Have you sought assistance for your bedwetter? Bedwetting accounts for 20% of visits to pediatricians. Has your doctor told you not to worry, your child will “grow out of it”? Have you been sent to a specialist for pelvic therapy, such as “biofeedback”. The #1 question I’m asked by parents looking for help for their child is: “Do you do biofeedback?” I do utilize biofeedback for pelvic floor re-education and training, as studies have shown it to be effective in treating bedwetting and other forms on incontinence. However, as a pediatric pelvic health physical therapist, I offer much more. First, let’s discuss biofeedback.
What is biofeedback and how does it help bedwetting?
Biofeedback refers to teaching increased awareness and control over a biological process. In the treatment of bedwetting, the goal would be to train your child to relax (“downtrain”), activate (“uptrain”), and/or coordinate their pelvic floor muscles to promote improved urinary continence. This can be done using a mirror to visualize the area around the anus while practicing verbally guided exercises. Surface electromyography (sEMG) is another form of biofeedback. This involves placing small adhesive electrodes externally around your child’s anus. Nothing is done internally. These electrodes read the electrical activity of your child’s pelvic floor muscles. This information is amplified using an animated computer program. This allows your child to see visual feedback (eg. flower opening/closing) when relaxing or contracting the muscles around their anus. SEMG is the method typically recommended for treatment of bedwetting.
What happens when biofeedback isn’t enough to stop bedwetting?
Has your child “flunked” pelvic therapy? Of course not. The frustration with limited results in sEMG biofeedback often stems from the lack of a holistic approach. Physical Therapists are musculoskeletal experts. We have extensive training in anatomy, physiology and movement of the body. This training affords a pediatric pelvic health physical therapist the opportunity to look at your child in a holistic way, not solely focusing on the pelvic floor. Nothing in our body works in isolation. If your child sprained an ankle, odds are a PT would not only work on his/her ankle, but would also look at posture and hip control. Same idea. Your child’s pelvic floor therapy will be more effective when other musculoskeletal deficits are addressed.
Other components a Pediatric Pelvic Health Physical Therapist may incorporate into your child’s program (in addition to sEMG), include a full musculoskeletal evaluation, breathing pattern assessment, myofascial release, bladder re-training program, behavior/diet modification, and more. If you feel your child can benefit from additional support, seek out a consultation with a local pediatric pelvic PT.
Marina D. Castellanos is a Pelvic Health Physical Therapist in Westchester County, NY. She performs home visits, and has office hours in Eastchester (The Temperance Center), and Portchester (Developmental Steps). To learn more check out