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Does your child, or someone you know, over the age of 4 have difficulty going to the bathroom, leaking urine/feces throughout the day, experience bed wetting, or complain of abdominal pain?  Pelvic floor physical therapy might help!

Typical bladder control begins around the age of 4.  Dryness for 2 hours, uncomfortable sensation when wet, knowing when it’s time to void, ability to don/doff clothing, willingness to interrupt activities for toileting, and good strength of abdominal muscles needed to sit/stand/walk all indicate readiness for potty training.  Potential delays in bladder control include can include life event changes that are difficult to adapt to, such as having a younger sibling, moving, changes in daily routine, or an underlying medical condition.

Indications to seek treatment from medical personnel, including a trained pediatric physical therapist, include: daytime incontinence (continuous or intermittent), nighttime incontinence (discreet amounts while sleeping or urgency to get up and go to bathroom), hesitancy (difficulty initiating stream), straining (abdominal pressure is applied to initiate stream), weak stream (weak force of urine output), intermittency (discreet spurts of urine output versus steady stream), dysuria (pain with urinating), holding maneuvers (postpone void with observable strategies including standing on tip toes, potty dance, crossing legs forcefully), unable to fully urinate, post-pee dribble, and spraying of urine stream.  Some of these are signs/symptoms of obstruction, can lead to potential chronic urinary tract infections, and need to be addressed.  Bladder capacity, urine output, fiber intake, and normal daily visits to the bathroom are age dependent. 

A pediatric pelvic floor physical therapist can address bowel and bladder dysfunction.  What do typical physical therapy sessions look like?  A bladder diary may be advised to track daily liquid/food intake, how often the child goes potty, amounts of output, and any leakage throughout the day.  Bladder and bowel irritants will be discussed.  Constipation, if any, will be addressed first followed by urinary symptoms.  Manual treatments, such as massage, might be used.   Education on muscle strengthening and/or relaxation will be included.  Changes in daily voiding will be discussed.  Proper breathing techniques might be advised.  A visual examination will help guide the treatment plan.  Home exercises will be instructed. 

Remember, your kiddo is not alone. Incontinence in children is fairly common and can be addressed early on.  There are medical treatments that can be addressed prior to attending physical therapy that will help with the treatment process and improve outcomes.  Sessions usually take place once per week and carried out over several weeks.

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