Tag: Constipation


Pediatric Incontinence
& Pelvic Floor Health

  • cutout incontinence

  • Toddler Incontinence

  • teenage incontinence

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what is pediatric incontinence therapy?

Pediatric incontinence occurs when children over the age of 4 have difficulty controlling their urine and have leakage. It can occur at night or during the daytime. This can add additional stress to the child, their parents, and impact participation in social events. Physical therapy and occupational therapy can help with this in a variety of ways.  

What could be involved?

Common symptoms associated with pediatric incontinence:

  • Bedwetting (Enuresis): 

Urination during the nighttime can be caused from constipation, increased production of urine at night, and/or intake of bladder irritants prior to bed.

  • Overactive bladder: 

This is a sudden and uncontrollable urge to urinate. Children may have accidents from not making it to the bathroom on time, and may often sprint to the bathroom to avoid an accident. 

  • Dysfunctional voiding: 

Children may have difficulty fully emptying their bladder and may be contracting the muscles that need to relax during urination. This leads to less emptying with occasional leaking.

  • Urinary urgency: 

Child may feel like they need to use the restroom frequently and without much warning.

  • Voiding postponement: 

Often associated with a low number of voids per day. A typical child voids 4-5 times a day. This can be related to low awareness of need to void as well as purposeful withholding.

  • Stress incontinence: 

This occurs when a small amount of urine leaks with exertion such as with playground activities. 

  • Giggle incontinence: 

A complete void occurs during or immediately after laughing with normal bladder function when not laughing.

What does a treatment session look like?

Physical or occupational therapists with pediatric incontinence training will meet with the child and their parent(s) and/or guardian to get a history of the current concerns. A physical examination is then completed to look at the muscles of the abdomen, legs, and back. The parent or guardian is present throughout the exam and the exam occurs over clothing. The findings of the exam are then sent to the referring physician to determine the most appropriate treatment plan for that child. Treatment sessions are one therapist to one child. They occur in a private treatment room with the children dressed and caregiver present. Our therapists incorporate a holistic approach that includes diet, sleep patterns, and other behavioral conditions that could be impacting the child’s continence. Our multidisciplinary team is able to collaborate to determine the best strategies for each child. These strategies may include:

  • Core strengthening
  • Biofeedback
  • Bladder re-training
  • Behavior and diet strategies
  • Body awareness to help realize the urge to go
  • Posture training
  • Sensory strategies to assist with tolerance for public bathrooms and toileting
  • Review of bathroom setup
  • Bowel and bladder logs
  • Increasing variety of foods and limiting bladder irritants
  • Modified O’Regan Protocol

What is biofeedback?

Biofeedback is a little machine that helps children learn to relax and contract their muscles that help them use the bathroom more efficiently. Little stickers are attached to their muscles and give feedback to a computer. This feedback is connected to a game that responds to the child’s relaxation or contraction of specific muscles. Biofeedback is commonly used for pediatric incontinence, but can also be used for body awareness to help strengthen specific muscles. Biofeedback sessions occur in a private treatment room with an adult caregiver present. 

Modified O’Regan Protocol (M.O.P.)

We have a M.O.P. ( Modified O’Regan Protocol) specialist, Andrea Turnell, PT, DPT, on staff that can support your child’s M.O.P journey and assist in interpreting your process!

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Potty Accidents

Potty Accidents

Why is my child having potty accidents?

Potty accidents aren’t fun for anyone. It can impact a child’s relationships with their family and friends.  Here are 5 common reasons children have accidents


Chronic constipation is the main cause of pee and poop accidents in children that have been potty trained. This is a great handout to see if your child has any of the main signs of constipation. Did you know that pooping every day doesn’t mean they aren’t constipated? “The Poo in You” is a video with a great explanation of what happens inside the body. 

Lack of Awareness 

Many kids may not have any idea that they have to go. They may not realize that they have to use the bathroom until it’s too late, or until they’ve already gone. Knowing what is happening inside the body can be a hard concept for kids with difficulty with sensory awareness. 

Poor Potty Posture 

Poor potty posture makes it hard to clear out the bladder and bowels. The Squatty Potty  or other step stool helps support the feet which lets the pelvic floor muscles relax. Therapists can also help with postural awareness and strength to help with the proper potty posture for successful toileting.

Scary Bathrooms

The bathroom can be a scary place for kids! Sitting with dangling feet, the noise, and the smell can all make kids avoid the potty. Many children avoid public bathrooms because of these fears. 

Medical Reasons

There could be a medical reason your child is having accidents. If you have concerns about your child’s accidents talk to your pediatrician. They can help decide if a referral to gastroenterology or urology is needed.


Who can help my child?

If you think your child might have constipation or is struggling with accidents, please reach out for a free screening! Sometimes, you may need the help of a physical, speech, or occupational therapist to help identify the reasons for your child’s accidents and/or constipation. 

