Pediatric Incontinence

What is pediatric pelvic floor physical therapy?

Does your child have:

  • Daytime wetting (Urinary Incontinence)
  • Constipation/pain with bowel movements
  • Diarrhea with or without soiling underwear
  • Involuntary loss of stool (Encoporesis)
  • Pain/Burning with urination
  • Bed wetting (Enuresis)
  • Painful bowel movements
  • Constant strong need to urinate/defecate (urgency)
  • Urinary frequency (urinating more than 8 times in a 24 hour period)
  • Not fully emptying their bladder (urinary retention)
  • Abdominal/pelvic pain;vaginal/penis pain
  • Frequent urinary tract infections (after seeing urologist)
  • Painful periods
  • Bloating/excessive gas
  • Loss of urine with laughing (Giggle incontinence)

If so, your child may benefit from pediatric pelvic floor physical therapy.

5 million children complain of nighttime bedwetting

20% of pediatrician visits are for incontinence (loss of urine) problems

15% of gastrointestinal doctors visits are for lower bowel function.

3% of visits to pediatricians for constipation

Bladder and bowel dysfunction (difficulty with urination and/or having a bowel movement) affects many children but is often not discussed, even with doctors, and therefore goes untreated leading to further embarrassment and shame for children. It is key to address dysfunction early to prevent problems progressing in to adolescent and adult years.

It is not uncommon for a children ages 5 and older to have bowel and/or bladder dysfunction but it can be concerning to both children and parents. There may also be issues with pain around menstruation, urination and bowel movements that may benefit from seeing a physical therapist. Pediatric pelvic floor physical therapy looks to address the previously stated conditions from an evidence based perspective in a non-invasive, comforting environment.

Pelvic Floor Muscles:

The muscles and tissues that sit inside the pelvis work to create support for abdominal and pelvic organs and help control bowel and bladder activity. If these muscles are not working correctly, if they are too tight/weak or if they are hyper or hypo sensitive, dysfunction can occur and cause unwanted symptoms.

Medical research has shown that proper pelvic floor muscle training and biofeedback can greatly improve dysfunctional voiding in children.

Types of Pediatric Pelvic Floor Dysfunctions We Treat at
PT Your Way & Advanced Specialty Care:

Loss of urine (Urinary Incontinence): There are many causes of urinary incontinence in children including: constipation in which the stool in the rectum causes pressure on the bladder, tight or weak pelvic floor muscles, or more structural abnormalities that require further medical attention.

Urinary frequency: Having to use the restroom more than 8 times a day is considered urinary frequency. Urinary frequency can be caused from dietary issues, pelvic floor muscle overactivity, central nervous system dysfunction or inadequate voiding techniques. Depending on the actual cause of urinary frequency, the Therapists at PT Your Way will devise a specific treatment plan to restore a normal bladder emptying schedule.

Pelvic/Abdominal Pain: There are many causes of pelvic and abdominal pain, some of which can be helped with physical therapy. Here at PT Your Way, our therapists are skilled in addressing the source of the pain, not just the symptom of pain. Endometriosis, IBS/IBD and other GI dysfunction, tight pelvic floor muscles/guarding and history of trauma are just a few of the pediatric presentations we see for pelvic pain. Our therapists are able to use surface EMG and manual techniques to help the patient decrease sensation of pain and take back control of their lives.

Constipation: Having less than 3 bowel movements a week that are hard and enlarged can cause straining, pelvic floor muscle stretching, pain and can contribute to urinary incontinence. Children can develop a fear of having future bowel movements and a vicious cycle of avoidance and pain is established. We will address the cause of the constipation which can be from pelvic pain, muscle weakness/elongation, tightness or muscle spasms. We will educate both parent and child on proper nutrition, fiber and hydration, provide guidelines on bowel training and ensure your child is sitting correctly on the toilet. Establishing painfree soft and regular bowel movements is crucial for pelvic health. Constipation can be one of the main causes of bedwetting.

What to expect at PT Your Way:

PT Your Way recognizes the severity of these conditions in the pediatric population and works very hard to make both parent and patient feel comfortable. The advanced training of the physical therapist will allow for approaching each patient on an individualized level with extensive review of past medical history often done ahead of time depending on the age of the patient. The sessions are tailored to the patient based on age as well.

Treatments:

Therapists at PT Your Way are trained in addressing pediatric issues using research supported treatments. Treatments may include but are not limited to:

Explanation of anatomy on an age appropriate level to help the patient and family better understand the nature of the pathology.

Therapeutic Exercises: developed based on an individualized basis and dependent on pathology.

External examination of the pelvic region with parent present to determine if other comorbidities are present and if the patient can use pelvic floor muscles properly

Soft tissue mobilization for normalizing length/tension relationships of muscles and fascia

Food and fluid journals/Nutritional assessment followed by education per the child’s needs.

Visceral assessment and mobilization to ensure proper balance of the organs by assessing their mobility and motility

Surface EMG (biofeedback) as needed using sensors “stickers” near the perineum (EXTERNALLY) to help the patient better understand how the pelvic floor muscles are functioning. This modality is fully explained to family and child prior to use and is never a required intervention. However, research has shown the benefits in significantly improving bowel and bladder dysfunction. THis modality uses animation videos to help the child learn how to tighten and relax their pelvic floor muscles.

Bowel and bladder training:

With help from the family, a detailed journal of urinary and fecal frequency and consistency is recorded on a diary for 3 days up to 1 week. Depending on what is found in the records the child may be put on a specific bowel and or bladder training program.

The practitioners at PT Your Way strongly believe in an integrative approach and strive to work with your doctor and other members of the healthcare team for optimal outcomes.

Here at Physical Therapy Your Way & Advanced Specialty Care, we understand the importance of consistency in care. Therefore, you will work 1-on-1 with the same therapist throughout your rehabilitation. This partnership, will not only aid in improving your symptoms, but provide you with tools to help you control and manage your symptoms.

Closing Statement:

If you or someone you know may benefit from pediatric physical therapy, schedule a consult with us!

Help your child regain their confidence and manage their symptoms. At PT Your Way & Advanced Specialty Care, a physical therapist with expertise in pediatric pelvic floor dysfunction will work 1-on-1 with you and your child to improve symptoms and aid in the road to recovery. Our ultimate goal is to get your child back to performing the activities in their life that bring them joy without the added stress of pelvic floor, urinary or bowel dysfunction!

Call (571) 312-6966 to schedule an appointment or…

Email Your Questions to Our Knowledgeable Therapists

Recommended reference websites: i-c-c-s.org