Pediatric

We Treat Pediatric Bladder and Bowel Dysfunction:

At Purple Mountain PT we have advanced training and experience for pediatric bladder and bowel conditions. You have found the right place to help your child! Our Doctors of Physical Therapy enjoy children and will provide your child holistic, positive and rewarding physical therapy that addresses your child’s bladder and bowel problems and eases stress in your household, all while keeping you, the parent, involved in the treatment plan so you can feel less stress and greater support. Whether your child is struggling with pediatric urinary incontinence, bedwetting, constipation or developmental delays that are causing pediatric bladder and bowel control to be compromised, we can help you. Read on to learn more about our approach and what we can do to help you and your child.

Our Program for Pediatric Bladder and Bowel Disorders, such as Bedwetting, Constipation, Urinary Incontinence, Urinary Frequency and Urgency

Our program for pediatric bladder and bowel control is holistic, positive, based in best practices and provided by an expert Doctor of Physical Therapy who has advanced post-doctoral training specific to pediatric bladder and bowel developmental goals and treatments. We treat children struggling with issues related to constipation, bedwetting, urinary urgency, urinary incontinence, fecal incontinence, and more!  We have been laser-focused on pelvic health, bladder and bowel problems and this has included advanced, post-doctoral training specific to pediatric bladder and bowel developmental stages, dysfunction and therapy to resolve problems.

Physical Therapy Interventions We Use for Pediatric Bladder and Bowel Disorders:

Our physical therapy intervention is specific to your child and fits with your family’s needs. We do not offer cookie-cutter treatment, because we have found that each child’s problems and contributions to their problems is unique. By evaluating your child properly, we will identify the specifics of how we can help you and your child to recover bladder and bowel function.

We Partner with Parents and Children to Uplift Your Child and Help Them Learn How to Optimize Their Bladder and Bowel Function

We partner with the parent and child to offer effective, uplifting and results-oriented care. Often children dealing with bladder and bowel problems have underlying pelvic floor dysfunction and feel disempowered and embarrassed. We are here to change that!  The children we treat typically come to us feeling shy or embarrassed and finish their PT with smiles and more socially engaged with their peers.

Pediatric Pelvic Physical Therapy is Non-Invasive and Helps Your Child Learn How to Control Their Bladder and Bowel Muscles

Physical therapy for pediatric bladder and bowel problems, such as bedwetting, incontinence, urinary urgency and constipation, offers a non-invasive solution to restore function, eliminate pain, and optimize pediatric bowel and bladder health. This “non-invasive” portion of what we offer is the special thing that makes our care unique. We are not asking you or your child to rely upon medications. We are not using invasive techniques that have side effects. Instead, our methods are a combination of gentle and therapeutic exercises, hands-on treatments, play-based games, education, practicing toileting methods and, in general, securing buy-in from your child to get them to develop better control over their bladder and bowel.

Wondering What Pediatric Bladder and Bowel Conditions We Treat?  This Gives You An Abbreviated List:

Pediatric bladder and bowel conditions we treat:  This list gives you an idea into our experience and how we may be able to help your child’s bladder and bowel control. If your child’s condition is not listed here, please know we have experience working with a wide variety of bladder and bowel problems, including congenital defects, neurologic conditions, developmental delay and more.

1. Urinary incontinence
2. Nocturnal Enuresis (bedwetting)
3. Urinary urgency
4. Urinary frequency
5. Urinary retention
6. Fecal urgency, frequency and/or retention
7. Bowel incontinence, pain with defecation, inability to empty bowels
8. Excessive gas, abdominal bloating
9. Constipation, diarrhea with/without soiling/staining
10. Giggle incontinence
11. Post-void residual
12. Imperforate anus (aftercare following surgery)
13. Hirschprung’s disease (aftercare following surgery)
14. Chronic pain
15. Sports related injury
16. Developmental delay

What Does Pediatric Bladder and Bowel Physical Therapy Include?

We use a combination of treatments to engage your child in their plan of care. These include a variety of things such as biofeedback, play-based exercise, core stabilization, toileting practice, games to simulate tuning into their body’s signals and manual therapy techniques.

