Pelvic floor disorders, though often associated with adulthood, can affect children too. These problems relate to the group of muscles forming a kind of hammock across the pelvis, supporting the bladder, bowels, and the uterus in girls.

Understanding these disorders, their causes, symptoms, and treatment options can help parents seek timely help for their children and implement preventive measures.

What Causes Pediatric Pelvic Floor Disorders?

Several underlying medical conditions and behavioral factors can contribute to pelvic floor disorders in children. Let’s take a closer look at examples of each to understand better how they may affect your child.

Underlying Medical Conditions

Certain medical conditions can predispose a child to develop pelvic floor disorders. These may include:

1. Neurological disorders: Conditions like spina bifida, cerebral palsy, or a spinal cord injury can interfere with nerve signals between the brain and the pelvic floor muscles, leading to dysfunction.
2. Congenital anomalies: Some children are born with structural abnormalities in the pelvic region, such as an imperforate anus (a missing or blocked anus), which can contribute to pelvic floor disorders.
3. Post-surgical complications: Surgery in the pelvic region can sometimes damage or weaken the pelvic floor muscles.

Behavioral Factors

Behavioral factors can also play a part in developing pediatric pelvic floor disorders. These include:

1. Chronic constipation: Regular straining during bowel movements can weaken the pelvic floor muscles over time.
2. Improper toilet training: Inappropriate toilet training techniques may lead to dysfunctional elimination syndromes.
3. Overactive bladder: Children with this condition may constantly contract their pelvic floor muscles, which can lead to fatigue and dysfunction.

Symptoms of Pediatric Pelvic Floor Disorders

The symptoms can vary greatly depending on the specific disorder and its severity. Some common signs and symptoms include:

1. Urinary problems: These may include incontinence (involuntary leakage), urgency, frequent urination, or painful urination.
2. Bowel issues: Symptoms might include constipation, incontinence, or painful bowel movements.
3. Pelvic pain: Children may complain of discomfort or pain in the lower abdomen or pelvic region.
4. Behavioral changes: Affected children may start avoiding social activities due to embarrassment or fear of accidents.

When Should Parents Seek Medical Attention?

Parents should consider seeking medical help if their child is displaying persistent symptoms related to the pelvic floor. Also, if the child’s symptoms interfere with their daily activities and quality of life, or if there’s a significant behavioral change, it’s a solid indicator to consult a healthcare professional.

Pediatric Pelvic Floor Physical Therapy Examinations

Specially trained healthcare professionals conduct pediatric pelvic floor physical therapy examinations. The assessment typically includes:

1. Detailed medical history: The therapist will ask about the child’s medical history, symptoms, daily habits, and any medications or treatments they’ve received.
2. Physical examination: A non-invasive physical examination is carried out to evaluate the child’s posture, strength, and flexibility. This examination usually does not involve any internal examination.
3. Pelvic floor muscle assessment: Through gentle external touch, the therapist can assess the child’s ability to contract and relax the pelvic floor muscles.

Home Exercises for Pediatric Pelvic Floor Disorders

With the guidance of a healthcare provider or physical therapist, parents and children can practice exercises at home to strengthen the pelvic floor muscles. Some examples include:

1. Squat Program: These exercises involve playing, hanging out in squat position to help coordination contraction and relaxation of the pelvic floor. Performed daily.
2. Bladder training: This involves scheduled urination — going to the toilet according to the clock rather than waiting for the need to go. It can help children gain better control over their bladder function.
3. Bowel Training: Similar to bladder training, bowel training involves setting regular times for the child to sit on the toilet and try to pass a bowel movement. This can help establish a regular bowel routine and reduce episodes of incontinence.
4. Breathing Exercises: Deep breathing exercises can help relax the pelvic floor muscles, reducing tension and associated discomfort.
5. Stretching Exercises: Specific stretching exercises can help ease muscle tension, improve muscle flexibility, and promote better posture, all of which can contribute to improved pelvic floor function.
6. Biofeedback: While this is usually done with the help of a therapist, simple biofeedback exercises can sometimes be performed at home. These exercises help children visualize and understand their pelvic floor muscle movements, making it easier for them to control these muscles.

Unfortunately, it may be difficult for parents and children to effectively plan and implement these kinds of exercises during their already-busy days. However, some of the children’s regular, day-to-day activities may already encourage improvement in their pelvic floor, so parents can encourage their children to engage in them more often where possible.

Some of these activities may include:

1. Playing on the playground: Climbing, swinging, and other playground activities can all work the core and pelvic floor muscles.
2. Participating in sports or dance: Many sports, like soccer, gymnastics, or dance, engage the core muscles and, by extension, the pelvic floor.
3. Jumping or hopping: These simple actions can work the pelvic floor muscles. Jumping jacks, hopscotch, or jumping rope are all good options.
4. Regular bathroom breaks: Encouraging kids to take regular bathroom breaks every 2 hours can help prevent overstretching the bladder and straining the pelvic floor muscles.
5. Avoid straining during bowel movements: Kids should be taught not to strain or rush when having a bowel movement, as this can weaken the pelvic floor muscles. If constipation is a problem, dietary changes may be needed.
6. Balancing on one foot: Children can try to balance on one foot while brushing their teeth or standing in line.
7. Riding a bike or scooter: This requires balance and engages the core.