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Pelvic Health

Pediatric Pelvic Health

Pediatric Pelvic Health Physical Therapy in Midtown East Manhattan

Pediatric Pelvic Therapy

Having a child experience difficulty with bowel and or bladder control can be an overwhelming emotional situation for both the parent and child. It is often difficult to understand the dysfunction as a parent, and it can be frustrating not knowing how to help. Children are often left feeling shame and embarrassment, which can sometimes exacerbate the problem and lead to behavioral changes. Typically, children are toilet trained by age 4. After age 4, bowel and bladder dysfunction is considered a major medical issue that can affect the family unit. Pelvic problems in children can greatly influence the quality of life, self-esteem, social interactions, and participation in sports. Millions of children suffer from pelvic floor dysfunction. In fact, 20% of all pediatric visits are for incontinence problems. Unfortunately, most children with these problems don't receive the correct treatment.  Pediatric pelvic floor physical therapy in Midtown East Manhattan can help you and your child learn strategies to manage these issues.

Common Pediatric Pelvic Health  Problems that can be addressed with Pelvic health Physical Therapy:

  • Enuresis: Urinary Incontinence/Bedwetting (Nocturnal Enuresis)
  • Urinary Frequency (increased or decreased)/Urgency 
  • Urinary Retention
  • Day-time incontinence
  • Giggle incontinence
  • Nocturia: Waking up in the night to urinate
  • Difficulty with urination: straining, slow flow, pain with or after urination
  • Reduced sensation of bladder or bowel fullness
  • Pain in abdomen, bladder or lower back
  • Chronic Constipation
  • Encopresis: Bowel incontinence and/or the inability to empty the bowel
  • Recovery following pediatric pelvic surgery
  • Vesicoureteral reflux: Abnormal flow of urine from the bladder up towards the ureters (towards the kidneys). 
  • Neurological disorders: Children with Cerebral Palsy, Autism, Down’s Syndrome, and Spina Bifida have a higher incidence of constipation and bladder dysfunction.  They often have muscle tone and mobility impairments that require an integrated pediatric and pelvic therapy approach.

Pediatric Pelvic Health Physical Therapy in Midtown East Manhattan

Physical Therapy is a non-invasive approach that can be very effective in helping your child gain control and independence with bowel and bladder function. Pediatric pelvic rehabilitation uses special techniques to treat disorders affecting the pelvis and pelvic floor muscles that may be the root cause of bladder and bowel voiding problems and pain.  Your child’s therapist will evaluate the muscles of the pelvic girdle and pelvic floor to determine whether they are weak, tight, painful, or lack the appropriate coordination associated with normal bowel and bladder functioning. Examination of pelvic floor muscles is performed externally. A pelvic physical therapist can help restore normality in bladder and bowel function and prevent the progression of problems that, if left untreated, may be carried over into adult life. Pelvic dysfunction problems in children are markedly different from those in adults, and our therapists are specially trained in pediatric pelvic health physical therapy. They will work closely with you, your child, his/her pediatrician or other healthcare providers to provide a specialized treatment program that will meet your child’s individual needs.  Due to the embarrassment, anxiety, and pain often associated with bowel and bladder issues in children, it is the goal of your child’s physical therapist to make the evaluation and follow-up treatment sessions as comfortable as possible for both you and your child. You or an authorized guardian will always be present in a comfortable and private room. 

What to Expect During Your Child’s First Visit:

You and your child will first meet with your Physical Therapist to discuss what brought you to Pelvic Physical Therapy.  This is a great opportunity to tell “your child’s story” about their complaint or difficulties.  The therapist will then ask questions about your child’s symptoms and medical history.  Questions will hone in on information about current and past bowel and bladder history.  The goal is to obtain as much relevant information about your child’s condition to determine the best treatment plan to help your child get better.  Once all the pertinent information is gathered, the therapist will examine your child’s sitting and standing posture, their gross motor skills, and how he/she moves.  The way you hold your body and move may affect the pelvic floor region.  Additionally, the therapist will evaluate your child’s low back, abdominals, hips, and pelvic girdle, assessing their alignment, range of motion, strength, and coordination.  Dysfunction in these areas can contribute to pelvic floor and bowel/bladder problems.  Your child’s first session will provide the therapist with a wealth of information to help guide the treatment program. 

Pelvic Floor Treatment Techniques may include:

  • Pelvic floor relaxation and/or strengthening exercises
  • Core muscle and breathing coordination exercises
  • Coordination training of pelvic floor and pelvic girdle musculature
  • Behavioral training and education on toilet habits/hygiene/hydration
  • Modalities and manual techniques for pain or myofascial restrictions
  • Biofeedback to help regain control of the pelvic floor muscles

Biofeedback Therapy in Midtown East Manhattan

Biofeedback is a fundamental tool for pelvic floor physical therapy.  It improves neuromuscular control of muscles by externally measuring the level of muscle activity.  It then translates this muscle activity into a visual representation which can help you understand how to most effectively activate the appropriate muscles. It assists in understanding whether a muscle is being contracted too much or too little by comparing the feeling with the visual representation on the computer screen.  Additionally, it helps in the evaluation of the pelvic floor muscles, allowing the therapist to tailor an exercise program specific to each child’s needs.  For children, the added benefit of the computer representation is that it can be turned into a game, thus improving their enjoyment and motivation.   Biofeedback helps patients learn how to control muscles they probably were never aware they had.  It can help strengthen or activate underused and weak muscles (often in the case for those who suffer from incontinence or prolapse).  Likewise, it can assist in relaxing muscles that are tight and overused (such as for those with chronic constipation, dyssinergia, or anism in which the anal muscles cannot relax to allow for defecation).  For those with pain due to tight pelvic floor muscles (such as dyspareunia and vaginismus), biofeedback is a very helpful tool in learning to relax overworked muscles.

Call us today to learn more about our pediatric physical therapy program.

Check out these two videos to learn more about our pediatric pelvic health program:

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