The pelvic floor is a group of muscles that are located in the pelvis. These important muscles provide support for the pelvic organs and core and help control urinary and bowel functions. The pelvic floor is like any muscle in the body and can become tight, weak, go into spasm, or have poor muscle coordination. Pelvic floor therapy can help with many different types of dysfunction 

• Constipation

• Increased urinary frequency

• Decreased urinary frequency

• Day-time/Night-time incontinence

• Bed-wetting/enuresis

• Giggle incontinence

• Incontinence in the athletic child or teenager

• Waking up in the night to urinate or nocturia

• Difficulty with urination, straining, slow flow, pain during or after urination

• Reduced sensation of bladder or bowel fullness

• Pain in the abdomen, bladder or lower back

• Fecal incontinence

• Treatment after pediatric pelvic surgery

Our therapists are trained with the use of biofeedback. Biofeedback for pelvic floor muscle retraining is a treatment to help our patients learn how to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease some types of pelvic floor pain. It is a painless process that uses special sensors and a computer monitor to display information about muscle activity. This information or "feedback" is used to gain sensitivity, and with practice, control over pelvic floor muscle function. Biofeedback uses graphics and games such as rockets or dolphins to encourage the patient to either engage their pelvic floor, hold the contraction, and release. There are settings for downtraining for patients with hyperactive muscles that give them an achievable goal which is the ability to move the goal line, as well as uptraining to improve activation of muscle. It was found that interactive computer game-based biofeedback in childhood functional outlet obstruction showed improved voiding pattern flow rates, decreased episodes of soiling, perceived severity of constipation and quality of life scores.

Biofeedback uses a series of games that make progression achievable and fun for patients. The dolphin game works by showing the patient how to contract with the dolphin going into the air. Holding a controlled contraction allows the dolphin to begin a dive and relaxing the pelvic floor makes the dolphin return to the water. Building coordination, proprioception, strength, and endurance of the muscle for voiding.

The rocket ship works by controlling a contraction moving the rocket to the loading dock. The patient has to maintain a controlled contraction to allow the ship to “prepare for take off” then the relax sends the rocket ship. This allows patients to problem solve and improve the coordination of their pelvic floor to increased controlled voiding.  

Two other ways to help train the pelvic floor is downtraining is a tool used for kiddos who are stuck in a spasm which makes it difficult to completely void, as well as potential pain, or poor stream when urinating. The goal line is movable making the achievement reachable and ability to make it harder as the patient progresses. Uptraining works, again by allowing the patient to reach an achievable goal, this however works on strength and coordination of the muscle to improve proper voiding.