We don’t tend to think about children having pelvic floor dysfunction – it’s a condition that’s associated more with childbirth, obesity, ageing, heavy lifting and elite athletes. Pelvic floor dysfunction is not always recognized as the cause of ongoing bladder frequency, urgency, and pelvic and low back pain in adults let alone children.

Recently a friend asked me to see her 11-year-old daughter Ami, the sweetest little girl who I’d known since she was a baby. Six months earlier she had a urinary tract infection that resolved with antibiotics. Unfortunately she still had marked bladder urgency and frequent toilet visits even though her mid stream urine tests were bacteria free.

Ami had done gymnastics for 4 years and sat in a tall rigid position with firm abdominal tension and her upper back over arched. When Ami lay down I felt her abdominal, spinal, hip and thigh muscles. Tight, painful areas in her rectus abdominis muscles bought on the bladder urgency and painful trigger points were present where the abdominals inserted into her pubic bones. Checking the spinal, buttock and thigh muscles had Ami squirming, as the muscles were excessively tight and tender.

Ami and her mum were only too happy to start the program of relaxing baths followed by releasing massage, muscle stretches and deep breathing. We chatted about her sporting activities and Ami admitted she would gladly replace gym with swimming and going to yoga and taking a walk with mum. Changing the way she holds her body and reducing muscle tightness will show Ami how they relate to her bladder symptoms.

Correcting the issues early reduces the likelihood of worsening problems when Ami is an adult. Many adults suffer with urgency and pain for years before they are referred to a physiotherapist specializing in pelvic floor dysfunction.