Pelvic Floor Dysfunction in Children and Adolescents: A Guide for Parents

Pelvic floor dysfunction, a condition affecting the muscles that support the bladder, bowel, and reproductive organs, is not limited to adults. Children as young as four years old can experience symptoms that may persist through adolescence. These symptoms can significantly impact a child's quality of life and may include urinary urgency, urinary frequency, urinary incontinence, bedwetting, and constipation. For example, a child may experience a sudden urge to urinate during travel, or a teenager may leak urine while participating in sports.

In some cases, pelvic floor dysfunction may be associated with congenital conditions such as anal-rectal malformations or tethered cord, which may require surgical intervention.

What are the Signs of Pelvic Floor Dysfunction in Children?

• Urinary urgency (sudden, strong need to pee)
• Urinary frequency (peeing very often)
• Bedwetting (after age 5)
• Constipation
• Encopresis (accidental bowel movements/pooping accidents)

How Can Physical Therapy Help?

Pelvic floor physical therapy offers a gentle and effective way to address these issues. Our therapists use a variety of techniques, including:

• Posture on the toilet and toileting techniques 
• Strengthening of the pelvic floor and core muscles 
• Muscle coordination exercises 
• Teaching a bowel massage 
• There could be tools used such as a visual biofeedback or surface EMG biofeedback 
• Expect to have a home exercise program issued using equipment like an exercise ball 
• May suggest behavior modifications if appropriate

What to expect at a physical therapy session

• We'll listen to your concerns, starting with a thorough history to understand your child's specific challenges.
• We'll assess your child's physical condition, evaluating strength, posture, and breathing patterns.
• We'll discuss toileting habits, diet, and fluid intake.
• We take a gentle approach and typically avoid internal or invasive treatments with children. If you have any concerns about treatment methods, please discuss them with your provider.

What Can You Do?

Pelvic floor physical therapy is a great treatment option with minimal side effects for the symptoms listed above. Here you can learn stretches, exercises, relaxation techniques, and improve toileting mechanics. We can coordinate the best care team for you. You can also reach out to our Pelvic Health Navigator at (402) 717-7358.