A leading cause of childhood visits to the doctor. Whilst the role of food (diet) and fluid (water) cannot be underestimated, defaecatory technique (or ‘how to poo’) and tricks to ‘call the poo’ can be very beneficial in getting that gut going again. Tummy massage is taught to parents/caregivers, and the role of stress and inhibitory behaviours are discussed. We have all sorts of fun tricks to ‘track your poo’.
Please ‘choose your poo’….
Both boys and girls can suffer with bed-wetting. This differs between individuals, and the causes are complex. Assessment is limited to a thorough history. Ultrasound is only performed when indicated, requested and consented to. There are many strategies, from relaxation and voiding techniques, to behavioural considerations, to options for calming an overactive bladder. Advice regarding other options including alarms and medication is also given.
Please complete a bladder chart… TIP: you can weigh any wet nappies to get an idea of quantity of leakage.
Leaking with activity
Interestingly, it is the physical elite who suffer from stress incontinence the most.
80% of the Swedish national trampoline team, ages 12-22, leaked during training.
Other impact sports include running and ball games (athletics, football, tennis, hockey, netball/basketball), all of which increase the incidence and prevalence of leaking in female teenagers. In strong young athletes, advice usually looks at ways to minimize impact and load transfer through the pelvis.
There’s nothing like giggling girls. Once started, they can’t stop. This can be too true for some, where mirth spills over, and so does the bladder. Not addressed by strengthening the pelvic floor muscles, but rather by calming the overly enthusiastic bladder.
The female athlete triad
High exercise levels, low body mass, absent delayed and/or interrupted menses (periods) – these young sportswomen form a vulnerable group who are best managed by a multi-disciplinary team (MDT), including obstetrician/ gynaecologist, psychologist, dietitian and coach.
The male adolescent sportsman
High impact and excessive training can lead to a number of overload scenarios in young sportsmen – trigger points in the pelvic floor muscles disturbing normal bladder and bowel function;
- excessive rotational demand on the groin or buttock in football players
- excessive load of the low back in cricket players
- excessive stretch of pelvic nerves during loaded deep squats / leg press
- excessive weight-bearing on the ischial tuberosities (sit bones) in cyclists
- excessive posterior pelvic tilt in rowers
Management of our (elite) young sportsmen is based on individual presentation and sporting demands. Ultrasound is a very useful tool when trying to break down movements into their component actions.