Ok, so someone has recommended you see a Pediatric Pelvic Floor Physical Therapist (we’ll just call them Pelvic Floor PTs because otherwise that’s a very long name!) and you’re thinking: “what in the world is that?!”. I totally get it. It’s confusing. It may even feel a bit scary or embarrassing. Let’s go over what Pelvic Floor PT is and what it will be like when you go.
A Pediatric Pelvic Floor PT is someone who helps kids with things like constipation (not being able to get all the poop out of your body), pee accidents, poop accidents, or wetting the bed. Sometimes kids go to Pelvic Floor PT because their hips, penis, vagina, or bottom hurts. Pelvic Floor PTs can help figure out what is causing these things to happen and can help figure out how to make things work better.
The first thing to know is that lots of kids work with Pelvic Floor PTs. You are not alone in this. When someone breaks an arm, we all sign the cast and talk about it over lunch. However, when we are having challenges with pooping, peeing, or our bottom areas, we typically don’t talk about it much with our friends. Sometimes this makes it seem like we are the only ones going through this! There’s a good chance that some of your friends have gone through the same thing and just aren’t talking about it. In fact, about one in every five kids has had something not work quite right with their pelvic floor! There’s nothing you are doing wrong and there’s no need to feel embarrassed.
At this point, you may be thinking, “Hold up! What even is a pelvic floor??”. Good question! The pelvic floor is a team of muscles inside of your hips which help hold all of your guts where they need to be, help pee and poop come out of our bodies when it’s time to go to the bathroom, and who help pee and poop stay in our bodies when it’s NOT time to go to the bathroom. They typically work on their own without us having to tell them what to do, but when something goes wrong and they stop listening to us, it can be chaos!
Thankfully, your Pelvic Floor PT can help. These PTs are specially trained doctors who help figure out what is going wrong with our pelvic floors and help us teach our pelvic floors how to work again.
Ok, so now let’s talk about what your first visit to the Pelvic Floor PT will be like! The first visit will likely be a lot of talking at first. We want you and your parent or guardian to tell us all the details of what’s been going on. The more information you can give your Pelvic Floor PT, the more clues they will have to help figure out the mystery of what is going wrong and make a plan to help. They will also probably send you home with some detective work yourself! Sometimes they’ll give you a journal to keep track of when you pee and poop, what your poops look like, when you are drinking, and if you have any pee or poop accidents.
After you are done telling your story of what’s been going on, your Pelvic Floor PT is going to want to take a quick look at your back, belly, legs, and hips. They may gently press parts of your body to see if anything else may be making things harder on your pelvic floor.
The next step is to see what your pelvic floor muscles are doing! Pelvic Floor PTs do this by using a machine called “biofeedback”. I often call it the “Butt Video Game” because that’s pretty much what it is! Biofeedback uses small smart stickers placed on the outside of your bottom to show what your muscles are doing on a computer screen. The stickers talk to the computer through long wires. I don’t know about you, but anytime I see something with wires and a long name at a doctor’s office, I get SCARED! But don’t worry, it never hurts and can actually be pretty fun (there’s a reason we call it the Butt Video Game!). We need to use biofeedback because the pelvic floor is hidden inside our hips and we can’t see it move. It would be super tricky to learn how to coach your pelvic floor without it!
Now let’s talk about the steps to use the biofeedback. With your parent or guardian’s permission and after talking with you, your Pelvic Floor PT will let you either take off your pants and underwear or just pull them down far enough for them to put the stickers where they need to go. They’ll give you a towel or blanket to cover up with when they’re not putting the stickers on. Your Pelvic Floor PT will come back when you’re ready, place the stickers quickly right next to where the poop comes out (your anus), and then cover you back up (you don’t want a cold bottom!). Nothing goes on the inside of your body and nothing hurts!
It’s important to remember that no one should touch your bottom unless your parent or guardian says it’s ok, they are explaining why touching your body is needed, and you are in a doctor’s office. Here it is safe to let someone touch your bottom because your Pelvic Floor PT is a doctor, your parent or guardian says it’s ok, they’ve explained why they want to touch (to coach your pelvic floor!), and you are in their doctor’s office.
The next step is the fun part of the biofeedback! We get to see what your muscles are actually doing! When you squeeze your pelvic floor muscles, nothing on the outside of your body should move, but you’ll see the line of the computer screen go up. When you let your pelvic floor muscles relax, you’ll see the line go down. Your Pelvic Floor PT will ask you to draw different shapes by squeezing and relaxing your pelvic floor muscles. Squeezing your pelvic floor muscles is called a “kegel” and is the same thing you’d do if you were trying to stop pee or hold back gas.
When you and your Pelvic Floor PT finish your investigation and have fine-tuned your butt-drawing skills with the biofeedback, they’ll step out while you get dressed again. Once you’re ready, you, your parent or guardian, and your Pelvic Floor PT will make a plan of what exercises you’ll be doing at home and how frequently your PT wants you to come back to their office. At any point during your visit, but especially when you are talking through a plan at the end, ask any questions you may have. This is a team effort and you are the MVP!
If you have any questions about what to expect from Pelvic Floor PT, let your parent or guardian know and together you both can ask through the “Contact Us” section of our website!