Tag Archives: incontinence

Pediatric Pelvic Floor Therapy

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Potty training for any family is rarely described as an easy process. Yet when the child also struggles with functional constipation (no signs of abnormalities physically, seems to be of functional cause) and/or encopresis (involuntary defecation) it turns into a frustrating process that is difficult to get a handle on. Other factors and diagnosis that can prolong toilet training are Hirschsprung disease, Crohn’s, Imperforate anus, Celiac disease, slow transit systems, developmental delays, sensory processing disorders, Autism spectrum disorders, etc.

Pelvic Floor Therapy using Biofeedback (surface EMG)/Real Time Ultrasound (RTUS), therapeutic exercises, nutrition advice, and life style modifications can help navigate this difficult process and improve symptoms associated with chronic constipation, encopresis, and chronic laxative use.
Several studies have concluded positive outcomes with Pelvic Physical Therapy interventions.

A study completed by Zivkovic et al in 2012 looked at the use of diaphragmatic breathing exercises and retraining of the pelvic floor in children with dysfunctional voiding. They defined dysfunctional voiding as urinary incontinence, straining, weakened stream, feeling the bladder has not emptied, and increased EMG activity during the discharge of urine. Although this study focuses primarily on urinary issues, it also includes constipation in the treatment and outcomes. Forty-three patients between the ages of 5 and 13 with no neurological disorders were included in the study. The subjects underwent standard urotherapy with included education on normal voiding habits, appropriate fluid intake, keeping a voiding chart, and posture while voiding in addition to pelvic floor muscle retraining and diaphragmatic breathing exercises. Results showed 100% of patients were cured of their constipation, 83% were cured of urinary incontinence, and 66% were cured of nocturnal enuresis.

A recent study by Farahmand et al in 2015 researched the effect of pelvic floor muscle exercise for functional constipation in the pediatric population. Stool with holding and delayed colonic transit are most often the causes for children having difficulty with bowel movements. Behavioral modifications combined with laxatives still left 30% of children symptomatic. Forty children between the ages of 4 and 18 performed pelvic floor muscle exercise sessions at home, two times per day for 8 weeks. The children sat for 5 minutes in a semi-sitting (squatting) position while being supervised by parents. The patients increased the exercise duration 5 minutes per week for the first two weeks and stayed the same over the next six weeks. The results showed 90% of patients reported overall improvement of symptoms. Defecation frequency, fecal consistency and decrease in fecal diameter were all found to be significantly improved. The number of patients with stool withholding, fecal impaction, fecal incontinence, and painful defecation decreased as well.

Children and parents gain confidence and knowledge to take control of stooling and urination issues when they have the right information and tools to do so. Overall, it is important to know toileting problems are common in children and Pediatric Pelvic PT can help your family engage in a plan for success.

Call us with any questions and speak with your health care provider if a family member may be in need of this specialty.

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What is Pelvic Physical Therapy?

What is pelvic physical therapy?

Pelvic physical therapy is a specialization within physical therapy that addresses musculoskeletal dysfunction of the muscles of the pelvic floor as well as the muscles stabilizing the hips and core. Dysfunction in these muscles can lead to urinary or fecal incontinence, constipation, pelvic pain (including pain with sexual activity), difficulty reaching orgasm and even erectile dysfunction.

Who can benefit from pelvic physical therapy?

Men, women and children can all benefit from pelvic physical therapy. Some common diagnoses include:

  • Children with constipation, bed wetting, soiling of urine/feces during the day.
  • Women with pelvic pain, urinary incontinence, prolapse and post-partum.
  • Men with pelvic pain (including testicular and penile pain), erectile dysfunction, and urinary incontinence post-prostatectomy.

Who can practice as a pelvic physical therapist?

A physical therapist who completes post-graduate advanced education on the evaluation and treatment of pelvic floor dysfunction. These physical therapists often have additional post-graduate education on other systems including orthopedic, gastrointestinal, pediatric, reproduction/sexual health and are experts in treating musculoskeletal conditions of the pelvis.

A New Resource for Pelvic Floor Physical Therapy

This site is currently being constructed to serve as a resource for physicians, therapists and patients seeking more information about treatment options for a variety of pelvic floor dysfunctions.  The site will be managed by San Diego Pelvic Floor specialist Renee Cinco, PT of FunctionSmart Physical Therapy.  We will feature articles from experts both local and national to provide an online resource for men and women seeking options for care.  Many men and women suffer in silence with symptoms of incontinence, pelvic pain, painful intercourse, chronic constipation and much more.  We feel it’s time to break the silence.  Thank you for visiting.