Paediatric Continence Physiotherapy

Bladder and bowel issues are common in children, and physiotherapy is considered a first-line treatment for most paediatric continence concerns.

We provide gentle, practical strategies to help children improve bladder and bowel control, reduce accidents, and feel more confident in their day-to-day life.

How physiotherapy can help

We support children with a range of bladder and bowel concerns, including:

  • Daytime accidents

  • Nighttime accidents / bedwetting (nocturnal enuresis)

  • Urinary urgency and frequency

  • Giggle incontinence (leakage when laughing)

  • Chronic constipation

  • Faecal urgency or leakage

A supportive, child-friendly approach

Our sessions are designed to be relaxed, age-appropriate, and engaging.

We focus on:

  • Understanding your child’s bladder and bowel habits

  • Education for both child and parent

  • Simple, achievable strategies that fit into daily life

  • Building confidence and independence

There is no pressure, and everything is tailored to your child’s age, development, and comfort level.

Assessment and treatment

Our first appointment includes a thorough history of your child’s symptoms and other medical conditions, discussion about school, their preferences and hobbies, and how their symptoms are impacting on these things. After our first appointment, you may be asked to complete a bladder or bowel diary, which gives lots of valuable information about how the bladder and bowels are functioning.

We may also do a non-invasive physical examination, including looking at your child’s posture, muscle tone, gently palpating (touching) their abdominal wall.

Sometimes assessment may include the use of real-time ultrasound, which allows us to:

  • Visualise pelvic floor muscle function

  • Teach your child how to correctly relax and contract their muscles

  • Provide immediate, visual feedback in a way that is easy to understand

Treatment may include:

  • Bladder and bowel habit retraining

  • Pelvic floor muscle coordination (not just strengthening)

  • Strategies for managing urgency and accidents

  • Constipation management support

  • Guidance around fluid intake and toileting routines

Neurodivergence and continence

Bladder and bowel challenges are more common in children who are neurodivergent, including those with ADHD or autism.

We have experience working in this area and tailor our approach to suit your child’s needs including:

  • Flexible strategies

  • Sensory considerations

  • Reducing anxiety around toileting

  • Working at your child’s pace

When should I seek help?

It may be helpful to see a physiotherapist if your child:

  • Is having regular daytime accidents

  • Is wetting the bed after ~ 8 years old

  • Struggles with constipation or withholding

  • Needs to rush to the toilet frequently

  • Avoids using the toilet

Early support can make a big difference and help prevent these issues from becoming ongoing.

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