Paediatric Pelvic Health Physiotherapy: Your First Appointment

As a parent, the thought of bringing your child to a physiotherapy appointment focused on their bladder, bowel, and pelvic floor can bring up a lot of questions and maybe even a few fears. This article is here to help ease those worries by explaining what to expect during your first assessment.

What is Pelvic Health Physiotherapy for Children?

You might be wondering why a child would even need physiotherapy for their bladder and bowel. Think of it this way: just like any other muscles in the body, the muscles that control the bladder, bowel, and pelvic floor can sometimes have a few difficulties. These issues can show up in different ways, such as:

·       Daytime wetting or little wee accidents (enuresis)

·       Bedwetting (nocturnal enuresis)

·       Constipation, soiling, or poo accidents (encopresis)

·       Urgency or needing to go to the toilet very often

·       Pelvic pain (sometimes when making a wee or a poo)

These symptoms can appear even after your child has been fully potty trained, which can sometimes make a parent or child feel like potty training has failed. Please remember, this is nobody’s fault, and these problems are more common than you might think. Most importantly, there is help available!

Read our previous blog post Potty Problems for more information!

What Happens During the First Assessment?

The first appointment is all about gathering information and getting to know you and your child. It's a relaxed and private space where the physiotherapist will focus on building a trusting relationship with your child to help them feel comfortable.

Here’s a general idea of what you can expect:

• Before Your Appointment: You'll have the option to fill out a detailed online form. This is a great way to let the physiotherapist know exactly what your child is experiencing, along with any other helpful details like their diet, how much water they drink, and their medical history. Filling this out beforehand can save you some time during the first appointment.

• The First Chat: The physiotherapist will chat with you and your child (depending on their age) about your main concerns. This conversation is always kept child-friendly to ensure your child feels included and at ease.

• Observation: The physiotherapist will gently observe your child’s posture and how they move. This helps them see if any muscles are working a little too much or not quite enough. They might ask your child to do some simple things like breathing, sitting, walking, or other fun tasks.

• Physical Examination: It is very uncommon for a child to have an internal or external examination of the pelvic area during the first appointment. In our practice, we never perform internal examinations, even after the first visit. If this type of exam is ever needed, we would refer you to another appropriate practitioner. Palpation over the child's clothes may be done in order to feel movement of the pelvic floor muscle group, but likely not in the first assessment. This is only ever done with a full explanation, consent from both the child and the parent, and a parent or guardian is always required to be in the room.

• Education and Explanation: A big part of the first session is making sure both you and your child have a clear understanding of the underlying issues.

• Goal Setting and a Plan: This is often the most important part! Together, you, your child, and the physiotherapist will discuss a path forward and set both small and big goals. The plan might include:

  • Establishing healthy toilet routines.

  • Simple stretching, strengthening, or breathing exercises to do at home.

  • Keeping a bladder or bowel diary to track progress.

  • Referring you to another practitioner for more specialized care, if needed.

How to Prepare Your Child:

• Talk to them beforehand: Explain that they will be seeing a physiotherapist who helps kids with their bodies and muscles, especially when there are problems with wees or poos. Use simple and gentle language they can understand.

• Reassure them: Let them know it won't be painful or scary and that you will be right there with them the whole time. Mention that there will be toys and books to play with as well.

• Empower them: Remind them that it's okay to say "no" if they feel uncomfortable with anything.

• Bring a comfort item: A favorite toy or book can help them feel more secure and at ease.

Some Extra Tips:

• Pack a strappy top or t-shirt and some shorts for your child to wear if they prefer not to undress for the assessment.

• If you have completed a bladder diary or have any medical reports, please bring them along or email them to the therapist beforehand. The more information we have, the better!

• If there are any sensitive topics you'd like to discuss privately, you can set up a separate appointment or video call before or after the initial assessment.

We're Here to Help!

We understand that talking about these issues can feel sensitive for children. Our physiotherapist is skilled at creating a comfortable, non-judgmental environment. They use child-friendly language, toys, and visual aids to help children understand and participate in the assessment. Your child's comfort and privacy are our top priorities.

The first assessment is a very important step in understanding your child’s unique needs and creating a plan tailored for them. This is a team effort, and your involvement is incredibly valuable.

Please don't hesitate to contact us if you have any questions or would like to book an appointment!