PEDIATRIC PELVIC HEALTH
Pelvic floor physical therapy can be effective in helping a child gain control of his or her bladder and bowel. A group of muscles and soft tissue, called the pelvic floor, supports the pelvic organs and helps control urination/peeing and bowel control/pooping. Problems can occur in children that lead to difficulty with controlling urinating and bowel movements. This can happen when these muscles are too tight or too weak.
Pelvic Floor Therapy May Help With:
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Leaking urine/loss of urine (enuresis)
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Bedwetting (nocturnal enuresis)
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Waking up at night to urinate (nocturia)
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Giggle incontinence: leaking urine before or during laughing
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Frequent urination or overactive bladder
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Infrequent urination or under active bladder
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Constipation/diarrhea, painful bowel movements, over/under active bowels
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Fecal incontinence (encopresis)
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Abdominal pain
What to Expect at Your Child’s First Visit
During your first visit, you and your child will spend time talking with the physical therapist about what brought you in. This is a comfortable, low-pressure time to share your child’s story—what you’ve noticed, what your child is experiencing, and any concerns you may have.
Your therapist will ask questions about your child’s health, including bowel and bladder habits, to better understand what may be contributing to their symptoms. This information helps us create a plan that truly fits your child’s needs.
Next, the therapist will gently look at how your child moves. This may include watching them sit, stand, walk, and play. They’ll assess areas such as the hips, low back, tummy muscles, and pelvic region, as posture and movement patterns can affect the pelvic floor and bowel or bladder function.
Depending on your child’s concerns, a pelvic floor–specific evaluation may be recommended at a later visit. Internal pelvic floor exams are not typically performed on children. Pediatric assessments are done externally and are always child-friendly. Before any pelvic floor evaluation is performed, the therapist will clearly explain what it involves, why it’s helpful, and what you and your child can expect at the next session. You’ll have plenty of time to ask questions and make sure your child feels comfortable.
What to Expect During a Pelvic Floor Evaluation
We know that bowel and bladder concerns can be stressful for families. Our physical therapists work hard to make every pelvic floor evaluation calm, respectful, and supportive. Pediatric pelvic health is a routine part of our care, and your child’s comfort is always our priority. Because this is a sensitive area of the body, a parent or guardian must remain in the room for the entire session. The evaluation takes place in a private room on a padded therapy table—similar to what you might use during a massage.
What the External Assessment Looks Like
Your child will lie on their side or back, with their knees tucked to their chest. They will need to undress from the waist down so the therapist can see the anal and perineal area. This lets us observe how the pelvic floor muscles work.
The therapist will gently observe how your child:
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Tightens the pelvic floor (as if holding in urine/pee)
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Relaxes the pelvic floor (as if urinating)
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Bears down or “pushes” (similar to passing gas or having a bowel movement)
These observations help us understand how the muscles are coordinating, which is essential for bowel and bladder function.
Biofeedback (If Recommended)
Some children benefit from external biofeedback. This uses small stickers (electrodes) placed on the skin near the anus. The electrodes do not send electricity—they simply read what the muscles are doing. Visual feedback helps children learn to coordinate their pelvic floor muscles better.
Your Child’s Comfort Comes First
You and your child are in control throughout the entire process. You can ask questions at any time, request a pause, or choose not to continue with any part of the evaluation. Our goal is to create a safe, respectful environment where your child feels supported—not overwhelmed.
