Several weeks ago, I was lucky enough to be an assistant instructor at a Pediatric Myofascial Release Seminar.  Many of the therapists at the course had never taken a Myofascial Release Seminar.   It was a really beautiful reminder to me just how powerful this work is, how lucky I am not to just practice but also to receive this wonderful therapy, and how lucky I am to be able to share these techniques with my own daughter.

As therapists, we are trained to treat children with all kinds of developmental, neurological, and congenital issues.  As Myofascial Therapists, we also learn to how to assess and treat children who may generally be normal and healthy, but whose restriction patterns set them up for dysfunction.  These restrictions may come from a variety of things.  These can include how a  child was positioned in utero, generalized or specific trauma through the birth process, falls or accidents, or even extended positions in sitting in school, playing video games, or being on the computer.

I have decide to highlight just a few of the common issues in a “normal” child that can be helped with MFR.


Torticollis is the curving or bending of the head and neck to the side seen in young children.  While I was taught that this was mainly and issue of spasm of the Sternocleidomastoid muscle (SCM), in practical treatment it is surprising at how these children have restrictions in their pelvis and spine and how fascial pulls from these areas contribute or are a main source of this head pull.

Acid Reflux in Babies and Small Children

Our esophagus goes through the respiratory diaphragm (our main muscle for breathing) before it joins the stomach.  Tightness and restriction in the diaphragm can cause tightness in this complex and exacerbate reflux symptoms.  Imbalances in the rib cage and breast bone can also affect these symptoms due to their pull on these sensitive structures.  Many of us have treated small children who have projectile vomiting after eating.  Many of these children have significant reduction in their symptoms after MFR treatments targeting the chest and diaphragm(and their parents get some relief too!).  These results are achieved without the use of acid reducing drugs.  While I am a proponent of medications when they are indicated, I also believe that if we can avoid the use of medication when we might not need it (especially in children!), it is usually the better course of action.

Chronic Ear Infections/Ear Tubes

It is safe to say that many of us know at least several children who have had to have “tubes” placed because of chronic ear infections.  Some of this is due to anatomy.  In adults, our Eustachian tubes sit at more of an angle which helps them drain.  In small children, the Eustachian tubes are more horizontal and do not drain as well setting them up for infection.  As a mother and a therapist, I was pretty tuned into my daughters cranium.  The bones of the skull shift, and if I would feel my daughter’s frontal bone or temporal bones shift and wasn’t able to treat her immediately, she would get an ear infection >90% of the time.  It would start with congestion or allergy drainage and then shift to a full blown ear infection.

When our cranial alignment is off, our heads can not drain the way they were designed to and this leads to issues.  I think babies are susceptible to this because of the lack of independent head movement and the bouncers, bassinets, and cribs they are placed in.  The lack of head motion when placed in these devices can lead to flattening of the head and cranial imbalance.

The really fun part about this is babies require very little work to come back into balance of their cranium, especially in non mobile babies.  Once they start moving it gets a little more difficult to get them to stay still and work on them.  I believe early cranial work can set us up for more balance and less ear and sinus infections as children and as adults.


Braces are a common right of passage for older children.  We hear about teeth being pulled, spacers being placed, and cranks being adjusted “to make more space.”

If crowding is noticed early (like way before braces are necessary) gentle work through the palate, maxilla, and jaw may help create more space.  If your child is already at the point of needing braces, cranial work can both help the pain of the spacing process as well as address restrictions and pain patterns in the neck and shoulders developed by spending extended periods of time in the dentist/orthodontist’s chair.


In PT school we are constantly reminded that structure affects function and function affects structure.  Unfortunately more and more of children’s time seems to be spent in sedentary activities-sitting in the car, sitting at school, watching videos etc.  These sitting postures affect congestion within the pelvis and abdomen and can set us up for restrictions throughout the abdomen.

When we remember that restricted fascia can exert up to 2000 pounds of pressure per square inch, we can understand how restriction in the abdomen might affect the natural mobility and motility of our colon and how it might lead to constipation.  As Myofascial Therapists, we have helped many children with constipation symptoms by working the abdominal viscera, balancing the pelvis, and treating the tailbone.  When we open the system, our organs are able to move and work as they are intended.

Bed Wetting and Urinary and Fecal Incontinence

It is not uncommon for children up to 5-7 years of age to have bedwetting issues.  When we want to be more involved in the process is when a child who was previously dry during the night starting having bed wetting episodes or if the child is starting to be bothered or embarrassed by the episodes.

Interestingly, chronic constipation issues play a huge role in bed wetting and incontinence issues.  It is estimated that 60% of incontinence issues can be eliminated with a good bowel and dietary routine.  Your therapist can review daily habits to see if this might be all your child needs to become dry.

If diet and a bowel program alone are not enough to solve the issues, we can work on pelvic floor strengthening exercises and behavior modification techniques to help your child stay dry.

Bowel and Bladder incontinence episodes are often termed “accidents.”  This term is a misnomer because accidents usually indicate fault and can make your child feel guilty.  In fact the effects of bed wetting can lead to poor self esteems, frustration, anger, shame, feelings of failure, humiliation, and embarrassment.  It is empowering for both the child and their parents to have tools and a plan to help either day or night time continence issues.

At Hands On, we enjoy helping individuals of all ages progress towards health and wellness.  Have more questions about any of these topics?  Give us a call or send us a note.  We love to hear from you!

Be Well!

Erin Arnold, PT