Can Pediatric Pelvic Floor Physical Therapy Help With Toilet Training?

    What is Pediatric Pelvic Floor Physical Therapy? 


    Toilet training can be difficult for both children and their parents or caregivers. When children are unable to gain control of their bladders or bowels, it can be very upsetting for everyone involved. When children are unable to achieve the same level of control as their peers, they may feel frustrated, angry, or have a sense of helplessness. This is especially likely to be the case as children continue to mature and develop.


    Most children are ready to start toilet training between the ages of 22 and 30 months, and the training typically takes about six months to complete. There are a variety of developmental aspects that can affect how quickly child masters using the toilet. Children in the United States are typically expected to have completed toilet training by the age of 3, which can have a negative impact on their ability to participate in activities at school and social gatherings. When “accidents” continue to happen despite an individual’s best efforts to toilet train them, pediatric pelvic floor physical therapy might be the next appropriate step.


    The primary goal of pediatric pelvic physical therapy is to help children and their families improve their ability to control their bowel and bladder coordination. This is distinct from traditional pediatric physical therapy in that the emphasis in pediatric pelvic physical therapy is placed on the muscles found on the pelvic floor.


    The muscles that make up the pelvic floor, just like any other muscles of the body, are capable of being trained using the appropriate exercise techniques. A great number of people, including children, struggle to achieve coordination of the muscles that make up the pelvic floor. These people require the assistance of a pelvic physical therapist to facilitate them through the process.


    Typical symptoms of the pelvic floor in children include the following:


    • Increased or decreased frequency in voiding
    • Incontinence of urine
    • Urgency
    • Nocturia
    • Incontinence of bowel movements
    • Constipation
    • Difficulty or pain when urinating or eliminating bowel movements


    Pediatric Pelvic Floor Physical Therapy: Evaluation


    This type of therapy requires a referral from a licensed pediatric urologist. The initial appointment for your child will consist of an evaluation and will last for approximately two hours. Before the first appointment for your child, you will be sent the necessary forms in the mail. Please remember to bring the finished forms with you so that the therapist can go over them with you and take a detailed medical history of your child.


    After that, the therapist will wrap the anus with electrodes that are gel-based. Your child will be sitting in a comfortable chair while they look at a computer that is linked to the electrodes. Your child can perform pelvic floor exercises on the computer, and the therapist, you, and your child will all be able to see the muscles contracting and relaxing as your child does so. After analyzing the results, the therapist will review them with you and your child and discuss their meaning.


    What does it look like when a child undergoes an evaluation for pediatric pelvic floor physical therapy? 


    The pediatric physical therapist will discuss the child’s symptoms and medical history with the parent(s) and/or caregiver(s). A general assessment of the child’s range of motion, strength, and coordination will be carried out as part of the general assessment of the child’s gross motor skills. In addition to providing the child with exercises and techniques to alleviate their symptoms, a bladder or bowel journaling may also be recommended, depending on the circumstances.


    What steps should I take to begin with pediatric pelvic floor physical therapy? 


    After diagnostic testing has been completed, the majority of pediatric patients have been recommended to participate in pediatric pelvic floor physical therapy by their primary care physician or a gastrology specialist. Although a referral is not considered necessary, having one can be helpful when deciding on a course of treatment for physical therapy. After that, they will create an exercise program tailored to your child’s needs and your own lifestyle habits.


    Pediatric Pelvic Floor Physical Therapy: What To Expect After Evaluation


    Your child will continue to be connected to the computer at each appointment following the evaluation in the same manner that he or she was during the evaluation. Your child will participate in several exercises designed to strengthen the pelvic floor muscles with the therapist’s guidance. Your child will be encouraged to continue working through the entirety of the session by receiving visual feedback from the computer.


    What are Pelvic Health Physiotherapists?


    Physiotherapists who are registered and specialize in the treatment of pelvic health issues are called “Pelvic Health Physiotherapists.” Pelvic health physiotherapists are required to get certifications by participating in ongoing continuing education and passing examinations to treat pelvic conditions. In the same way that physiotherapists working in other settings do, their mission is to assist their patients in returning as quickly as they can to their normal daily routines. Their ultimate objective is to assist patients and their families in reducing the negative effects that the patients’ and families’ concerns regarding their pelvic health are having on their lives.

    How exactly can a physiotherapist specializing in pelvic health assist children experiencing problems with their bowels and bladders?


    • Educating the child about the structure and function of their urinary and gastrointestinal systems entertainingly and imaginatively to engage the child in the care plan for their pelvic health.


    • Providing the child and their family with information about how the child’s diet and consumption of healthy fluids can affect the child’s bladder/bowel habits and overall pelvic health.


    • Educating about the anatomy and purpose of the pelvic floor muscles in a manner that is appropriate for the age and how these pelvic floor muscles are associated with successful bowel and bladder routines.


    • Provides techniques and exercises to help improve posture and alignment, both of which affect the pelvic floor’s efficiency and effectiveness.


    • Exercises that focus on strength-building and improving coordination in the core, hip, and pelvic floor muscles.


    • A variety of entertaining and unique recommendations to help children who have struggles voiding


    • Strategies for children and their families to implement if their children have a low bladder capacity or are constantly on the move to use the restroom.


    • Suggestions for children who struggle to control their urges to urinate or who experience urinary frequency when it is the appropriate restroom time.


    • Natural biofeedback techniques and methods to help the child better coordinate their pelvic floor muscles to improve their ability to use the bathroom on their own.


    • Child-tailored home programs designed to improve overall success with toilet training on a day-to-day basis


    • Family-specific timetables, charts, and tracking systems to monitor bowel and bladder function throughout the pediatric pelvic floor physical therapy plan of care to ensure that the patient is making progress and is successful.


    • Recommendations tailored to the needs of each child regarding toileting routines.

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