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Monthly archive for March 2019

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

I never imagined that bowel movements and urination would become a daily topic of conversation. Then I had kids. It instantly became the norm to pay attention to whether the baby went poop each day, what it looked like, how many times, etc. As my child got a few years older the questions changed, but the topic stayed the same – do you have to go potty, does your stomach hurt, when was the last time you went, etc…

When your child is having issues with constipation or bed wetting, it can be difficult to properly diagnose. As a parent, you can’t help but wonder if this is just a normal part of growing up, or if you should be concerned.

By six years old, most children should have full control of their bowel and bladder function. Yet, it is estimated that up to 20% of pediatric healthcare visits revolve around bladder and bowel problems. And, up to 25% of children visiting a pediatric gastroenterologist experience bouts of constipation or encopresis (bowel leakage or soiled undies).

These issues can be frustrating for both parents and children. But, help is available through pediatric pelvic floor physical therapy – a safe and effective treatment options for infants, toddlers, and children.

Common pediatric pelvic floor issues include:

Pediatric bed wetting & daytime incontinence – Most children begin to stay dry the entire night between the ages 3 and 5. The primary reason for nighttime leakage is constipation, followed by not fully emptying during the day. Our bodies are designed to hold urine and children should not have to get up to urinate at night.

Pediatric Constipation – Constipation is one of the most common gastrointestinal complaints among children, but can also be a contributor to urinary leakage or the urgency to go. Pediatric bladder and bowel dysfunction can continue well into adulthood so it’s important to get this taken care of early on. Contributing factors to constipation can include diet, emotional issues, and sometimes busy children simply ignoring the signs that they have to go.

Diastasis Recti – A common issue in infants, especially those born prematurely, diastasis recti is a separation between the left and right side of the rectus abdominis muscle, which is the muscle that covers the front surface of the belly. This can also lead to poor trunk control, which can affect the bowels as well.

Other diagnosis that affect the pelvic floor in children – voiding dysfunction (when your child’s bladder is not emptying, or they are not urinating normally or fully), urinary urgency and frequency, vesicoureteral reflux (backflow of urine into the kidney), and pelvic pain.

Treatment for pediatric pelvic floor issues

Physical therapy can be a safe and effective way to help a child gain control of his or her bladder. By focusing on a group of muscles and soft tissue, called the pelvic floor, which support the pelvic organs and help control bladder function. When these muscles are too tight, too weak, or in spasm it can cause problems in children because the pelvic floor muscles aren’t working well with the bladder.

Children who are experiencing issues with bladder and bowel control may be more prone to bladder infections, constipation, difficulty sensing when the bladder is full, or other problems resulting from not completely emptying the bladder. This can also lead to urinary or bowel leakage and wetting during the day or night.

Pediatric pelvic floor treatment techniques may include:

  • Biofeedback – Helping children learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease pelvic floor pain
  • Behavorial and diet modification
  • Soft tissue mobilization – Using hands-on techniques on muscles, ligaments and fascia with the goal of  optimizing muscle function
  • Stretching and strengthening of pelvic floor and surrounding muscles
  • Relaxation techniques

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

 

As a mother of two children, I’m passionate about pediatric pelvic floor issues and eliminating the stigma surrounding them. There’s a level of stress and embarrassment associated with these conditions, for both parents and children. It’s important to understand that pediatric pelvic floor issues aren’t normal, but they are treatable with the right help. If a child had ankle problems, you would address those problems with a specialist. The same should go for bowel and bladder issues – these are real problems that should be talked about openly so children can get the help they need.

Melissa VanKampen
Pelvic Floor Expert & Physical Therapist Assistant

Physical therapy may help if:

  • Child is 5 years or older and still wears pull-ups
  • Medication is needed for bladder or bowel control
  • Urinary incontinence or leakage
  • Bed wetting (nocturnal enuresis)
  • Laughing causes urine leakage
  • Frequent urination or overactive bladder
  • Infrequent urination or underactive bladder
  • Constipation/diarrhea, painful bowel movements, over/underactive bowels

With a parent present, a physical therapist with specific training in pediatric pelvic floor therapy will examine the muscles of the abdomen, pelvis, and pelvic floor area. Consultation and treatment often consists of muscle retraining, biofeedback, patient and family education, behavior and diet modification, soft tissue massage, stretching and strengthening of the pelvic floor and surrounding muscles, and a home exercise program. We have expert physical therapists on site who are specifically trained to work with this population.

