How Can Physical Therapy Help My Child with Bedwetting and Daytime Incontinence

Written by:
Dr. Ashlea Lytle
November 18, 2019
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Are your kids still having accidents at night? Are they peeing their pants at school? Do they feel embarrassed? Are they missing out on social activities? Urinary incontinence could be normal for their age but there does come a time when children should be dry during both the day and night. A physical therapist who specializes in pediatric pelvic health can determine why they're still having accidents and how to help.

Pediatric pelvic health is an area of specialty within the field of physical therapy. It is not a significant part of a physical therapist’s education. Rather, it is a specialization requiring much further study, training and practice following graduation from PT school. A pediatric pelvic health specialist holds both a degree in physical therapy as well as advanced credentials in the assessment and treatment of children with diagnoses that involve the pelvic floor musculature. Having this additional knowledge gives the physical therapist an even greater understanding of how to help your child from head to toe.

There are several things a pediatric pelvic health specialist will assess during a physical therapy session. This may include a thorough review of the child's history, many objective measures including movement patterns and pelvic floor mechanics, and daily logs of diet and bladder/bowel routine.

The diet log helps determine if the kids are consuming any bladder irritants like red/blue dye drinks, or whether their diet consists of foods that may cause constipation. The bladder and bowel log shows how often they are urinating throughout the day, when they are losing their urine at night, and what their bowel movements look like (i.e. rabbit droppings, sausage, etc.). Based on this information, the specialist can create a diet and bladder plan appropriate for the child (and guardian).

The pediatric pelvic health specialist will also evaluate the child’s movement patterns to see if there are any apparent muscle weaknesses that could be contributing to the underlying source of the pelvic floor issues. This is done via a visual functional screen, followed by a full-body movement assessment performed on the Redcord, a suspension exercise system that tests how you control and sequence movement patterns.

Through the power of neuromuscular activation, Redcord can help the child regain control of movement patterns. Utilizing slings and bungee cords, the specialist creates a weightless, painless exercise environment so that the child can perform precise movements with sufficient muscle control. Neuromuscular activation is like flipping on a light switch to muscles that have gone dim due to pain, injury and inactivity. When the mind and body are fully connected, the results are unrivaled.

Before conducting a pelvic floor examination, the specialist will obtain consent from both the child and guardian. A visual, auditory and/or tactile signal will help the child understand how to contract the pelvic floor muscles. This is called biofeedback and it is very important for the child to learn how the pelvic floor works to eliminate urine and feces properly.

There are several other things your pediatric pelvic health specialist will assess depending on your specific needs. You will receive a lesson on urination and defecation anatomy as well as potty mechanics. At Activcore, every treatment session takes place in a private room on a one-on-one basis, with the same therapist at each visit.

Something to keep in mind, if someone is having dysfunctional bladder problems, is that they're probably not doing it on purpose, and they need support to overcome this from family, teachers, babysitters, and others involved in their daily life.

You can learn more about this topic by visiting our Pediatric Pelvic Health page.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Need help? We're here for you. Contact us today to request an appointment. Also check out our Telehealth offerings to get help from the comfort of your home.

Dr. Ashlea Lytle

VP Colorado Region | Physical Therapist | Doctor of Physical Therapy
Ashlea Lytle is a Doctor of Physical Therapy (DPT) who has been practicing for over a decade in the Denver area. She specializes in sports, general orthopedics, and pelvic health for adults and kids. She splits her time at Activcore in Castle Rock, CO (located inside Optimal Health Chiropractic) and at Activcore in Greenwood Village, CO (located inside Pilates Denver).
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