A little cheerful girl in a circus dreams

Pelvic Floor Physical Therapy

Guiding Children and Parents through the daily struggle of Bedwetting and Bowel Accidents.

Black and white smooth gradient background image, gray.jpg

What is pediatric pelvic floor physical therapy?

Pediatric pelvic floor therapy is where the family, your child's doctor, and the pediatric physical therapist all come together to help your child with bowel and bladder issues.

Your pelvic floor therapist will combine regular play, pediatric physical therapy, and pediatric pelvic floor therapy to help them with their issue.

Your pelvic floor therapist may also use behavioral strategies that your child can use daily to help with their problem, as well as education to help them understand their bowel or bladder problem, and work with their doctor and/or dietician to make dietary suggestions.

Conditions pediatric pelvic floor therapists may treat

We work with children age 5 and up, but we're happy to begin earlier at age 4 to offer helpful education	We see kids who struggle with constipation
Bowel incontinence	Difficulty sensing that they need to go
Leakage when playing, laughing or jumping	Bedwetting past age 5 or 6
Urinary problems, such as increased/decreased frequency, weak or intermittent stream, or incomplete emptying	Urinary tract infections
Abdominal pain	Kids presenting with withholding behaviors or holding maneuvers
And kids with a history of bowel or bladder surgeries or other medical problems

A peek into what a pelvic floor therapy session may look like

We Play

Regular pediatric physical therapy may look like the following:

Our play suits your child's unique challenges	We may work on strengthening their back
Address posture	Strengthening their stomach muscles
Breathing techniques and how to expand their rib cage	Address issues in their feet and legs
Improve balance	Coordination
Body awareness	And many more!

Pediatric physical therapy sessions for pelvic floor issues may include the following:

Pelvic floor play can include many things, such as breathing awareness	Organ anatomy
Reading bowel and bladder story books	Learning the long pathway food travels
The therapist may give mom or dad a food diary to fill out	Learning optimum toileting posture
Learning how to do "belly big, belly round" when pushing to have a bowel movement	Finding out if orthopedic factors are affecting their pelvic floor
Learning about interoception	Playing healthy food games
The therapist may utilize surface EMG biofeedback so they can see on a computer screen how their pelvic floor works	How to relax their pelvic floor while urinating
Learning how to not strain	How good posture will help the food go down
We will encourage crossed-legged sitting vs w-sitting	We will do fun strengthening exercise to help the pelvic floor
Learn how to do a belly massage	Learn how slowing down will make their organs happy and work better
The therapist may use gentle visceral manipulation to calm their nervous sytem and mobilize their organs	And through every visit aiming to make their life just a tiny little bit easier

My child struggles, and I suspect pelvic floor problems, but could their behavior be normal?

Feel free to call a pelvic floor physical therapist near you to discuss your concerns.

Here are some helpful screening tools to help you determine whether your child might benefit from a little extra support!

A screen for pelvic floor dysfunction:

To screen for pelvic floor dysfunction. (Credit Dawn Scandalcini)	Does your child usually pee less than 4 times a day?
Does your child ever leak pee when they sleep at night?	Does your child poop less than 3 times per week?
Does your child ever have to push hard or strain to make their poop come out?	Does your child ever feel embarrassed, anxious or don't do things with friends because of pee or poop problems?

A screen for difficulty with interoception:

Interoception Screen. Does you child know what is happening inside their body?	Does your child go more than 3 hours without asking for food or drink?
Does your child need to be reminded to drink liquids throughout the day?	Does your child seem to get overtired quickly or easily?
Are "bedtime battles" frequent in your home (more than 4x/week)?

A screen for constipation:

Constipation screen: Could constipation be the cause of your child's bedwetting or daytime leaking.	A history of constipation.
Infrequent bowel movements.	Hard stools or stools clogging the toilet.
Needing to strain or push to have a bowel movement.	Leaking stool or smearing in their underwear.
Lacking the urge to have a bowel movement.	Withholding bowel movements.

Other behavioral signs that may indicate that pelvic floor therapy may be helpful for your child include the following:

Withholding behaviors	Avoidance behaviors
Constantly cleaning	Holding maneuvers, such as "the potty dance" while refusing to go
Hiding their problems	Hiding in closets
And who won't tell anybody

My child is shy. How can the therapist help them feel comfortable during their sessions?

We try our best to make your child feel comfortable	We feel that it is crucial that your child bonds with our pelvic floor physical therapist
We structure the visits to meet your child where they are	We have your child be involved in the decision-making process

Let's introduce you to the kids who come for pelvic floor therapy

They are beautiful	They appreciate learning new things
They are content	They are good decision makers
They are sweet	They are curious
They love it when talked to in language they understand	They are loving
And they can be all over the place