Pediatric pelvic floor physical therapy is a specialized area of physical therapy designed to treat children with pelvic floor dysfunction.
It addresses many of the same muscle groups as traditional pelvic floor therapy, including themuscles that support the bladder and bowel, but the approach is adapted for childhood spinal and muscular development, as well as for childhood attention spans! Treatment is developmentally appropriate, play-based, and centered on building healthy bowel and bladder habits.
If your child struggles with constipation, bedwetting, or potty training delays, pediatric pelvic floor therapy may be an effective and conservative treatment option.
Yes! Up to 50% of children experience bowel or bladder challenges at some point in their development. Many of these concerns are treatable with conservative, noninvasive care.
Pediatric pelvic floor physical therapy commonly treats:
These conditions are not discussed as openly as they could be, meaning that they’re often accompanied by some level of anxiety and shame. But they are extremely common! When bowel and bladder symptoms persist, it is often not a behavioral issue. It may be a coordination issue involving the pelvic floor muscles and/or systemic deficits surrounding the gastrointestinal system that can be managed conservatively (or more likely a combination of the two).
The exact cause of constipation and related pelvic floor dysfunction in children is not always clear. It is usually multifactorial, meaning more than one factor contributes.
Possible contributors include:
Some research suggests constipation may be more common in children with anxiety or lower muscle tone. Regardless, these patterns are treatable. Pelvic floor dysfunction is not a sign of laziness or lack of effort. And it is not a sign of a parental failure.
With guidance and practice, children can learn to coordinate their postural and pelvic floor muscles more effectively and develop consistent bowel and bladder habits.
Children of all ages can benefit from treatment, especially for diagnoses such as functional constipation.
Pelvic floor dysfunction is most commonly seen in children ages five to ten. Younger and older children can also benefit based on the history and presentation. Treatment strategies are always adapted to your child’s developmental stage and comfort level.
Evaluation is designed to feel safe, collaborative, and age appropriate. And the parent is always included, though the goal is to give the child the ability to take charge of their plan of care.
It typically includes:
Most of the medical, birth, and developmental history is shared by the parent or guardian. The
child contributes as they feel comfortable.
We discuss:
The physical therapist assesses posture, breathing patterns, spinal mobility, and overall coordination to identify muscle imbalances that may contribute to constipation or incontinence.
In some cases, an external pelvic floor assessment may be guided by the therapist and performed by the parent. This is typically done at a later visit once the child feels comfortable with treatment and discussion. It is important to note that internal pelvic floor exams are never performed on children for pelvic rehabilitation, whether in person or virtually.
Treatment is play based and interactive.
Rather than traditional exercise sessions, therapy often includes:
Children learn how to relax and coordinate their pelvic floor muscles through activities that feel natural and are developmentally appropriate. They learn to establish a mind-body connection to control all involved musculature.
Education is a large component of pediatric pelvic floor therapy. Parents and caregivers play an essential role in supporting consistency at home.
Pediatric pelvic floor physical therapy is highly specialized. There are relatively few providers trained to treat this population, which can make access difficult.
Virtual care increases access and allows families to receive expert treatment without travel.
Parents also likely wonder whether their child will be able to focus during a virtual session.
With therapist guidance and parent involvement, virtual sessions can be effective and engaging. Treatment is interactive and adaptable. Education, which is a major part of pediatric pelvic floor
therapy, translates well to a virtual format.
Virtual sessions also allow treatment to happen:
Consistency is one of the most important factors in successful treatment.
Pelvic floor therapy is a process.
Most children begin with weekly sessions to establish coordination and routine. As progress is made, sessions may become less frequent while the home program becomes the primary focus.
Parental involvement is essential. Carryover between sessions, including implementing toileting routines and completing home activities, drives lasting improvement.
Every child is different and timelines vary. Many families can expect treatment to span approximately six to twelve months to fully address pelvic floor dysfunction and establish long term bowel and bladder habits.
With steady support and consistency, meaningful improvement is achievable.
Constipation, bedwetting, and incontinence can be frustrating for children and parents; they can often feel out-of-control and like they disrupt every part of life. It’s important to know these challenges are common and treatable.
Pelvic floor physical therapy provides a conservative, evidence based approach that focuses on coordination, habit formation, and muscle function rather than blame.
With the right support, children can build confidence in their bodies and develop healthy lifelong bowel and bladder patterns.
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