From Frustration to Confidence: How Pediatric Pelvic Floor Training Empowers Therapists

Emma is a bright, energetic 7-year-old who loves art class, playground games, and reading with her mom at night. But at school, Emma’s teacher notices something troubling: she fidgets constantly in her chair, asks to use the bathroom several times a day, and sometimes doesn’t make it in time.

At home, things aren’t much better. Emma has frequent leaks, complains of stomach aches, and refuses to poop unless she is at home. Playdates and sleepovers are stressful, and her parents are exhausted.

The pediatrician had already suggested “it’s just constipation” and recommended more fiber and fluids. But months later, Emma is still struggling. Her parents feel like they have tried everything, yet nothing is working.

If you’re a pediatric therapist, you’ve probably met your own version of Emma. These kids show up in your clinic with challenges like:

• • Daytime urinary incontinence or bedwetting
  • Chronic constipation and painful bowel movements
  • Urgency and frequency that disrupt classroom participation
  • Abdominal pain linked to stool withholding
  • Toileting anxiety or refusal to use the bathroom outside of home
  • Loss of appetite and GERD

You recognize the problem. You want to help. But without training in pediatric pelvic floor therapy, you may not feel confident enough to address it directly.

This is understandable because most pediatric therapy clinical rotations and programs don’t cover the pelvic floor at all. Therapists graduate prepared to assess motor development, sensory integration, and posture, but pediatric pelvic health is rarely addressed.

That gap leaves families bouncing from pediatricians to specialists to therapists, without finding someone who can truly address the root cause.

If Emma’s story feels familiar, it’s because kids like her walk into your clinic every week. You see the signs: the frequent bathroom trips, the leaking that derails playtime, and the worried parents desperate for answers.

Yet, many pediatric therapists hesitate to address bowel and bladder issues head-on. Why? Because most of us were never trained to do so.

You might be thinking:

• “Is this within my scope?”
  Pediatric bowel and bladder dysfunction can feel like it belongs solely to the medical side, like something for pediatricians, gastroenterologists, or urologists to manage. But here’s the reality: pelvic floor dysfunction can be a musculoskeletal issue. As a pediatric PT or OT, you are uniquely qualified to address the movement, posture, and coordination components of toileting. You just need the tools. And be sure check your state’s practice act to understand your scope fully.
• “I wouldn’t know what assessment tools to use.”
  Unlike motor development or orthopedic rehab, there aren’t standard protocols most therapists learn in school for evaluating bowel and bladder. Without a framework, it’s easy to feel lost. Do you start with history-taking? A voiding diary? Posture? Muscle coordination? The uncertainty can hold you back from even trying.
• “What if parents ask questions I can’t answer?”
  Families dealing with bowel and bladder dysfunction are often frustrated and anxious for solutions. When they ask, “Why is this happening?” or “What can we do at home?”, it can feel intimidating if you don’t have clear, evidence-based guidance to share. That lack of confidence can make you avoid the conversation altogether.

The result? Kids like Emma keep slipping through the cracks. Therapists feel stuck, parents feel unsupported, and children continue to struggle with something that is not only common, but also treatable when approached with the right knowledge and skillset.

That’s exactly why pediatric pelvic floor training is so important in our therapy world. With the right framework, you’ll know how to screen, assess, and treat bowel and bladder dysfunction in a way that’s within your scope and deeply impactful for kids and families.

The truth is, Emma’s symptoms aren’t “just constipation.” They are signs of pediatric bowel and bladder dysfunction connected to the pelvic floor. Without training, you might feel uncertain about how to help.

You may focus on some general advice (i.e. “drink more water,” “eat more fiber,” “try a stool under her feet”) without ever addressing the real problem. Emma’s family leaves feeling like they’ve already tried these suggestions, and you are left frustrated without any progress.

Now imagine that you have specialized training in pediatric pelvic floor therapy. Instead of vague recommendations, you know how to look deeper.

You’re able to assess the strength and coordination of Emma’s pelvic floor muscles. You understand how poor toileting posture leads to straining and incomplete emptying. You can see the patterns of withholding behavior and explain how those habits reinforce dysfunctional voiding over time.

Most importantly, you have tools to intervene. With confidence, you can guide Emma through breathing and relaxation strategies and teach her posture techniques that make toileting easier. You know how to use biofeedback to retrain the pelvic floor and help her family build a structured bowel and bladder program to create consistency at home and school.

Rather than feeling helpless, you become a source of hope and solutions. Emma begins to regain her independence and confidence. She can finally focus on being a kid again, without bowel and bladder issues holding her back.

All your hesitations about treating pelvic floor dysfunction… they are exactly why I created the Peds Level 1: Treatment of Bowel and Bladder Disorders course. This course is specifically designed for pediatric PTs and OTs who want to expand their practice into pediatric pelvic floor therapy.

Here’s what you’ll learn how to:

• Understand normal voiding development and common causes of dysfunction.
• Evaluate bowel and bladder conditions like constipation, incontinence, and bedwetting.
• Use tools such as biofeedback and external techniques for assessment.
• Teach children and families effective strategies for healthy toileting habits.
• Apply case studies to guide real-world treatment planning and progressions.

By the end, you’ll have a solid foundation in how to assess and treat children with bowel and bladder dysfunction, and the confidence to make a difference.

When you learn and utilize your pelvic floor training, the results ripple outward in powerful ways. Children experience more confidence in their daily routines. Families feel supported and empowered, no longer frustrated or alone in their search for answers. Schools benefit as well, with kids able to participate more fully in class, focus on learning, and attend without the constant interruptions of bathroom trips.

And for therapists, the change is just as meaningful. With the right training, you become the trusted provider who can solve problems that others couldn’t, giving you the tools to truly transform a child’s health and quality of life.

👉 Join me live on October 25-26, 2025 for the virtual Peds Level 1: Treatment of Bowel and Bladder Disorders.

Don’t miss out on this opportunity to expand your skills and make a greater impact!