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Pediatric Incontinence

Constipation: How Physiotherapy Can Help

Jenny Roy
March 17, 2021
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Constipation is very common in children, and can be very difficult for them to manage. We’ve all been there before, and know how uncomfortable constipation can be. For little ones, it can impede with their desire to play, sit properly, can cause accidents, bedwetting and a lot of stress and anxiety. It is not something that parents often associate with physiotherapy, but it definitely should be. Physiotherapy can help your child to have more frequent success in the bathroom!

How do you know if your child is constipated?

Some signs of constipation are: 2 or fewer bowel movements per week; painful bowel movements;very large stools for their age; bed wetting; pediatric incontinence (urine).Signs that children are trying to hold in their stool, often due to a fear of pain, include clenching buttocks, extending legs, toe walking, and very narrow gait.

What causes constipation?

Not only can constipation be linked to one’s diet; it can also be a direct result of a weak core and delayed motor milestones. The pelvic floor and the diaphragm are extremely important members of the core musculature. They work together by moving down on inhalation and up on exhalation. This helps to stimulate organs involved in bowel movements to move things along. If a child has a weak core oris a “breath holder”, this core unit is not working together optimally and it can have a direct impact on bathroom habits.

Posture is also very important in the function of the pelvic floor. Poor posture can put the core unit at a more difficult position to be used. This can decrease the pressure in the abdominal cavity, and therefore put less pressure on the intestines to move “things” along. W-sitting, although a favourite position for many, can be detrimental to the pelvic floor. It can stretch out the pelvic floor and put itat a weak position, leading to an overactive bladder.

Physio’s Top Tips for Home:

Posture: When sitting on the toilet, a “squatty potty” or stool that puts your child’s hips above a 90 degree angle can help to put the rectum at an optimal angle to allow stool to go through. Encourage your child to sit up tall and take deep breaths with a full exhalation.

Abdominal Massage: Massaging the lower abdominal area can help to increase the pressure in the abdominal cavity and get things moving. Parents can use their hands to apply firm pressure, and it can also help to have a child roll their bellies over a firm exercise ball.

Core strengthening: It is important to not only increase the strength of the core, but improve motor planning to allow each element of the core to work together optimally. A physiotherapist can help train your child’s core through breathing exercises as well as other fun core strengthening exercises.

Schedule: Eating causes a reaction in our bodies that stimulates bowel activity. This typically occurs 20-40 minutes after a meal. Take advantage of this and have your child go to the bathroom during this time. Try to create a stress-free environment by not putting pressure on your child to have success and to have books or toys to make it fun. Aim to have them sit for their age in minutes. If your child is 6, have them stay for 6 minutes!

Water Intake: It is essential that our bodies have enough water for bathroom habits to be consistent and frequent! Try making a sticker chart to ensure that your child is drinking enough water throughout the day.  

If your child is experiencing constipation, don’t hesitate to give us a call. It can be an awkward thing to talk about, but it’s important to normalize this conversation so that children realize that it is not something to be embarrassed about and actually quite common. Physiotherapists can help to work on alignment, core strength, motor planning, myofascial release, etc. so that your child experiences as much bathroom success as possible!

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