Adolescent Pelvic Floor Physical Therapy at Nationwide Children’s Hospital

The adolescent pelvic floor physical therapists at Nationwide Children’s Hospital help children and teens with bladder problems, bowel problems, pelvic pain and related conditions. Therapy may help improve muscle control, reduce discomfort and make bathroom and everyday activities easier.

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What Is the Pelvic Floor?

The pelvic floor is a group of muscles at the bottom of your pelvis or lower abdomen area. These muscles act like a small hammock. They help hold your organs in place, help support your pelvis and core, and are important for going to the bathroom.

What Are Functions of the Pelvic Floor?

Helps you control your urine, stool, and gas
Holds and supports your organs, like your bladder and intestines
Helps your hips and back stay strong when you move or lift things
Helps with good posture and breathing
Helps move blood and fluid through your body, like a small pump

What Is Pelvic Floor Physical Therapy?

Pelvic floor muscles can get weak or tight, just like any other muscles in your body. When these muscles don’t work well, they can cause pain, urine leaks, or trouble having a bowel movement. Pelvic floor physical therapy helps stretch or strengthen these muscles. This can help reduce pain, improve core strength, support healthy bathroom habits, and help you do everyday activities or sports.

Conditions We Treat

Urinary incontinence (stress, urge, nighttime)
Pelvic and/or abdominal pain
Constipation
Bowel concerns
Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease
Endometriosis
Low back pain
Coccydynia or tailbone pain
Hip pain

What to Expect at Your First Visit

Please have a parent, guardian, or family member present for the first visit. The team will explain pelvic floor physical therapy and treatment expectations. Wear loose-fitting, comfortable clothing to allow the physical therapist to assess your child.

All evaluation and treatment will be external only.

Questions Your Physical Therapist May Ask

Your therapist will complete a medical and health history and will ask a lot of questions about:

Past orthopedic or sports injuries
Physical activity levels
History of pelvic or abdominal pain
Menstruation
Gynecological history
General health history
Bathroom routine
Toileting habits or issues (frequency, pain, difficulty)
Nutrition

What the Evaluation May Include

Your or your child’s exam will also include an assessment of:

Posture
Back and hip flexibility
Hip, core and back strength
Ability to activate and relax pelvic floor
Breathing pattern
Performance of functional tasks (squat, plank, etc.)

Your Pelvic Floor Treatment Plan

After evaluation, your therapist will develop a treatment plan for you or your child. The plan may include:

Education about pelvic floor muscles
Instruction on proper activation and relaxation of pelvic floor muscles
Proper breathing techniques
Stretches for tight muscles
Strengthening for weak muscles
Improving posture and core strength
Modifications to toileting strategies and daily routine
Guidance on home exercises
Gradual return to daily, recreational, or sports activities
Manual therapy
Modalities including electromyography (EMG) biofeedback and rehab ultrasound

Pelvic Floor Biofeedback

Pelvic floor biofeedback is a modality that can be used to assess the activity and relaxation of the pelvic floor muscles. Ultrasound and/or surface EMG sensors may be utilized by your physical therapist to assess how your pelvic floor muscles are functioning.

Rehabilitation Ultrasound Biofeedback

Rehabilitation ultrasound biofeedback treatment involves viewing the pelvic floor with ultrasound. Your bladder needs to be full to view your pelvic floor. During this treatment, the ultrasound head will be placed on your lower abdominal area with ultrasound gel. You or your child will have the opportunity to view the pelvic floor muscles relax and contract on a screen with feedback from your physical therapy provider. To prepare for the appointment:

Wear athletic, comfortable clothing.
Use the bathroom (void) one hour before your appointment time.
Drink 20 to 24 ounces of water. Make sure to finish the water 30 minutes prior to appointment time.
Avoid voiding until after session is complete.

Surface EMG Biofeedback

During surface EMG biofeedback, small electrode stickers will be placed externally on your or your child’s perineal region to assess pelvic floor activity. Pelvic floor activity will be tracked on a computer. You or your child can play different games to work on pelvic floor muscle relaxation and contraction. Wear athletic, comfortable clothing to the appointment.

Pelvic Floor Physical Therapy Locations

*= biofeedback services provided at this location