Pediatric Incontinence & Physical Therapy

What is pediatric pelvic floor dysfunction?

Pediatric pelvic floor therapy dysfunction refers to a wide array of issues that occur when the muscles are weak, in spasm or too tight. Basically, the pelvic floor muscles are not working together efficiently with the bladder or bowel. These muscle problems can cause bladder/bowel leakage, daytime incontinence, nighttime incontinence (bedwetting) or dysfunctional elimination patterns (going too frequently or barely going at all). Children who experience dysfunctional elimination syndrome are at further risk for developing urinary tract infections, potentially evolving to bladder or kidney infections.

This dysfunction in children is relatively common but many people do not know there is effective treatment in physical therapy.

What are the typical bladder and bowel habits in children?

  • Bladder: When a child is 1-3 years old it is typical to void 11 times per day. As they get older and the bladder capacity increases, this number goes down. By age 12, 5-7 voids per day is considered normal (the same as adults).
  • Bowel: Bowel frequency decreases with age. By age 4, bowel frequency should be similar to adults with 4-9 bowel movements per week.

Can my child benefit from pediatric pelvic therapy

Millions of children suffer with pelvic floor dysfunction and are not getting the right help. Therapy can provide the noninvasive tools your family needs to take control of your child’s bladder and bowel functions. Typically, treatment is relevant once your child is 5 years of age or older, when dysfunction is considered to be a medical problem impacting quality of life.

Optimally, the bladder and pelvic floor muscles work opposite each other to successfully urinate. When the bladder contracts or the bowels need to empty, the pelvic floor muscles relax. Your child will learn exercises to relax and strengthen the pelvic floor muscles at the appropriate time, positioning to help void and empty completely, as well as learn to avoid bowel or bladder leakage.

How do you treat pelvic floor dysfunction in pediatric patients and what can I expect from a visit?

It is important to note that children are seen by a provider specially trained in pediatric pelvic conditions and every child is seen with a parent or guardian during the course of treatment. We cover a bladder schedule to help improve bladder habits as well as education on how bladder function relates to pelvic floor muscles. External biofeedback of the pelvic floor muscles may be used to help relearn how to strengthen, contract, and relax muscles. Additionally, we will develop a home program that your child can work on between visits. Children are normally seen for 6-8 visits over the course of treatment, with each visit lasting between 40-60 minutes. Moreover, we work with every child and their guardian to establish a plan of care that will best suit their needs, and make necessary adjustments as they progress through physical therapy. 

//Originally published in the March 2018 issue of Nature’s Pathways Magazine.

//Tori splits her time between our Appleton and Menasha clinics. She specializes in pelvic physical therapy, and is trained in pediatric pelvic floor dysfunction. Call to book an appointment with Tori at 920-727-9878.