The goal of pediatric bladder and bowel pelvic floor physical therapy is to improve muscle coordination, strength, and flexibility to restore function, improve movement, and to optimize bladder and bowel function!  For example, some children have embarrassing loss of urine during school and we can resolve this. Other children have severe constipation, lower abdominal pain and difficulty using the toilet; we will help teach your child how to defecate effectively while we also create a lifestyle plan to improve bowel function. Our treatment methods may include:

• Pelvic floor muscle evaluation and treatment (no internal treatment) so that your child learns which muscles need to be controlled and improved. The parent is always included in our care and our approach is very educational for both parent and child. Often, we find the child does not perceive that they tighten their pelvic floor, which impairs their ability to urinate and defecate effectively, for example.
• Bladder and bowel schedule to improve habits
• Muscle re-education of the abdomen, hips, and pelvic floor. This is an important component of addressing pediatric bladder and bowel control and function. If your child has core muscle weakness, compromised motor control, discoordination of their breathing/abdominal wall and pelvic floor or any neurologic condition, then the bladder and bowel function will be impaired. Our expert Doctor of Physical Therapy pediatric bladder & bowel care will help your child to gain strength, motor control and proper coordination of their muscles.
• Parent and Child education on food and drink choices
• Teaching your child to learn the body’s signals that they need to void
• Empowering your child to not be fearful of a bowel movement
• Play based games and activities that are fun for your child while also re-training their bladder and bowel control and awareness.
• Rewards and encouragement for your child.

We Provide Customized Treatment Programs for Your Child’s Unique Bladder and Bowel Needs:

Each child receives a treatment plan customized for them! The treatment environment is welcoming and fun, so your child feels relaxed and able to heal. Parents tell us that working with us has eased household stress around their child’s bladder and bowel function. We know that parents worry about their child’s self esteem and ability to function in school when bowel and bladder control is not optimized. We are here to reduce your stress and to be an expert physical therapist for your child so that you, the parent, are not alone through this process.

Here are some other examples of pediatric bowel and bladder conditions that we treat and what you might expect.

All treatment begins with an evaluation, during which we figure out, with you, what are the driving factors causing the problem and we will develop a treatment plan to achieve your goals. We begin treatment at this first appointment and often our parents and children come back telling us they felt so much relief. t makes our day when the kiddos arrive happy and joyful because they controlled their bladder and bowel more effectively.

Pediatric Enuresis (Urinary Incontinence, children who wet their pants)

Urinary incontinence can be embarrassing and disruptive for a young child. The psychological strains on a child due to urinary incontinence are well documented, which is why it is recommended that treatment for incontinence be mandatory. Children should be able to gain continence no later than 4 years old. Incontinence beyond that point should start to be addressed by your child’s medical team. In the majority of cases, there is no structural, neurologic, or other organic cause to be found. This is where pelvic floor physical therapy comes in! Children do not choose to wet or soil their pants. Often dysfunctional voiding habits have developed for a variety of reasons that need to be addressed by a qualified physical therapist with advanced training. Through identifying pelvic floor dysfunction, retraining the movement system, and improving bladder and bowel hygiene your child can live without fear of leaks!

Nocturnal Enuresis (bedwetting)
My child is over 4 years old and still wets the bed.

Bedwetting is common, but not normal. The urinary system reaches maturity at age 4 which means that your child should not be experiencing leaks of the bladder during the day or at night. If bedwetting is occurring, it is likely driven by chronic constipation. Pelvic floor physical therapy can help correct constipation by addressing bowel habits, diet, and fluid intake. We also look at toileting posture, core, hip, and abdominal strength to optimize bowel function. Read more about our physical therapy for bedwetting, constipation and enuresis.  If interested to speak with our staff, call 616-516-4334 or submit your questions here.

Pediatric Urinary Urgency
My child always has to run to the bathroom and sometimes might lose urine on the way.

