What is Pediatric Pelvic Physical Therapy?

Toilet training is a challenge for parents and caregivers. It can be distressing when children are unable to achieve control of their bladder or bowels.  Especially as children grow and develop, they may experience frustration, anger, or a sense of helplessness when they cannot seem to achieve the same level of control as their peers.  Most children are ready to toilet train between the ages of 22-30 months of age, with training duration lasting about 6 months.  There are numerous developmental factors that can impact the progression of toilet training.  In the United States, children are expected to be fully toilet trained by age 3, often affecting their participation in school activities and social gatherings.  When “accidents” continue to occur, pediatric pelvic physical therapy may be an appropriate next step in toilet training. 

Pediatric pelvic physical therapy focuses on helping children and their families with gaining control of their bladder and bowel coordination.  This is different from general pediatric physical therapy, because in pediatric pelvic physical therapy the focus is on the pelvic floor muscles.

The pelvic floor muscles, like any other muscle in the body, can be trained through appropriate exercise strategies.  Many individuals, including children, have difficulty in achieving coordination of the pelvic floor muscles and require the expertise of a pelvic physical therapist to guide them.  

Typical symptoms include:

  • Increased or decreased voiding frequency
  • Incontinence of urine: daytime or nighttime (enuresis)
  • Urgency
  • Nocturia (waking up at night to void)
  • Incontinence of bowel movements (encopresis)
  • Constipation
  • Difficulty or pain with emptying urine or eliminating bowel movements

What does the evaluation look like?

Your pediatric physical therapist will speak with the parent(s) and/or caregivers regarding the child’s symptoms and history.  A general gross motor assessment will be performed in order to assess the child’s strength, coordination, and range of motion.  Exercises and strategies to address the child’s symptoms will be provided, as well as a bladder or bowel diary if appropriate.  

How do I get started with therapy?

Most pediatric patients have been referred to pelvic physical therapy by their physician and/or gastrology specialist after diagnostic testing has been performed.  While a referral is not required, it can be helpful in determining physical therapy treatment.  At N2 Physical Therapy, we can develop an exercise program that is appropriate for your child and your lifestyle.  

About Dr. Bomarito

Patty Bomarito is a pelvic physical therapist who specializes in the care of the pediatric population as well as the prenatal and postnatal population.  You can request an appointment with Patty at our Capitol Hill location at https://provider.kareo.com/patty-bomarito.