Pediatric Pelvic Floor Dysfunctions

Is your child over 6 years of age and wetting the bed?
Is your child over 4 years of age and still wearing pull ups?
Is your child on medication to regulate his/her bowel/bladder?

Although millions of children have been reported with pelvic floor dysfunction, many do not get the help they need. Typically, children are toilet trained by age 4 with only occasional problems. Pelvic floor dysfunction contributes to many of the above problems and occurs when the muscles of the pelvic floor are weak, or tense/tight. The pelvic floor muscles are basically a sling running from the tailbone to pubic bone, and are responsible for controlling the passage of bowel and bladder, and support our organs sitting above the sling (with the help of our low abdominals).

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    Does your child suffer from any of these problems?

  • Constipation
  • Fecal urgency
  • Bowel incontinence
  • Pain with defecation, inability to start bowel movement or empty bowels completely, straining
  • Excessive gas, abdominal bloating
  • Diarrhea
  • Urinary frequency (urinating over 8 times in a 24 hour period)
  • Urinary retention (not fully emptying bladder)
  • Nocturia (urge to void awakens child at night)
  • Enuresis (leakage at night while sleeping, or bedwetting)
  • Urinary incontinence (loss of urine)
  • Urinary urgency (constant/strong need to urinate)
  • Hesitancy (difficulty initiating voiding after age 5)

If you answered yes to any of the above, the Physical Therapists at Midwest Physical Therapy can help your child. They specialize in treating boys and girls with these problems.


Our first meeting includes the child and their parent/s or guardian and involves history taking and education about the pelvis, how the bowels and bladder work (provided at an understandable level for the age of the child). We also discuss diet, sleep patterns, fluid intake, voiding patterns, toileting habits, and other behavioral or environmental problems that could be contributing to the problem. The physical examination is done with an adult present and performed over clothing. With the patient’s (and parent’s) consent, muscles around the pelvis and stomach are tested for strength and flexibility. We work closely with the referring physician and Pediatrician to develop a plan of care.

Treatment sessions are one-on-one and performed in private and comfortable rooms, and may include some of the following:

  • Biofeedback and RUSI (rehabilitative ultrasound imaging)
  • Behavioral and diet modification
  • Education/Instruction in correct toileting habits
  • Strategies to avoid straining
  • Massage to abdomen/bowel
  • Hot and cold therapy
  • Strengthening of pelvic floor and surrounding muscles
  • Relaxation techniques
  • Logging/accountability for program and reward system