Pelvic Health in Children 101

Odds are you’ve landed here because you’re curious about pelvic health in pediatrics and wanted to learn more! Or maybe your child is experiencing challenges and you are searching for answers. 

In either case, you’ve come to the right place! Pelvic floor dysfunction is pretty common, but rarely discussed. 

It is estimated that “constipation in children accounts for 3% of visits to a general pediatrician and up to 25 % of visits to a pediatric gastroenterologist in the USA” (Koppen et. al, 2015). In addition, roughly “20% of children have some problems with bedwetting at age 5, and up to 10% still do at age 7” (AAP, 2019). 

Let's talk about it…. 

Who has a pelvic floor?

Anybody with a pelvis has a pelvic floor - this includes kids too!

The pelvic floor is a unique structure made up of 16 muscles that connects on four bony points in our pelvic - the pubic bone, the coccyx (tailbone), and ischial tuberosity to ischial tuberosity (your sits bones - if you put your hands on your bum and sit on them (hehe!) you will feel them. Pretty big area right?! 

The pelvic floor functions much like other muscles in our body and is responsible for 5 things:

• Sphincter Control (able to control voiding urine & stool)

• Support/Organ Protection (uterus, bowel, prostate, bladder)

• Sexual Function

• Stabilization of your body

• Sump Pump (endocrine function)

So how can pelvic floor therapy help?

Pelvic floor therapists are occupational or physical therapists who have undergone multiple courses specifically in pelvic health. Our passion is working with anyone who may be experiencing dysfunction or disruption to the 5 key processes mentioned above (and more!). Some common diagnoses or complaints we see include:

• Constipation

• Bedwetting

• Potty training difficulties

• Urinary or fecal incontinence 

• Kids who are neurodivergent or have sensory differences (autism, ADHD, etc.)

• Medical diagnosis that involve the pelvic floor

• Children with a history of urological, gastroenteric, or neurological conditions

How do we assess and treat the pelvic floor? 

While adult-based pelvic floor therapy often involves intra-vaginal or intra-rectal assessment & treatment, pediatrics does not.

Assessment

• We assess your child’s functional movement, bowel & bladder habits, nutritional & fluid intake, discuss their daily routine & activities, challenges in school or at home, and more depending on your child and their needs.

• When indicated, a skin & perineal assessment may also be beneficial in helping us to address your child’s bowel or bladder issues.

• If necessary, external palpation of pelvic floor muscles is conducted to make sure that they’re functioning correctly.

Treatment

First and foremost, we work with your family identify ways to functionally address the challenges you are experiencing (read: no home exercise plans if that is not what will work for your family!). 

Treatment most often looks like play, but we are trained to look at the following through the games & activities we utilize:

• Core strengthening & coordination

• Nutrition & fluid intake

• Strategies to improve sensory-based challenges

• Positioning

• Possible modifications to your daily routine

If this sounds like something that your family would benefit from, we would love to hear from you! Schedule an evaluation in your Philadelphia area home or at our gorgeous clinic in Fort Washington, PA!  

Not sure your child needs pelvic floor therapy?

Schedule a discovery call with one of our pediatric pelvic health therapists or e-mail us at info@flourishpelvichealth.com!

Resources:

American Academy of Pediatrics (AAP). (2019, June 26). Bedwetting in children & teens: Nocturnal Enuresis. HealthyChildren.org. Retrieved February 2, 2023, from https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx#:~:text=Around%2020%25%20of%20children%20have,%25%20and%203%25%20of%20children. 

Koppen, I. J., Lammers, L. A., Benninga, M. A., & Tabbers, M. M. (2015). Management of Functional Constipation in Children: Therapy in Practice. Paediatric drugs, 17(5), 349–360. https://doi.org/10.1007/s40272-015-0142-4