Consultation and Treatment
Consultation and Treatment
WHAT DOES TREATMENT INVOLVE FOR MY CHILD?

OUR FIRST SESSION CONSISTS OF:

Treatment is highly individualised and based on the findings of the evaluation AND on your family’s goals. Most importantly, we keep it fun, engaging, and rewarding for your child.



Treatment can include:

  • Initial comprehensive evaluation and treatment plan: 120 min
  • Education – helping you understand what is going on and why it is happening
  • Bowel or bladder scheduling and advice regarding fluid and fibre intake
  • Providing helpful tips/strategies to try at home such as positioning, behaviour modification, cueing, language/phrasing, diet adjustments.
  • Postural Education
  • Teaching patient’s “Proper Peeing/Pooping Posture” to ease and assist with complete evacuation of bladder and bowels.
  • Breath Work-. The diaphragm (muscle that assist with controlling breathing) and pelvic floor muscles work together to generate pressure, relax anal/urethral sphincters, and lengthen the pelvic floor muscles when urinating or having a bowel movement. These are often uncoordinated in children with faecal or urinary leakage.
  • Manual therapy (externally only) on abdomen or joints of lower body and pelvis, or the external pelvic floor muscle.
  • Exercises to retrain the pelvic floor- Children regain coordination in the pelvic floor muscles from the age of 4 years.
  • Coordination Exercises- The pelvic floor muscles surround the urinary and anal openings and play an important role in maintaining continence. In children that have constipation, the pelvic floor muscle is often uncoordinated—i.e. the child squeezes these muscles instead of relaxing them when attempting to pass a bowel movement. Coordination exercises can re-train these muscles to function as they should and thus improve constipation.
  • Manual therapy techniques to abdominal and pelvic girdle muscles that are tight or in spasm can contribute to urinary or faecal retention which can eventually lead to leakage.
  • A home program to pull it all together (which is key to seeing results!).
The follow-up session is approximately 6-8 visits over a course of several weeks or months.
There is NO internal examination of the pelvic floor muscles for children.

- Physical Examination: We will evaluate posture and breathing, joint mobility, muscle length, strength, and control. With your consent and the child’s consent, the therapist will likely want to evaluate the external pelvic floor muscles to determine your child’s ability to contract or relax the pelvic floor. This is done visually and/or with palpation.

- Physiotherapists can use a tool called “surface biofeedback” to evaluate a child’s ability to relax and contract these muscles at the appropriate times. The therapist places small sticky electrodes on either side of the child’s anus and instructs the child to squeeze or relax. Viewing a computer screen with customised images — aeroplane flying or flowers opening and closing, for example — the child and caregivers can see how much these muscles are squeezing and relaxing. Biofeedback also helps the child understand what his/her muscles feel like when they are contracting and relaxing. By placing the hand /finger over the external pelvic floor it is also giving feedback to the child of which muscles need to work or to relax. Another form of Biofeedback is supra pubic sonar over the bladder where the child will be able to see a full bladder and the effect of the pelvic floor muscle on the bladder.

- Exercises to do at home

Pelvic health physiotherapy can be very surprisingly effective at helping your child overcome bowel or bladder challenges. The physical benefits to your child are huge…but the best gifts of all are that of self-efficacy, self-esteem, and self-confidence.