Paediatric Pelvic Floor Physiotherapy

Children are not just tiny adults.

The first few years in a child’s life are crucial for the developing pelvic floor organs, including the bladder and bowels. By 36-months of age, most children have finished potty-training and can (for the most part) receive sensations of needing to urinate or have a bowel movement. After this age, if a child continues to have issues of urinary leakage, bed-wetting or stool withholding then a pelvic floor assessment can be helpful in recognizing the many factors that could be involved.

These factors include:

Diet

Lifestyle habits

Relationship with the potty/toilet

Sleep apnea

Psychological factors

And more…

What is Encopresis?

Encopresis is the term given to the soiling of stool in clothing of a child who is above the potty-training age, most often as a result of stool-withholding or severe constipation. The pelvic floor muscles play a major role in holding and releasing stool when appropriate. When a child suffers from ongoing constipation, the rectum can stretch and lead to leakage of stool matter in the underwear (also called “fecal incontinence”). Paediatric pelvic floor physiotherapy can be helpful in addressing these issues and identifying the contributing factors to reduce constipation, soften stool and strengthen the pelvic floor muscles responsible for maintaining fecal continence.

Urinary Incontinence

There are two types of paediatric incontinence: nocturnal (night or bedwetting) and diurnal (day wetting). Children can experience either one or both types of leakage. Many factors can contribute to ongoing urinary incontinence, including:

  • Voiding dysfunction or deferral

  • Urinary tract infection

  • Pelvic floor weakness

  • Distraction/Avoidance

  • Uncompleted toilet training

  • Unnatural voiding positions

  • Family history

Very commonly, urinary incontinence is associated with constipation that may or may not be diagnosed. In many children, treating constipation first may relieve signs of accidental wetting and allow them to regain control over their bladder.

If your child is over 5 and still having trouble holding in their urine, it is important to have them assessed by a paediatric or pelvic health physiotherapist.

What to expect from your child’s first appointment?

Unlike adult pelvic health exams, there is no internal component for the child. Instead, the physiotherapist will take a detailed history from the parents and child to determine the root cause of the problem and offer suggestions for behaviour modification as well as exercises to treat the incontinence. If needed, the physiotherapist may need to physically assess the pelvic floor muscles through gentle palpation and observation. Consent must be obtained from both the child and parent, and the parent must always be present during the appointment.

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