Why Would a Child Need Pelvic Floor Therapy?

We often see children as young as four years old and address common issues such as:

• Constipation - Even if your child is going to the bathroom every day, they may still be dealing with constipation which is a difficulty in emptying the bowels. By looking at the Bristol Stool Scale, you can see if your child’s poop is in the normal range which we consider type four. Outside of type four, they may be suffering from chronic constipation. 

• Encopresis - Sometimes called soiling is the repeated passing of stool (often involuntarily) into clothing. If you begin noticing your child is leaving skid marks in their underwear, they may be backed up or never fully emptying their bowels and can be a symptom of chronic constipation

• Abdominal/pelvic pain - It is not uncommon for many adolescents to be clenching their stomach muscles tightly. Yet, after appendicitis is ruled out for example, abdominal pain occurring more than once a week may be grounds for seeking PT treatment to release the tension in the abdominal muscles.

• Dysfunctional voiding - Voiding dysfunction is the irregularity of bladder or urinating function meaning your child is unable to completely empty their bladder. This can be a common symptom among children, including those who are neurodivergent, who may be hyper fixated on play, rushing due to being sensory overloaded from the bathroom environment or who frankly may be feeling uncomfortable or grossed out by using the bathroom!

• Enuresis (bedwetting) - It’s one of our beliefs that no child truly wants to wet the bed, or does it out of spite or lack of discipline. It can be challenging mentally for children who experience bedwetting as they feel uncomfortable and scared in the safe havens of their beds but may not understand what’s going on or how to prevent it from happening because it is involuntary. If bedwetting occurs more than three times, it can be presumed the child could have a low nocturnal bladder capacity that can be addressed through PT.

• Overactive bladder - Known as a chronic medical condition that causes a sudden, strong urge to urinate multiple times a day and night, even when the bladder isn't full. Some causes of OAB that may be affecting your child’s urgency to urinate could be stress, anxiety, constipation, and bladder spasms. 

• Daytime incontinence -  Bladder instability is one of the most common causes for daytime accidents. What most people may not realize, daytime accidents can originate from constipation and enter a vicious cycle of your child’s colon not empty which leads to leftover stool (and the bacteria inside of the colon to migrate!) in the colon; contributing to UTIs. 

  • There are many solutions to treating daytime accidents as simple as praising your child, helping them relax, and creating a schedule to empower your child to have healthy bathroom habits. Next time, you have to use the bathroom, don’t be afraid to bring your child in with you so they can understand the process of going to use the bathroom and how the bathroom doesn’t have to be an unspoken scary place. 

How Does Pelvic Floor PT Work For Children? 

1. Gathering a lot of information from parents & child. We will send out intake paperwork to ask you in-depth questions about this journey. It will serve as a guide for us when we meet virtually or in-person to determine the best plan of action. Depending on the case, we may also ask your pediatrician or specialist if they can perform an abdominal X-ray to measure the amount of stool burden and the diameter of the rectum to determine what severity of symptoms we are faced with. This will also help establish a more realistic timeframe for resolving these symptoms. 

2. Pelvic floor assessment: We either can observe visually or through a gloved hand touch through pants with mom/dad, to see if there is awareness/movement of the pelvic floor. Another option is using biofeedback, which includes sensors being applied to the outside of the skin around the rectum which then shows activation and relaxation on a screen, like a TV. 

• •  We do not perform any internal evaluation on children. The only exception to this rule is if a child is a teen and having difficulty with sexual function, with their parent’s consent and our PT evaluating the maturity of the teen, we may perform an internal assessment. Otherwise, pelvic floor PT is always external. 

3. Getting to know your child! Are we avoidant of certain sensory factors, concerns with school, eating habits, feeling thirst? How can we understand this process on their level through cartoons and play?