Pediatric Therapists

Therapists trained in pediatric incontinence can provide treatment with:

    • Core strengthening
    • Biofeedback
    • Bladder re-training
    • Behavior and diet strategies
    • Body awareness to help realize the urge to go 
    • Posture training
    • Increasing fiber rich food intake 
    • Increasing variety of foods
Infant Massage

Infant Massage

Benefits of Infant Massage

Massage has benefits at any age, but for babies it can be extra helpful! The best time to massage your baby is when they are awake, but alert. It doesn’t have to last long to get these benefits. You don’t need much, a comfortable room, something soft to place baby on, and some oil (here are some suggestions to pick out what works for you)!

Improved development 

Massage can improve circulation, improve muscle tone, and provide increased awareness of a baby’s body parts. It’s also a great time to talk to your baby which will help their speech and language.

Improved sleep

Daily massage can help babies build tolerance to handling and different input. This can help them learn to calm and relax their bodies on their own which can help them The relaxation linked to massage can help baby fall asleep on their own. 

Improved digestion

Babies occasionally experience difficulties with pooping or have increased gas. There are specific massage techniques that can help move gas bubbles and poop along. 

Parent and child bonding

Massage is a great way for parents, caregivers, and grandparents to bond with their baby. Babies respond differently to different strokes. It’s a great way for parents to pick up on the babies cues. It’s also a great excuse to get some 1:1 quiet time with baby. What a great way to break up that witching hour!

Improved body awareness

Body awareness helps babies start interacting with their environment. They get input when they recieve massage. This can help improve their awareness of where their body is in their environment. If your baby has a preference for using one side more than the other it can be a great way to help them be more aware of the side they don’t use as much


If you would like to learn how to massage your baby , BDI Playhouse offers Infant Massage classes in clinic and virtually. Trained therapists will help you find the best way to ready your baby’s unique cues to get the most out of massage! 


 Written By: Andrea Turnell, PT, DPT


Physical Therapy

Pediatric Physical Therapy

  • Serial Casting

Questions about Physical Therapy? 




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BDI Pediatric Physical Therapy

Pediatric physical therapy is for more than just injury rehab or treatment of a diagnosed motor condition. Many children need short term Physical Therapy to address minor challenges or concerns noted by parents. A diagnosis is not required or necessary.

Casting for Pediatric Orthotics

Physical Therapy can help with

  • Infant head shape: flat spots or other differences
  • Bladder and Bowel Training
  • Gross motor development
  • Milestones related to walking, sitting, crawling
  • Sports Performance
  • Scoliosis Intervention
  • Bike Riding
  • Difficulties in Gym and Physical Education Class
  • Muscle strengthening
  • Posture / postural control
  • Pre-gait and gait training
  • Neuromuscular function
  • Environmental adaptations / seating and positioning
  • Splinting / bracing / orthotics
  • Improving endurance
  • Coordination of movements
  • Balance training
  • Family education

If your child does have a diagnosed condition

If your child does have a diagnosed condition, you can feel confident in our collaborative team approach that brings multiple specialties together to address the whole picture and make sure nothing falls through the cracks.  Our therapists have a high commitment to continuing education and stay in tune with the latest research-proven methods for the treatment of:

  • Cerebral Palsy
  • Spina Bifida
  • Down Syndrome
  • Sports injuries
  • Scoliosis
  • Juvenile Rheumatoid Arthritis
  • Torticollis
  • Brachial Plexus injuries
  • Traumatic brain injuries
  • Spinal cord injuries
  • Decreased coordination
  • Incontinence
  • Various other motor conditions


Physical therapists assist children in reaching their fullest potential in functional independence and fitness.

Innovative programs are aimed at:

  • Enhancing strength, coordination and balance
  • Physical fitness
  • Wellness for optimal quality of life

If you have questions or concerns, a free 30 minute screening with a Pediatric PT is a GREAT place to start. Our therapists work with children with or without a diagnosis.

Schedule a screening

A-Z of our PT Services


Adaptive Sports

Aquatic Therapy



Ball Skills

Bike Riding

Bilateral Coordination


Bowel and Bladder Dysfunction




Developmental Screening

Dynamic Serial Casting


Early Intervention

Environmental Adaptations


Family Education


Gait Training

Gross Motor Skills


Health Promotion

Head Shape

Home Exercise Program


Incontinence Training

Infant Massage

Intensive therapy


Kinesiology Taping


Motor Learning

Myofascial Release


Neurodevelopmental Therapy (NDT)


Orthotic Assessment and Training


Pelvic Floor Education

Positioning to assist with feeding

Postural Awareness and Training

Prosthetic Training


Reflex Integration



Schroth Therapy

Serial Casting

Sports Injury Recovery



Toe Walking

Total Motion Release (TMR)



Visual Motor


Wheelchair Assessments

We are proud to collaborate with

Great Feedback from Great Families

My son Jayden is 11 and has been coming to BDI for the past 4 years. BDI has become family in the way they treat my son. I truly feel deep in my heart if it wasn’t for his PT my son wouldn’t be walking the way he is today. BDI hires only the BEST. Every child here is treated with respect and love and each parent is respected and appreciated for their role in their child’s treatment plan.”

Getting Started With Physical Therapy

Find answers here

Still not sure? Learn more about whether your child needs therapy here


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