If you feel your child may be suffering from any form of pelvic floor dysfunction, call our Coopersville office at 616.997.6172 or schedule a free consultation with Melissa VanKampen, physical therapist assistant and our lead expert in pediatric pelvic floor treatment. Melissa has taken numerous continued education courses in pediatric pelvic floor issues related to constipation and bed wetting.

 

Get more information about pediatric incontinence and pelvic floor dysfunction from Herman & Wallace, the pelvic rehabilitation institute.

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Treatment for Pediatric Constipation, Bed Wetting, & Leakage

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

Susie Kluting has used a wheelchair or crutches to get around her entire life, but one could argue that she’s equally comfortable on the ice. Despite being born with spina bifida, 26 year old Coopersville resident Susie has never let that get in her way. Susie has tried wheelchair tennis, wheelchair basketball, swimming, fencing, water skiing, and rock climbing. While she’s always enjoyed being active, she longed for a sport that would really speak to her – that’s where sled hockey came in.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckSpina bifida left Susie with limited use of her legs, but she never let her “different ability” get her down. The second youngest of six children, Susie grew up on a farm and inherited a love for animals and cheering on her siblings at their various sporting events. While she loved the years she spent showing rabbits through 4-H, riding four-wheelers with her brothers, and farm life in general, she wanted to find something new that she could do with people who were “more like her.”

At a young age Susie began trying a variety of different clinics and playing sports through Mary Free Bed. Although she tried many different sports and continued to attend sports camp every summer until she was 18, Sled Hockey is the one she excels in.

Sled hockey was invented in the early 1960s by a group of Swedes at a rehabilitation center who, despite their physical disabilities, wanted to continue playing hockey. Sled hockey follows most standard ice hockey rules, except players sit in specially designed sleds that sit on top of two hockey skate blades. Each player has two sticks which are used to hit the puck and to propel themselves.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

Northern Physical Therapy has been a big part of my recovery from all sports injuries, and they’ve helped tremendously in allowing me to maintain my ability for the past 8 years. I love the team at Northern! They’re so helpful, friendly and always happy to answer any questions I have. Northern PT has helped my independence as a young adult and made it possible for me to do daily tasks at home, take care of myself, enjoy activities with my family, and compete in team sports – for this I am so grateful. – Susie Kluting, physical therapy patient living with spina bifida

For the last six years Susie has been the Assistant Captain for the adult Grand Rapids Sled Wings, which was formed because of the high level of interest from players who were over 18, which is the age limit for the junior league. She has also been a part of the U.S.A women’s sled hockey team. Susie can even thank sled hockey for introducing her to her boyfriend Connor. They met in 2010 at a sled hockey camp in Rochester, N.Y. and have been dating since 2017.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckBecause Susie is living a majority of her life in a wheelchair, and is also someone who is very active, she understands that injury is always a possibility. To keep her game in check, and to maintain her level of daily activity, Susie regularly receives physical therapy treatments, even during her off season.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckHow can physical therapy help With spina bifida?
Physical therapy plays an important role in helping children and adults with spina bifida gain and maintain mobility, and function at their best throughout all stages of life. Spina bifida is a birth defect involving the spine that occurs when a baby’s “neural tube,” or fetal spinal cord, does not completely close in the early stages of development during the first month of a mother’s pregnancy.

Spina bifida may cause both physical and intellectual disabilities that range from mild to severe, depending on the size and location of the opening in the spine, and the extent to which the spinal cord and nerves are affected. Babies born with spina bifida often cannot move their legs due to weakness or paralysis resulting from spinal cord and nerve damage.

People living with spina bifida can experience partial or complete paralysis and may need assistive devices like braces, wheelchairs, or crutches. These people work with physical therapists to learn specific muscle strengthening exercises.

We can help
A spina bifida diagnosis can leave parents with many questions and concerns. If you’ve wondered how physical therapy can help you or your child, schedule a free consultation with one of our therapists. We’ll conduct an evaluation and talk about the different treatment opportunities available.

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An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

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