Pediatric Pelvic Floor Therapy

Physical Therapy for Childhood Constipation and Incontinence

Did you know that 1 in 20 visits to the doctor are for issues with constipation or bowel movements? Childhood constipation is common occurrence and can be successfully treated and prevented using a multidisciplinary approach that includes specialized pelvic physical therapy.

Constipation is what happens when stools do not easily pass through the intestines and out the body. Kids get constipated for a lot of reasons. Often, a child may delay going to the bathroom because he/she is engaged in play tasks and doesn’t want to stop playing. Over time, this causes the stool in the colon to get hard and backed up. When he/she does finally go to the bathroom, it can be very painful to pass that bowel movement. Then the child may fear going to the bathroom and having it hurt again, setting up a repetitive cycle that never seems to end.

Let’s briefly discuss signs/symptoms of constipation in children. These can include any or all of the following:

  • Abdominal pain
  • Straining
  • Lumpy or hard stools
  • Bleeding or pain with bowel movements
  • Less than 3 BM’s/week
  • Stools that plug the toilet
  • Lack of appetite
  • Urinary incontinence (leakage) or increased frequency
  • Fecal leakage (liquid stool moves around the impacted stool)
  • Reflux

Changes in bladder frequency

It is important to make your pediatrician aware or to seek further recommendations from a pediatric gastroenterologist. Doctors such as these make important recommendations regarding bowel medications to assist in “cleaning out” your child, keeping your child’s stool soft to prevent further problems or exacerbation in constipation, as well as rule out other more serious causes of constipation that need immediate medical attention. However, medications alone will not break the habits contributing to your child’s constipation. This is where pediatric pelvic floor physical therapy comes into play.

Pediatric Pelvic Physical Therapy is a highly specialized area of rehabilitation that can address chronic constipation and urinary/fecal accidents among other things. This type of physical therapy utilizes unique intervention techniques to address any tightness, weakness, or coordination issues present in the pelvic floor and pelvic girdle muscles that are typically impaired and contribute to constipation.

Here is a brief list of typical interventions utilized at Unified Therapy Services to treat constipation:

  • Abdominal massage
  • Stretching
  • Postural Education
  • Breath Work
  • Coordination Exercises
  • Therapeutic Exercises

Pediatric Pelvic Floor Therapy for Incontinence

As many as 1 in 7 school-aged children will struggle with pelvic floor dysfunction presented as incontinence. Many of these children will go on to suffer with bladder and bowel management into adulthood if it isn’t properly treated. The cause of pediatric incontinence is often times related to lack of strength or coordination of the muscles that make up the pelvic floor. Pelvic floor dysfunction can also present as leaking urine or feces, constipation, changes in voiding frequency, or a combination of these symptoms.

Physical therapy can help in providing exercises for the pelvic floor and abdominal muscles, improving posture, and providing patient and family education for improved pelvic health. Our specially trained physical therapist will work individually with your child and your family to provide optimal family-centered care to improve your child’s symptoms.

We can treat a wide array of causes of pelvic floor dysfunction including the following diagnoses:

  • Bedwetting
  • Constipation
  • Fecal incontinence
  • Overactive bladder
  • Urinary frequency/retention
  • Urinary incontinence
  • Urinary urgency

You will begin by meeting with a physical therapist to discuss your child’s bladder/bowel habits and they will assess your child’s symptoms. Based on your evaluation, treatment will include:

  • Behavior and diet strategies to improve your child’s bathroom habits
  • Stretching
  • Sensory Integration
  • Core strengthening
  • Patient and family education
  • Pelvic floor muscle reeducation
  • Posture training

Your child does not have to suffer with constipation or incontinence – these are treatable conditions with the right form of therapy! For more information or to schedule a consultation, please give us a call at 563-583-4003.

Sources:,, and Kelly Loeffelholz, DPT, Unified Therapy Services.

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Kelly Loeffelholz, DPT, is a Physical Therapist and Clinic Director at Unified Therapy Services who specializes in Pediatric Pelvic Health. She has been with Unified Therapy since 2012 and treats children with a wide range of conditions and ailments.