Orthopaedic examinations of children are recommended before they start school and at the ages of seven, ten and fourteen. These examinations are designed to monitor changes in children's musculoskeletal system, their development, growth and the stresses of different life stages. Children's musculoskeletal development can be affected by a lack of exercise, heavy school bags, a lot of sitting, prolonged use of mobile devices and age-inappropriate physical exertion in children who play active sports. Spinal examination has an important role to play in preschool examinations. An orthopaedic doctor may recommend an annual check-up to follow up a diagnosed scoliosis.