Pediatric Pelvic Health
Pediatric Pelvic Floor Physiotherapy in Burlington
Bedwetting that will not stop. Accidents at school. A child who withholds stool until it hurts. These are common, they are not behavioural failings, and they respond well to treatment.
Assessment and treatment are entirely external — there is no internal examination for children, ever. Sessions are unhurried, explained in language a child understands, and a caregiver stays throughout.
No referral needed · No internal exam · Ages 5 and up · Direct billing available
Why bladder problems are so often bowel problems
This is the piece most families have never been told. The rectum sits directly behind the bladder. When a child is constipated — and many constipated children have perfectly regular bowel movements, which is why it gets missed — the retained stool presses on the bladder, reduces how much it can hold, and triggers urgency and leaking.
That is why treating bedwetting sometimes means treating the bowel first. Families who have tried alarms, fluid restriction and waiting without success are often surprised how much changes once the constipation is properly addressed.
It is also why the assessment asks about both, in detail, even when you have only come about one of them.
What we treat
Pelvic floor physiotherapy for children addresses the muscles and habits behind bladder and bowel control.
Nighttime Bedwetting (Nocturnal Enuresis)
Wetting the bed past the age most children are dry is rarely about laziness or deep sleep alone. It often involves bladder capacity, daytime drinking and voiding patterns, constipation, and pelvic floor coordination — all of which respond to assessment and retraining.
Daytime Wetting and Urgency
Sudden dashes to the washroom, damp underwear, or holding until the last possible second. These usually reflect an overactive bladder or a pelvic floor that has learned to grip rather than relax, and both are trainable.
Constipation and Stool Withholding
A very common and very treatable driver of bladder symptoms. A full rectum presses on the bladder, so children who withhold stool often start wetting too. Treating the bowel frequently resolves the bladder problem alongside it.
Bowel Accidents (Encopresis)
Soiling is almost never behavioural. It is usually overflow around retained stool. Treatment addresses the retention and rebuilds the coordination needed to empty properly.
Incomplete Emptying and Frequent UTIs
Children who do not fully empty their bladder are more prone to recurrent urinary tract infections. Retraining how they sit, relax and empty reduces the residual volume that infections thrive on.
Giggle Incontinence and Activity-Related Leaking
Leaking with laughter, jumping or sport is common in school-age children and is not something they simply grow out of reliably. Coordination training addresses the timing between activity and pelvic floor response.
What the first visit looks like
- 1
We talk first
About bladder and bowel patterns, drinking and toileting habits, sleep, diet and routine. Your child is part of this conversation, not the subject of it.
- 2
External assessment only
Posture, breathing, abdominal and pelvic floor coordination — assessed over clothing. We explain each step before it happens and stop if your child wants to stop.
- 3
A plan you can actually run at home
Toileting position, a realistic drinking and voiding schedule, bowel management where it is needed, and a small number of exercises framed as games.
- 4
Follow-up and honest reassessment
We track what changes. If physiotherapy is not the right answer, or something needs medical investigation, we say so and help you get there.
Who your child sees
Pediatric pelvic health appointments are with Juhi Israni, Registered Physiotherapist. Pediatrics is one of her registered areas of practice with the College of Physiotherapists of Ontario, and she holds certification in Pediatric Pelvic Floor Physiotherapy alongside Pelvic Health Solutions Levels 1, 2 and 3.
She trained at Sancheti Institute of Physiotherapy (2019) and speaks English, Hindi, Marathi. Her registration can be verified on the College of Physiotherapists of Ontario public register.
Availability: Mondays and Fridays, 11am - 7pm.
Questions parents ask
Is there an internal examination for children?+
No. Pediatric pelvic floor assessment is entirely external. Any assessment of pelvic floor activity is done over top of clothing, and we explain everything before it happens. Nothing proceeds without consent from both the child and their caregiver.
What age can a child start pelvic floor physiotherapy?+
Generally from age 5. By that age most children can follow the cueing involved and participate in their own treatment, which is what makes it work. For younger children we are happy to talk through whether the timing is right.
What actually happens in a pediatric session?+
We start by talking with you and your child about their bladder and bowel patterns, diet, fluid intake and daily routine. Assessment looks at posture, breathing, core and pelvic floor coordination — all externally. Treatment is largely education, habit and schedule retraining, breathing work, toileting position, and simple exercises that feel like games rather than therapy.
Does my child need a doctor's referral?+
No referral is required in Ontario. You can book directly. Many families come after seeing a paediatrician or family doctor, but self-referral is equally welcome. If there are red flags that need medical investigation first, we will tell you.
Should a caregiver stay in the room?+
Yes. A parent or caregiver stays for the whole appointment. Much of the work happens at home between visits, so you need to hear the plan as much as your child does.
How long does treatment usually take?+
It varies with the child and the presentation. Bowel-driven bladder problems often improve noticeably within a few weeks of consistent home follow-through, while long-standing bedwetting can take longer. We reassess as we go and will tell you honestly if physiotherapy is not the right fit.
My child has been told they will grow out of it. Should we wait?+
Many children do outgrow bedwetting. But waiting has a cost when a child is avoiding sleepovers, camp or school trips, and when constipation is driving the symptoms it does not reliably resolve on its own. An assessment tells you which situation you are in, which is worth knowing either way.
Is it covered by insurance?+
Yes. It is billed as physiotherapy and is covered by most extended health plans. Direct billing is available, so in most cases there is nothing to pay at the visit.
Book a pediatric assessment
If accidents, bedwetting or constipation are affecting your child's confidence, sleep or willingness to go to sleepovers and camp, an assessment will tell you what is driving it and whether physiotherapy can help.