Treatment is highly individualised and based on the findings of the evaluation AND on your family’s goals. Most importantly, we keep it fun, engaging, and rewarding for your child. Treatment can include:
1. Education – helping you understand what is going on and why it is happening
2. Bowel or bladder scheduling
3. Biofeedback techniques or awareness training for the pelvic floor
4. Providing helpful tips/strategies to try at home such as positioning, behaviour
modification, cueing, language/phrasing, diet adjustments
5. Skin care/wiping techniques
6. Exercises to retrain the pelvic floor
7. Manual therapy (externally only) on abdomen or joints of lower body and pelvis, or the external pelvic floor muscle
8. Postural Education
9. Teaching patient’s “Proper Peeing/Pooping Posture” to ease and assist with complete evacuation of bladder and bowels
10. Breath Work
a. The diaphragm (muscle that assist with controlling breathing) and pelvic floor muscles work together to generate pressure, relax anal/urethral sphincters, and lengthen the pelvic floor muscles when urinating or having a bowel movement. These are often uncoordinated in children with faecal or urinary leakage
11. Coordination Exercises
a. The pelvic floor muscles surround the urinary and anal openings and play an important role in maintaining continence.
b. In children that have constipation, the pelvic floor muscle is often uncoordinated—i.e. the child squeezes these muscles instead of relaxing them when attempting to pass a bowel movement. Coordination exercises can re-train these muscles to function as they should and thus improve constipation
c. In children with urinary or faecal leakage not associated with constipation, these muscles can be uncoordinated and weak, thus contributing to urinary or faecal leakage. Coordination exercises can re-train these muscles to function as they should and thus improve accidents
d. Children regain coordination in the pelvic floor muscles from the age of 4 years.
12. Myofascial Release
a. Manual therapy techniques to abdominal and pelvic girdle muscles that are tight or in spasm can contribute to urinary or faecal retention which can eventually lead to leakage
13. Pelvic floor muscle (Pooping and Peeing Muscle) therapeutic Exercises
a. This includes strengthening the pelvic floor muscles (surrounding the anal and urinary openings) as well as other muscles of the pelvic girdle that support the abdominal and pelvic region.
14. Collaborating with the rest of your care team such as your paediatrician, OT, family doctor, etc.
15. A home program to pull it all together (which is key to seeing results!)