Children’s Health
PHYSIO DOWN UNDER SERVICES
Paediatric pelvic floor physiotherapy is a specialised therapy that focuses on pelvic conditions and symptoms for children from birth to 17 years. By 4 years of age, 90% of children have gained control over their bowel and bladder and have very few accidents. For the remaining 10%, bowel and bladder issues can present many challenges for the individual and the family. The child often experiences embarrassment and anxiety which can impact friendships, behaviors, and the ability to participate in social events such as sleepovers or sports. If untreated, bowel and bladder dysfunction can persist into adulthood. Children’s pelvic physiotherapy assists in retraining the systems and muscles to work properly to restore order and function.
Common concerns or symptoms that may indicate your child has a pelvic floor issue:
My child’s poo is very hard
My child is still in pull ups
We can’t do sleepovers due to their bedwetting
Why can’t my child hold their urine?
My child refuses to do a poo
My child is still having accidents
My child has poo in his underwear
We’ve tried laxatives but it’s not better
Bladder Dysfunction
- Bedwetting – (also known as enuresis) is involuntary urination during sleep after the age at which bladder control usually occurs. If your child is struggling with or bothered by bedwetting, there are treatments available.
- Daytime wetting: involuntary urinary leakage during the daytime at least twice per week in children over 5 years of age.
- Urinary incontinence: involuntary leaking of urine. There are a few types of incontinence and different causes, including pelvic floor muscle weakness. Leaking may occur during sports, playing or with laughing.
- Urinary urgency: the sudden and unexpected experience of an immediate and compelling need to pass urine. Your child may be losing control of urine on the way to the toilet or just before they get there.
- Urinary frequency: increased voiding frequency, so your child may go to the toilet more than 7-8 times per day (7 years and older), and it may be noticed that the child goes more than his/her peers.
- Giggle incontinence: sudden and involuntary episode of bladder emptying provoked by laughing.
- Infrequent urination
- Urinary retention
Bowel Dysfunction
- Constipation: If your child finds it difficult to poo and doesn’t go very regularly, they may be constipated.
- Painful bowel movements: This is usually linked with constipation, as either a cause or a result of difficulty emptying for a while.
- Faecal incontinence: the involuntary loss of stool. Your child will leak poo into their underwear or won’t make it to the toilet in time.
- Straining to complete bowel movement
- Pain in pelvic and/or abdominal area
What does a children’s pelvic physiotherapy assessment look like?
We understand that these conditions can be sensitive and embarrassing for your child.
During the initial assessment, medical history, symptoms, and goals will be discussed. The consultation may include examination of your child’s strength, range of motion, muscle flexibility, posture, movement patterns, and pelvic and core muscle control. Unlike adult pelvic health, an internal pelvic exam will never be completed. Muscle function will be assessed externally. This is usually achieved through visual observation of muscle movement during breathing or pelvic floor muscle exercises without clothing in place.
The therapist will discuss with your child and you the role of physiotherapy and why certain things are recommended. Consent is asked of both you and your child for any assessment or treatment techniques. You are both able to withdraw consent at any time for all or part of the assessment. Communication with your therapist is encouraged throughout treatment to help ensure that your child feels safe and comfortable during their sessions.
Treatment may include the following:
Following the assessment, a personalised treatment plan is developed based on your child's specific needs. We will establish achievable goals and milestones for improving pelvic health function and create a tailored program to achieve these goals.
Treatment may involve age-appropriate:
- Education about bladder/bowel function, their condition, pelvic floor muscles and how exercises will help their symptoms
- Exercises will be taught that can be done at home to improve symptoms between sessions
- Strategies for activities that bother symptoms during the day/night
- Bladder/bowel diaries to track symptoms and therapy progress more effectively
- Proper wiping techniques & toileting positions
- Management techniques for constipation
- Biofeedback for pelvic floor muscle retraining helps children see on a screen how their muscles are working
Throughout the treatment process, we will continually monitor your child's progress and make necessary adjustments to the treatment plan. Regular follow-up sessions will be recommended to assess progress, review exercises, and make any needed modifications. The frequency and amount of follow-up sessions will vary depending on the child’s presentation. Exercises, techniques, or strategies will be adjusted based on the child's response and progress. Ongoing education to the child and caregivers about the child's pelvic health and strategies for continued improvement will be provided.
Physio Down Under Pte Ltd
Address
491B River Valley Road
Valley Point (Office Tower)
Unit #04-01A
Singapore
248373
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