Understanding Paediatric Pelvic Floor Physiotherapy: A Guide for Parents

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Introduction

Urinary and bowel incontinence can be challenging for both kids and their caregivers. As parents, it’s natural to be concerned about what is considered “normal.” In this guide, we’ll shed light on typical bathroom behaviors based on age and explore how paediatric pelvic floor physiotherapy can be a game-changer in addressing issues related to incontinence.

Normal Bathroom Frequencies:

Understanding typical bathroom habits for different age groups is crucial. 

  • By the age of 5, most kids achieve full bladder control with 4-7 pees a day.
  • Nighttime waking for bathroom visits should decrease by this age, and dry nights usually follow within six months of gaining daytime bladder control.
  • By 12 years old, children should average 4-6 pees per day
  • Regular bowel movements should occur daily to every other day, with stool looking like long squishy snakes.

Urgency in Kids:

Feeling the need to go “RIGHT NOW” is normal until around age 5 or when a child achieves bladder control. If urgency persists, it may indicate overactive bladder muscles or difficulties recognizing early signals from their body.

How Pelvic Floor Physiotherapy Can Help:

Pelvic floor physiotherapy is a specialized branch of physical therapy tailored to children’s unique needs. At PlayWorks Physio, we focus on empowering kids to understand and control their bodies, ultimately restoring confidence in play.

Holistic Approach:

Our holistic approach addresses various factors contributing to incontinence, such as:

  • Muscle Dysfunction: Pelvic floor physiotherapy assesses and corrects weak or overactive pelvic floor muscles to restore control.
  • Posture and Alignment: We use engaging games to correct posture and alignment issues, promoting overall pelvic health.
  • Coordination and Control: Tailored techniques help children coordinate muscles involved in bladder control based on their developmental stage.
  • Behavior: For children with fears or challenges related to the toilet, we collaborate on problem-solving strategies for success.

Customized Treatment:

Treatment plans vary based on each child’s unique needs. Whether it’s working with neurodiverse children or addressing incontinence in elite teenage athletes, our team is dedicated to finding the best solutions for every situation. If your child is having pee or poop accidents outside of the ages listed above or if they are experiencing constipation, we can help. Also, if you have a child who experiences leaks throughout the day, especially with sports or higher impact activities, a pelvic floor physiotherapist can help. To learn more about physiotherapy for kids, click here.

Conclusion:

At PlayWorks Physio, we believe in providing comprehensive support to help children overcome incontinence challenges. Our paediatric pelvic floor physiotherapy aims to enhance the quality of life for kids, empowering them to embrace play with confidence. If you have concerns about leaks, urgency, or constipation, we’re here to help every step of the way. Click here to book a Pelvic Floor Initial Assessment.

Written By: Kate Heays

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A to Z what about Pee?!

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A to Z but what about Pee !?

Summer holidays – one of the most awaited times of the year! Perhaps it involves a camping trip, or a summer slumber party. Whatever it is; it’s time for kids, and parents to relax, reset, and be stress free from the school year! 

That is the case, unless you’re a kiddo (or a parent of a kiddo) with urinary incontinence. Summer holidays and fun, social plans can be absolutely terrifying. 

How can I go on a camping trip if I pee my pants sometimes?

How will my child go to the birthday sleepover if they wet the bed some nights? 

The most important thing to know is that wetting the bed, or clothing is not your fault, nor your kiddo’s fault. There are many things out there (including Paediatric Physio!) that can help kids decrease these occurrences, so keep smiling … we can help! 

A second crucial thing to know, is that this is more common than you might imagine. The number of children and teens who struggle with continence is astounding, so it’s not just you and your kiddo. And want to know something else? It’s especially common in athletes! So you’re not alone! Helping your child realize that several kids in their class or on their sports teams also live with this can help them appreciate this more. Urinary leakage typically comes with a bunch of shame, guilt and fear. So try to let it go, and again…it’s not your fault!

There are a few definitions I’m going to go over so you can start to understand what may be going on with your situation:

Continuous incontinence – this is for kiddos who constantly leak in non-discrete amounts. This is something that you should see a doctor about, and is usually more of a “hardware” issue, than a “software” issue.

Intermittent Incontinence – this applies to kiddos who have specific, urinary leakage incidents. This can be daytime only, nighttime, only, or both. It can be for kiddos who are over the age of 5 who never achieved continence (primary), but also for kiddos who have previously attained bladder control (secondary). More specific categories include:

    • Urge Incontinence: when a kiddo has a sudden or unexpected need to pee and can’t make it to the toilet in time.  
    • Stress Incontinence: when a kiddo has leakage with a specific activity such as coughing, sneezing, or laughing BUT ALSO during sports when you kick, run, or hop!
    • Nighttime Incontinence: when a kiddo wets the bed at night 

Who are the culprits ?!

Now you’re likely not going to believe this (as did I when I first heard it), but one of the main suspects of urinary incontinence is constipation! Let me explain…

When your rectum is full (even more so in little bodies), it pushes on the bladder and doesn’t allow it to fully fill. Furthermore, all that build up in the abdomen puts extra pressure on the “sensors” making it difficult to tell when it’s really time to go. Even pooping daily can mean constipation, so, everyone is assumed to be constipated until proven innocent! 

Next on the suspect list are those sneaky pelvic floor muscles. These muscles sit in your pelvis and control the flow of pee and poop out of your body. Sometimes they can be weak, however they can also be tight and gripping, trying to hold everything in. When these muscles can’t contract properly, it causes constipation, poo stains in undies, itchy bums, pee dribbles and even those bigger leaks. 

Other culprits can include things such as family history, life events (new sibling, divorce, illness/injury, etc), frequent urinary tract infections, early toilet training and sensory involvement. 

Ta-Da! The solution:

  1. Say it, repeat it, believe it: It is not your fault. You are not alone 🙂 
  2. Get yourself to a qualified physio who has extra training to treat the pelvic floor, but also who has experience working with kids. They will be able to assess the muscles (in a non-invasive way!!) as well as determine other culprits at play. Based on what they find, your paediatric physio can help you come up with a fun plan to becoming continent! CLICK HERE to book an appointment.
  3. It’s important to have a proactive health care team that is up to date with what’s going on. Knowledge is power and having a supportive team will help make the journey even easier! 

For more information check out this cool video made by SickKids in Toronto for a great summary!

https://www.youtube.com/watch?v=E8Khck8lWak

If you want to schedule an appointment with our paediatric physio and pelvic floor trained physio CLICK HERE.

Written by: Karly Dagys, Physiotherapist

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