Your pelvic floor muscles are like any other in the body they are just internal, so nobody really talks about them! They are located at the base of your pelvis and support/surround your openings (penis urethra, anus for boys and vagina, urethra, anus for girls). Because these muscles don’t “move a limb in space” or provide “external feedback” (i.e. you don’t see or feel them) during their use throughout the day, dysfunction can go “unchecked.” One dysfunction that commonly appears in children pelvic floor owners is too much tension! Below are 6 signs that your child’s pelvic floor muscles may be too tense!
1. Nighttime Bedwetting
Many parents are told that nighttime bedwetting is something “your child will grow out of” or “it’s genetic and eventually will resolve.” This can be frustrating for parents as it leaves both you and your child INACTIVE in remedy this common problem! While bedwetting can have genetic links it is NOT a “sentence” that your child must pay or wait to grow out of! Poor daytime urinary frequency, constipation, and incomplete emptying---all impacted by a “too tense” pelvic floor are MORE LIKELY causes to your child’s nighttime bedwetting.
2. Difficulty with peeing or pooping
As mentioned above, the pelvic floor muscles surround your “poop and pee holes” (as well as surround the vaginal opening or travel up to mid-shaft of the penis). These muscles need appropriate resting tension as well as ability to contract AND lengthen to allow for poop or pee to smoothly exit the body.
3. Strong or frequent peeing
I see this ALL. THE. TIME. clinically but I feel this connection is often missed by clinicians! Abnormally strong urge to urinate or peeing too frequent is often a sign of too much tension/poor mobility. Picture this: I give you a 50 lb. dumbbell and tell you to hold it in your right hand but with your elbow straight and arm raise above your head. I then tell you to hold if there for 20 hours. Eventually your shoulder and arm muscles will signal an “overwhelming URGE” to let go or set the weight down. Now think of that scenario as it applies to your child’s pelvic floor and a sustained squeeze or muscle tension----eventually their body will signal an “overwhelming URGE” to pee and can often lead to frequent peeing.
As mentioned above, the pelvic floor muscles surround your openings INCLUDING your “poop hole.” Those muscles need to be soft and relaxed as well as have proper coordination to lengthen and open to allow poop to exit the body. If your pelvic floor muscles are “too tense” then your poop hole will not relax and lengthen appropriately to allow poop to exit. The longer poop sits in your body, the harder it gets. The harder your poop is, the more difficult it is to pass or exit the body…hence CONSTIPATION!
Hot take—This one may seem a little counterintuitive but let me blow your mind with this knowledge BOMB! Most people assume that having leakage equates to “weak or loose” pelvic floor muscles. Now while this is the case in some scenarios, in children it is often the opposite! Picture this: I ask you to flex your elbow at 90 degrees and hold it there for a YEAR straight. Do you think you would be able to straighten it out after a year of holding it flexed? NO! Your muscles adaptively shorten from chronic tension. Would this very same arm be able to do as many bicep curls as an arm that has full range of motion! NOPE! Would you get dressed, shower, or go through daily life the same using that “shortened” arm? NOPE! In order to have “good strength” you need to FIRST have “good length!” Pee leakage in children can come from a tense and weak pelvic floor described above. This would present at pee leakage with a strong urge or on the way to the restroom, leaking with exercise or activity, leaking with laughing, etc. Poo leakage again can come from a tense and weak pelvic floor in combination with constipation. Picture this--- your child is constipated and has a “blockage” sitting at the base of the colon and is unable to pass this. Despite this, your child still continues to eat and go about their normal routine---hence continuing to make “new poop.” New poop that is made starts off soft and when it meets the “poop blockage” it sneaks around it and slides out---often presenting as poo smears or small leaks.
6. Frequent UTI’s
This is another feature that is often caused by a pelvic floor that is “too tense” and uncoordinated. When peeing, your child’s pelvic floor muscles need to be soft, relaxed, and “inactive” to allow pee to exit the body. Picture a garden hose with the water on. When you “pinch” or “kink” the hose, water may not exit as well or incompletely. This is what occurs when your child has too much tension---incomplete emptying of the bladder. Incomplete emptying of the bladder can cause stagnant or “older” urine in the bladder which is more prone to infections. Constipation and fecal smears can also cause bacteria which can ALSO contribute to frequent UTI’s.
If you think your child’s pelvic floor may be too tense or you are dealing with any of the 6 signs below, contact us so we can help! Check out the 2 other blog posts in this series including 5 signs your Pelvic Floor is too tense for WOMEN and MEN.
© Amanda Moe 2022. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Amanda Moe and/or COM-Physical Therapy 2022 with appropriate and specific direction to the original content