Does your child do the potty dance or barely make it to the toilet in time? Often this is caused by a disruption in the delicate communication system between your bladder and your brain. Children with urinary urgency frequently have underlying pelvic floor dysfunction and constipation which is irritating their bladder and impacting their health and quality of life. At Purple Mountain Physical Therapy, we address underlying constipation, downtrain the nervous system and address underlying sensory processing deficits and optimize pelvic floor dysfunction in order to get rid of urgency.

Pediatric Urinary Frequency
Everywhere we go, we have to find a bathroom!

Is your child always stopping the car on road trips or frequently having to get up at school to go to the bathroom? This may not be under their control! Often children develop dysfunctional voiding and unhelpful habits that compound themselves over time. Your child may not be fully emptying their bladder on the toilet or may need to modify their diet and fluid intake in order to help calm their bladder and help it fully empty. No one chooses to go to the bathroom every hour and your child deserves support to allow their bladder to heal!

Pediatric Urinary Retention and Post-void Residual
My child may have had urinary tract infections. Or my child may not seem to empty fully. After urinating, my child may still need to go again, even just 30 minutes later.

Overtime unhealthy bladder habits and constipation can lead to a stretched and irritated bladder that does not empty completely. In order to fully empty, the muscles of the pelvic floor and the internal muscles of the bladder need to be coordinated. A stretched bladder does not contract properly and needs special voiding and habit changes in order to retrain it. Pelvic floor physical therapy instructs your child in strategies to improve voiding and addresses coordination deficits between the urinary system and the pelvic floor to allow the bladder to empty the optimal amount.

Pediatric Fecal Urgency, Frequency and/or Retention
My child sometimes has “skids” on the underwear, may rush to the toilet to complete a bowel movement and may have multiple bowel movements in one day. Even after a bowel movement, sometimes my child may have a stomachache and/or look distended.

The pelvic floor controls your child’s bowel function as well! The communication system between the rectum, the pelvic floor, and the brain is delicate. When discoordinated, your child may not get the signal to have a bowel movement until it is too late, may feel like they need to go too often, or not be able to empty completely. When we restore full range of motion to the pelvic floor, improve pelvic floor strength, and address poor defecation mechanics bowel issues resolve. Your child deserves to live without being on the look-out for every bathroom.

Pediatric Bowel (Fecal) Incontinence, Encopresis, Pain with Defecation, Inability to Empty Bowels
My child loses stool sometimes and may complain that a bowel movement hurts. I suspect my child may be “holding in” their stool and avoiding having a bowel movement.

At Purple Mountain Physical Therapy, we believe that children do not choose to soil themselves intentionally. If this is occurring, there is underlying constipation in almost all cases that must be addressed with your child’s medical team. Pelvic floor physical therapy can help address issues with diet, fluid intake, pelvic floor coordination, pelvic floor tension, movement disorder, abdominal, and hip weakness that is likely causing bowel leaks. We are amazed every day when we see the difference in mood and behavior that restoring bowel function can make.

Pediatric Excessive Gas, Abdominal Bloating
My child farts a lot. More than would be expected. The abdomen also looks distended/bloated sometimes.

The pelvic floor, diaphragm, and abdomen need to be in good coordination to prevent gas leaks and abdominal bloating. If you think of the diaphragm as the roof and the pelvic floor as… the floor of your abdominal cavity when those muscles are tight or constricted it squishes the contents of your abdomen which impairs digestion and can cause bloating. By instructing proper breathing patterns and addressing pelvic floor dysfunction we can relieve bloating and excessive gas.

Pediatric Constipation, Withholding bowel movements, Diarrhea with/without Soiling/Staining
My child may or may not have daily bowel movements. Movements may or may not be complete. My child may have abdominal pain intermittently. My child may have a bloated abdomen sometimes. My child’s stool may sometimes look like little or big balls, instead of banana-shaped.

