Strength and Endurance

The child could often perform movements correctly initially, but technique deteriorated with fatigue.

Physiotherapy Approach

Rather than focusing purely on swimming technique, physiotherapy targeted the underlying physical skills needed for efficient swimming.

Intervention focused on:

  • Core strength and postural control

  • Upper limb strength and coordination

  • Lower limb strength and kicking mechanics

  • Flexibility and movement quality

  • Endurance for sustained activity

Parents were provided with simple home activities to reinforce these skills between sessions.

Progress and Outcomes

Over time, the family reported noticeable improvements in swimming participation.

The child showed improvements in:

  • Swimming endurance

  • Freestyle arm movements

  • Leg control during kicking

  • General coordination

  • Confidence during physical activities

Most importantly, improvements were beginning to transfer into real-world participation, including swimming lessons and recreational activities.

How Can the NDIS Help?

Many children who access NDIS-funded physiotherapy experience challenges similar to those described in this case.

Physiotherapy may support children who have difficulties with:

  • Gross motor development

  • Developmental delay

  • Autism spectrum disorder

  • Coordination difficulties

  • Balance and strength

  • Participation in sport and recreation

The goal is rarely to improve strength for the sake of strength. Instead, physiotherapy focuses on helping children participate more successfully in meaningful activities such as swimming lessons, playground play, community activities and school sport.

For families in Ryde, NSW and surrounding areas, paediatric physiotherapy can form an important part of an NDIS support plan when physical development and participation are impacted by a child's disability or developmental condition.

What Parents Can Learn From This Case

If your child is struggling with swimming, the problem may not actually be swimming technique.

Common underlying factors include:

  • Poor core strength

  • Motor planning difficulties

  • Coordination challenges

  • Reduced endurance

  • Muscle tightness

Identifying and addressing these contributing factors can often help children participate more successfully in swimming lessons and other physical activities.

Frequently Asked Questions

Can physiotherapy help a child improve their swimming?

Physiotherapy can help children develop the strength, coordination, endurance and movement control that support swimming skill development.

Why does my child bend their knees when kicking?

This can occur for several reasons, including muscle tightness, reduced strength, poor motor control, or difficulty coordinating movements.

Should I seek a physiotherapy assessment if my child is not progressing in swimming?

If your child is consistently struggling despite regular lessons and practice, an assessment may help identify underlying factors affecting their progress.

Can NDIS funding be used for physiotherapy?

Many children access physiotherapy through the NDIS when therapy supports participation, functional development and plan goals.

Conclusion

This real-life case from Ryde, NSW highlights an important point: children who struggle with swimming are not always struggling because of swimming technique alone.

This article was written by Shashini Soysa a senior paediatric physiotherapist at Sydney Child Physio.

If you have concerns regarding your child’s coordination, strength, flexibility, endurance, or motor control contact us to have a paediatric physiotherapist assess your child in the comfort of your own home.

Shashini Soysa