Not Just Small Adults: The Playful Path of Pediatric Pelvic Physical Therapy

Helping kids feel confident, comfortable, and in control again

f you’ve spent even five minutes with me, you already know I’m passionate about pelvic health. Yes — I talk about poop a lot 😄… because it affects so many parts of our daily life and well-being.

If pelvic therapy can transform the life of a new mom healing after childbirth or an adult struggling with chronic pelvic pain, just imagine what it can do for children — who are still developing physically and emotionally.

Yet many parents have never even heard of pediatric pelvic floor physical therapy. When they do, they often look confused and ask:

“What could possibly be wrong with a child’s pelvic floor?” “Wait… what do you do with kids?”

Great questions. And incredibly common ones.

Today, let’s break it all down: what pediatric pelvic PT is, why it’s needed, and how different it is from adult care — in a way that’s reassuring, empowering, and clear.

🧠 Pelvic Health 101: What’s Going On in There?

The pelvic floor is a group of muscles that help:

• Control peeing and pooping

• Support the digestive and urinary organs

• Stabilize posture and core strength

• Coordinate breathing and body movement

Kids and adults can struggle if these muscles are: 🚫 Too tight🚫 Too weak🚫 Not working together with the bladder or bowels

When that happens, children may experience:

• Bedwetting or daytime accidents

• Poop withholding or fear of the toilet

• Constipation and painful poops

• Leakage or stains in underwear

• Tummy aches or pelvic discomfort

And these challenges aren’t “just a phase.”They can impact:

• Self-esteem

• Social confidence

• School participation

• Sleep

• Emotional well-being

Pelvic PT supports both the physical and the emotional side of bathroom function — helping kids reclaim comfort, confidence, and independence.

Walking on various unstable surfaces builds body awareness, hip strength and balance skills.

⚖️ Adults vs. Kids

Same anatomy. Totally different therapy approach.

✅ Adult Pelvic Therapy

Most adult clients come in due to:

• Pregnancy or postpartum changes

• Hormonal shifts

• Pelvic surgery

• Musculoskeletal or nerve pain

Treatment is often:

• Manual therapy

• Specific exercise prescription

• Nervous system regulation

• Lifestyle and bladder/bowel strategies

Adults want to understand ALL the details — the “why” and the “how” — so they feel in control of their healing.

🧸 Pediatric Pelvic Therapy

Now imagine trying to give that same education to a 6-year-old. 👀We have to get creative!

For kids, therapy is:

🎯 Functional: focused on toileting success

🎨 Fun: play-based and game-driven

💛 Emotionally safe: zero shame or judgment

👨‍👩‍👧 Family supported: you’re part of the team

We treat:

• Nighttime bedwetting

• Daytime urinary leaks

• Constipation + encopresis (poop accidents)

• Withholding behaviors

• Toilet refusal or fear

• Delayed toilet independence

We celebrate every single win — from sitting on the toilet without fear to recognizing the first urge to go. The skill of tuning into one’s body takes practice and encouragement.

We use straws, pom poms, and unstable surfaces to build respiratory capacity and core strength.

🎉 Therapy That Feels Like Play

Kids do best when movement feels like a game. So we:

• Climb, jump, and balance to build core + pelvic muscle coordination

• Play breathing games using bubbles or straws to relax the pelvic floor

• Use visuals and stories to explain how pee and poop exit the body

• Practice posture and pushing mechanics in child-friendly ways

• Normalize bathroom talk so nothing feels scary or embarrassing

And importantly:

🚫 NO internal exams with children.

✅ Assessments are gentle, external, and based entirely on comfort and consent.

✅ We keep communication honest, simple, and judgment-free.

We want kids to feel empowered by learning the language of their own body.

💬 The Power of Validation

“It’s not your fault.”

Many children have been told:

• “You’re too old for accidents”

• “You’re just being lazy”

• “Why can’t you do this like other kids?”

These messages — even said in frustration — can feel like blame. We help shift the narrative:

🧠 Bathroom success is a skill.

💪 Muscles can learn new patterns.

🌈 Bodies can heal with support.

When shame goes down, progress speeds up.

🎯 What Success Really Looks Like

Yes, we care about dry underwear and comfortable poops…

But the real transformation is when a child:

✨ Sleeps through the night without worry

✨ Gets excited to go to a sleepover

✨ Plays sports without fear of accidents

✨ Joins class without bathroom anxiety

✨ Says proudly “I did it!”

They deserve the confidence that comes with a body that works for them — not against them.

Fun activities can help work on balance, crossing midline, and strengthening abdominals.

💛 Why Choose a Specialist?

Pediatric pelvic health requires:

• Developmental expertise

• Trauma-informed communication

• Play-based learning strategies

• Medical collaboration with pediatricians

• A safe, encouraging environment

Therapists like me love working with kids — not just treating a diagnosis but supporting the whole child.

When children feel safe, understood, and supported, healing follows.

💌 Ready to explore whether pelvic PT could help your child?

If your child is struggling with:🚽 Toilet refusal🥺 Painful or difficult poops💧 Daytime or nighttime accidents😣 Withholding due to fear or discomfort📚 School or social limitations

— you are NOT alone.

And your child is NOT “behind” or “misbehaving.”

Their body just needs some extra support — and that’s where we come in.

Let’s create a plan to help your child succeed!

There is so much hope. And it starts with one brave step forward. 💛