Pediatric Pelvic Health Therapy

Did you know? Bedwetting, or enuresis, affects15% of girls and 22% of boys.

Talking about bowel (poo) and bladder (pee) habits can be very private and personal for both your child and for you! However, you should know you are not the only one going through these experiences, and we are here to help!

Our physical therapists can work with your child’s pelvic health challenges through a treatment plan that includes education, exercises, biofeedback, stretches, manual feedback, and breathing techniques.

Diagnoses or conditions treated as part of pelvic health include:

  • Urinary incontinence: uncontrollable leakage of urine
  • Enuresis (bed-wetting): nighttime accidents
  • Overactive or underactive bladder
  • Urge incontinence: sudden and unexpected urge to immediately void (pee) which leads to leakage because your child cannot hold it
  • Voiding postponement: “holding in” the pee and/or poop
  • Difficulties with peeing or pooping
  • Stress incontinence: urinary leakage during jumping or playing on the playground
  • Vaginal reflux: vaginal entrapment of urine that then causes leakage within 20 minutes after voiding (peeing)
  • Giggle incontinence: leakage during laughter
  • Bowel bladder dysfunction: bladder dysfunction due to constipation
  • Nocturia: waking up in the middle of the night to go to the bathroom
  • Dysuria: pain with urination
  • Bowel dysfunction: challenges with bowel movements
  • Constipation: retention of stool with decreased bowel movements
  • Encopresis or fecal incontinence: involuntary passing of feces (poop)
  • Anal incontinence: involuntary passing of feces and gas
  • Functional fecal retention: when a fecal mass forms due to avoiding going poop
  • Toilet refusal syndrome or a phobia related to toileting

Normal ranges for going bladder voids and bowel movements:

Bladder voids (Peeing):

  • Approximately 11 times per day for ages 1-3 years old
  • Approximately 4-6 times per day for ages 4 and older

Bowel movements (Pooping):

  • Before age 4, many factors such as diet and motility will impact the number of bowel movements a child has
  • After age 4, the normal range is 4-9 bowel movements per week

If your child is outside of these ranges, you should talk to your child’s pediatrician or contact one of our physical therapists for help in determining the cause.

Potential changes that should be of concern:

  • Sudden change in bowel and/or bladder function
  • Loss of strength
  • Loss of sensation in the legs or tingling sensation
  • Increased falls
  • Weak stream when urinating
  • Low back pain

What should I expect when seeing a physical therapist for concerns with my child’s pelvic health?

Our physical therapists have taken extensive continuing education and training to help make this process as easy as possible for both your child and for you! 

Our evaluation and treatment process includes:

  • Review of your child’s medical history, diet, and current concerns
  • Education about your child’s toileting habits and challenges
  • Determining your child’s strengths and weaknesses
  • Assessing areas in your child such as posture, strength, flexibility, coordination, pelvic floor muscles, and an external examination.  Please note that internal examinations are never performed.
  • Developing a plan of care that is best for you and your child. This may include referrals to outside healthcare professionals to provide the best all-inclusive care.

Resource:
Sandalcidi, Dawn. 2021. “Pediatric Incontinence and Pelvic Floor Dysfunction.” Online Continuing Education through Herman & Wallace. Lecture presented online via teachable, September 18.