Pediatric Pelvic Floor Physical Therapy

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Pediatric Pelvic Floor Physical Therapy

Author: Juliana Remer PT, DPT N2 Physical Therapy Denver location

Potty training is often a challenging time for parents and kids. Most kids during this period will experience wetting or soiling episodes during the years of potty training.

However, by the age of six, the majority of children have full control of their bowel and bladder function. Yet, an estimated 20% of pediatric visits are for concerns regarding bladder and bowel problems.

Also, according to the International Foundation for Functional Gastrointestinal Disorders (IFFGD) 10-25% of children visiting a pediatric gastroenterologist are complaining of constipation or encopresis (bowel leakage).

This can be a very frustrating for both the parents and the children. It is important to know that help is available; an emerging, safe and effective treatment for these children is pelvic floor physical therapy.

Common issues with pelvic floor dysfunction in children can result in the following issues:


  • Urinary incontinence
    • Daytime wetting
    • Nighttime bedwetting(nocturnal enuresis)
    • Giggle incontinence
    • Stress urinary incontinence
  • Overactive bladder
  • Urinary urgency/frequency
  • Urinary retention (vesicoureteral reflux)
  • Dysfunctional voiding


  • Chronic constipation
  • Painful defecation
  • Fecal incontinence (encopresis)
  • Fecal urgency/frequency


  • Abnormal bloating (abdominophrenic dyssynergia)
  • Abdominal pain

The pediatric gastroenterologists or pediatric urologists will first perform tests to rule out infections, congenital issues, central nervous system or endocrine causes of voiding dysfunction. If it has been determined that there is a sensory and muscular component that is contributing to a child’s bowel and/or bladder problems then physical therapy can definitely help.

Pediatric Pelvic Floor PT

Image via Flickr by Torrey Wiley.

What to expect with pediatric pelvic floor physical therapy:

Each appointment will be in a private room with the parent or guardian present. Successful treatment really relies on the collaborative team of the MD, the parents, the PT and of course the child.

Treatment will include:

  • Education on how the bowel and bladder works
  • Use of a bowel and bladder diary
  • Dietary/nutritional education
  • Postural assessment
  • Pelvic floor education using biofeedback
    • Biofeedback is a tool to help the children understand and learn how to the pelvic floor muscles function. External electrodes are used and connected to a screen with traditional or more kid friendly graphics.
  • Breathing techniques and exercises
  • Manual therapy (belly massages, myofascial techniques)
  • Nothing will be painful and your child’s comfort and understanding is integral

It is important for the child and the family to know that these bowel and bladder problems are not his or her fault. Treatment is positive and compassionate and gives the child confidence to progress and succeed.

We have physical therapists at each N2 Physical Therapy location that have training in pediatric pelvic floor physical therapy. Please call the location most convenient to you if you have any questions or would like to schedule an appointment.

Juliana Remer PT, DPT

Featured image via Flickr by Todd Morris.

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About the Author:

Juliana Remer PT, DPT
Juliana focuses on treating patients with chronic pain, hip, sacroiliac joint and lumbar spine dysfunction. She holds certifications in Functional Dry Needling, the Selective Functional Movement Assessment and the Functional Movement Screen.

Juliana received her Doctorate of Physical Therapy from Regis University, and dedicates her continuing education to pelvic floor coursework.

Location: N2 Physical Therapy Denver