Digestion begins at the mouth with chewing. Food then travels down the esophagus and churns in the stomach. From the stomach, nutrients are then absorbed in the small intestine and proceed to the large intestine. In the large intestine, food is pushed along by smooth muscle activity called peristalsis until it reaches the rectum. The rectum then senses fullness and signals to your brain that it is time to defecate. In order to empty your bowels, the pelvic floor must relax, and the abdomen must generate gentle force to fully evacuate. If any part of this cycle is disrupted, it can lead to constipation or diarrhea. You can think of it like a wave that crowd members perform in a stadium. If one section of the stadium decided not to stand-up, then the wave might come to a complete halt or the wave might become choppy or irregular. This is functional constipation and functional diarrhea respectively. With physical therapy, our goal is to identify problem areas with digestion and get your child’s system functioning appropriately again.

Pediatric Giggle Incontinence
My child loses urine when laughing.

Children with giggle incontinence experience complete emptying of their bladder due to involuntary contraction of the bladder wall. It often begins between ages 5 and 7 and resolves at puberty. Pelvic floor retraining is a proven method to reduce or eliminate symptoms of giggle incontinence as proper pelvic floor activation can help modulate the involuntary contraction of the bladder wall that occurs. Studies show that pelvic floor retraining through biofeedback and bladder hygiene has a 90% success rate in treating this condition prior to puberty.

Imperforate Anus Syndrome (aftercare following surgery)
My child was born with an anorectal malformation that prevented them from having normal BMs. My child may have had a small anal opening or an opening in the wrong place. Bowel movements may have been severely painful or severe constipation may have been the norm. Our household may have revolved around our child’s bowel needs and care. Our child has had surgery and needs help to gain control over bowel movements.

Children with imperforate anus often have struggles regaining bowel function following reconstructive surgery. Pelvic floor physical therapy can assist in maximizing bowel function through optimizing pelvic floor muscle function, determining neurologic status of the area, addressing coccyx mobility and scar adhesions to support your child through their recovery.

Hirschprung’s disease (aftercare following surgery)
My child was born with a blockage of the intestine and lacks the nerve in the bottom segment of the colon. My child’s large intestine may not have developed in a typical manner. My child has had corrective surgery and would benefit from physical therapy to learn how to restore the ability to push the stool out of the body.

Most individuals with Hirschprung’s disease gain continence in adulthood, but many struggle with problems related to constipation and incontinence at school-age. Pelvic floor physical therapy can improve quality of life as your child is healing by addressing scar mobility, improving pelvic floor range of motion and coordination, addressing toileting habits, improving sensation and awareness of the pelvic floor, and addressing deficits in interoception (or your child’s ability to feel the inner workings of their body e.g. the need to have a bowel movement.)

Pediatric Chronic Pain (including chronic pelvic pain, anal pain, abdominal pain, hips and low back)
My child may experience ongoing abdominal pain that has brought us to the ER and we may have been told our child is constipated. My child may be complaining of pain in the anus or genital area. My child’s pain is a source of stress for us parents and the unpredictable nature of it has impaired our ability to have fun and simply enjoy our months.

Chronic pain is multifactorial. The presence of pain is driven by a complex relationship between pelvic floor, musculoskeletal, gynecological, urological, neurological (peripheral nerves, central nervous system and autonomic nervous system), neuroendocrine, immune and gastrointestinal. At Purple Mountain Physical Therapy, we have the time and expertise to listen to your child’s specific needs and identify problem areas for them that are contributing to their pain. We work with your child’s healthcare team to get them moving better and improve their quality of life.

Pediatric Developmental Delay
My child may not be developing at a typical rate. Possibly my child was born with a neurologic condition, autism, cerebral palsy or other condition. Often the kids we see have no known cause for their developmental delay, but do have problems with establishing healthy bladder and bowel control.

We work with children of all abilities. Often kiddos who have autism, down syndrome, cerebral palsy, and developmental delay have underlying pelvic floor dysfunction due to alterations in muscle tone and coordination. These children do not need to live with toileting problems! With the individualized care they receive from pediatric pelvic floor physical therapy at Purple Mountain, it is possible to improve bowel and bladder function and eliminate leaks!  We enjoy working with children of all developmental abilities. We have found these children respond well to our methods and look forward to their appointments.