Pediatric Pelvic Floor Therapy: Your Top Questions Answered

Bathroom struggles can feel overwhelming — for children and their caregivers. Whether your child experiences constipation, daytime or nighttime wetting, stool withholding, or anxiety around toileting, pediatric pelvic floor therapy offers a compassionate and effective path forward.

At Fundamental Physical Therapy, we want you to feel informed and empowered as you take this next step. Below are answers to the most common questions parents ask when exploring pelvic PT for their child.

🧩 “My child poops every day — why would they need therapy for constipation?”

Many families are told, “If they’re going daily, they’re fine.” But constipation is about more than frequency — it’s about quality and comfort too.

We look at:

• Consistency: Hard, large, or pebble-like stools = constipation

• Effort: Straining or pain means the bowel isn’t functioning well

• Efficiency: Kids may not fully empty, leaving stool behind

• Behavioral cues: Avoiding bathroom breaks, crossing legs, hiding

When stool becomes stuck in the colon, it can:

• Press on and irritate the bladder, leading to accidents

• Stretch out the rectum making it less sensitive to urge and weak

• Reduce the body’s ability to sense when it’s time to go

• Make bowel movements painful → which causes withholding

• Create a cycle of fear, avoidance, and more constipation

✨ Even a child who “goes every day” may still struggle silently.

Pelvic PT gets to the root of the problem by helping the body coordinate the digestive and urinary systems more comfortably and effectively.

Constipation involves more than infrequent poops!

🔁 “We did a cleanout and it didn’t help — why would therapy make a difference?”

Cleanouts are helpful…for a few days.

The challenge? They don’t fix:

• Muscle tension or weakness in the pelvic floor

• Difficulty sensing a full bladder or bowel

• Toilet posture or pushing mechanics

• Daily habits affecting digestion

• Stress or emotional barriers

Without addressing the underlying causes, stools can build right back up — a cycle we lovingly call the “Constipation Carousel.” 🎠

Pelvic PT uses a guided, proactive approach:✅ Progressive strengthening or relaxation as needed✅ Education around hydration, fiber, movement, and bathroom routine✅ Strategies for sensory processing and nervous system regulation✅ Coordination of bowel and bladder function✅ Collaboration with your child’s pediatrician

When kids understand how their body works and why toileting matters, progress sticks — and confidence grows.

😣 “My child withholds or refuses the toilet. It’s becoming a power struggle. How does PT help?”

You’re definitely not alone — and your child is not doing this “on purpose.”

Children may resist the toilet because:

• It hurt to go once, and they remember

• The bathroom feels loud, cold, or uncomfortable

• They feel rushed or anxious

• They struggle to relax the right muscles

• They have low sensation and don’t realize they need to go

• They fear doing it “wrong” and getting in trouble

Kids protect themselves by avoiding things that feel scary or painful — that’s not defiance, that’s survival behavior.

Pelvic PT helps by: ✅Creating fun, positive associations with toileting ✅Teaching the brain-body connection ✅ Supporting relaxation and confidence in new sensations ✅Working on posture and mechanics for success ✅Improving strength, coordination, and gross motor skills

When the stress comes down, progress goes up — for the whole family.

🩺 What does pediatric pelvic floor therapy involve?

We work hard to make therapy playful, engaging, and tailored to your child’s comfort level.

Before the first appointment:

Parents complete a detailed survey about bowel/bladder history, medical factors, routine, and behavior. This saves valuable time and helps us support your child right from the start.

During the appointment:

We:

• Build rapport through games and conversation

• Explain how the body works using kid-friendly visuals

• Assess gross motor skills, balance, reflexes, and breathing

• Observe posture and alignment

• Introduce pelvic floor muscles and how they function

• Gently check how well those muscles tighten and relax (externally only!)

We do NOT perform internal exams or internal treatment on children. Comfort, consent, and trust always guide treatment.

After the visit:

We:

✅ Provide a simple home program you can start immediately

✅ Communicate with your pediatrician to ensure a team approach

✅ Discuss goals collaboratively and set realistic expectations

We genuinely want therapy to feel like a safe space where your child can grow — physically and emotionally.

Pediatric Pelvic Health focuses on child friendly activities and exercises.

🕔 “I don’t want my child to miss school — do you offer late appointments?”

Yes! We are typically in clinic Tuesday–Thursday (with occasional Fridays), seeing patients from 8:00 AM to 5:30 PM.

That said…Many children are mentally and physically fatigued after school. When energy is low, attention and participation can decline — especially when learning new motor skills.

We’ll help you find a time when your child can be most successful, whether that’s before school, during lunch, early afternoon, or after school.

🧒👧 “Can I bring siblings to the appointment?”

We understand that childcare is tricky — we’ve been there!

However, toileting challenges can feel embarrassing for kids, so privacy and emotional safety come first. Siblings can cause:

• Distractions

• Self-consciousness

• Teasing or interrupting

• Limited one-on-one focus

Whenever possible, we encourage arrangements that allow the session to be dedicated solely to your child’s needs.

💡 The Bottom Line

Pediatric pelvic floor therapy is:

✅ Non-invasive

✅ Rooted in science

✅ Compassionate and kid-centered

✅ Focused on long-term success

✅ Supportive for the whole family

We’ll guide you through every step — from frustration to freedom.

💬 Ready to help your child feel confident and comfortable again?

We are here to answer any questions and build a plan that works for your child — and your family!