Physiotherapy
Pediatrics Pelvic Health
Why do Pelvic Health Symptoms occur in children?
The pelvic floor is a group of muscles located within the pelvis, connecting to the pubic bone at the front, the tailbone at the back, and the sitting bones on either side. In children, these muscles play a key role in controlling the bladder and bowels, supporting healthy circulation, contributing to core strength, and providing support for the pelvic organs.
When pelvic health symptoms occur, it often means the pelvic floor muscles are either overactive or underactive. Hypertonicity happens when the muscles contract too much, becoming overworked and overly tight. Hypotonicity is the opposite—when the muscles don’t contract enough, leaving them too relaxed. Both conditions can lead to pelvic health problems in children.
There are many reasons why a child may experience urinary incontinence. This can include constipation² as well as cognitive and behavioural factors, such as difficulty recognizing the need to urinate, stress, and anxiety³. For this reason, it’s important to address the issue using a holistic, comprehensive, and multi-system approach.
Symptoms and Conditions in Pediatric Pelvic Health
● Daytime Urinary incontinence (during coughing, sneezing, exercise, laughing)
● Nighttime bedwetting (Enuresis)
● Urinary frequency or urgency
● Under-active bladder or urinary retention
● Chronic Constipation or stool retention
● Fecal incontinence
● Pain while voiding bladder or bowels
● Pain in perineal or rectal region
How can Pediatric Pelvic Health Physiotherapy help?
A Pediatric Pelvic Health Physiotherapist is specially trained in evaluating, managing, and treating conditions related to children’s pelvic health. The assessment begins with a thorough discussion of the child’s medical history to gain a clear understanding of their concerns. This is followed by a physical examination that may include assessments of breathing, posture, movement, muscles, joints, connective tissue, and other body systems.
With consent, the pelvic floor may be examined using visual observation, gentle external palpation, and biofeedback techniques. Based on the findings, the physiotherapist will collaborate with the child and their family—and, when needed, coordinate with other healthcare providers—to create the most effective treatment plan.
What does treatment involve?
Treatment plans are always personalized to meet the unique needs of each child. Your physiotherapist will consider the child’s medical history, results from the physical examination, the needs of the family, and overall goals to create the most effective treatment approach. Treatment options may include:
● Education regarding the child’s symptoms, condition, assessment findings, and treatment plan
● Bladder habit modifications and training
● Bowel habit modifications and training
● Strategies regarding toilet positioning
● Constipation management
● Targeted manual therapy of the myofascial system
● Visceral mobilizations
● Pelvic floor muscle downregulation and relaxation
● Pelvic floor muscle strengthening and training
● Biofeedback techniques to help increase awareness
● Motor control training and strengthening of the deep core musculature
● Motor control training and strengthening of the abdominal wall, hips and thorax
● Postural education and retraining
● Functional retraining of the neuro-muscular system to achieve the child’s movement and activity goals
● Liaising with the child’s other healthcare professionals to achieve holistic and comprehensive treatment outcomes
If you are unsure of whether Pelvic Floor Physiotherapy will help with your symptoms and condition, we highly encourage you to contact us for a 15 minute Free Phone Consultation. One of our specialised Pelvic Floor Physiotherapists will discuss your concerns with you, and help you determine whether this is the best course of treatment for you.
1. International Children’s Continence Society, 2015. Accessed: October 2, 2021.
2. Constipation in Children (2013). Accessed: October 2, 2021. http://digestive.niddk.nih.gov/ddiseases/pubs/constipationchild/#common
3. Thibodeau, B. A., Metcalfe, P., Koop, P., & Moore, K. (2013). Urinary incontinence and quality of life in children. Journal of pediatric urology, 9(1), 78-83.
4. Urinary Incontinence in Children. (2012). Accessed: October 2, 2021 from http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren/index.aspx