A Day In The Life
Hi, my name is Tammie Luthringer and I am a pelvic floor physical therapist.
What the heck is THAT, you ask? I am a physical therapist that focuses on the muscles of the pelvic floor. What it comes down to is, I focus on muscular problems related to bowel, bladder, and sexual health. Yikes! No, wait, keep reading; you will really learn some things about your body.
Regardless of where you are in life, you have probably experienced a pelvic floor condition including, constipation, bladder leaking, painful intercourse, ligament pain in pregnancy, bedwetting, erectile dysfunction, and the list goes on. Because these conditions are common, people think they are just things that you must live with. NOT TRUE! All the above can be treated by learning how the muscles are supposed to work and practicing exercises that force the muscles to work as they were designed. Check out what a typical day in my life includes. It is so interesting, and I love being able to connect with people regarding subjects that are not so easy to talk about it.
I usually get to work early because I like to visit with my sister who is the nurse where we work. She’s funny, and it’s a real treat to get to work with her. Today my first patient is a gentleman that has suffered from constipation for most of his life. He only has a bowel movement every three-five days, and he has to take medicine to do so. Guess what we determine is his evaluation? When he bears down, his muscles restrict. So, I teach him exercises to focus on relaxing specific muscles so that when he attempts a bowel movement, his body responds correctly. IT WORKS! I also spend time teaching him tricks to improve his diet, to encourage regularity. The standard American diet (SAD) is a real issue when it comes to constipation. He is elated that his bowel health is improving. I see him once a week.
Next up is a young lady who is pregnant for the second time and wants to prevent a painful episiotomy and to have a natural childbirth. She is in her second trimester and is having some bladder leaking. We are focusing on pelvic floor strengthening at this point in her pregnancy. I utilize biofeedback with electrodes applied to the pelvic floor to measure the coordination and endurance of her pelvic floor muscles. These exercises have already improved her bladder leaking. When we get closer to delivery, we will move on to pelvic floor relaxation and perineal massage to prepare for childbirth. We also discuss how to avoid constipation with a healthy diet and deep breathing, which will certainly help with delivery and recovery. It is very rewarding when a pregnant patient delivers easily and recovers quickly. I will see her once every two to three weeks until delivery.
Next, I am seeing a patient for the 4th time. She suffers from bladder leaking when she sneezes, runs, laughs, etc. The leaking was requiring her to wear a pad, and she hated it. We started her on an exercise program for strengthening the pelvic floor... yes, Kegels. However, most people who are leaking are unable to do these exercises correctly. So, we got her on the biofeedback machine to insure she is using her muscles properly, and, very quickly, she got the hang of it. Today she has met all her goals. No leaking, no pads, and she understands the importance of continuing the exercises at home. She is discharged. I LOVE THAT I WAS ABLE TO HELP HER.
Now, it is after school time. I am seeing a little girl that is suffering from bedwetting. She is embarrassed and wants to stay the night with friends without having to wear pull-ups. We determine ultimately this is an issue of constipation and lack of pelvic floor coordination. We came up with a menu that improves her ability to have regular bowel movements. We also practice learning the difference between squeezing and relaxing, which improves her coordination. This will help her recognize how to stop bedwetting. I have a really cool computer program that enables kids to practice these exercises. It’s a video game that kids really like. It’s very exciting when these kids color me a picture of them jumping on a trampoline without having an accident. VERY REWARDING!
On this particular day, I am not seeing any patients suffering from a tight or stiff pelvic floor. This is a very common diagnosis in my practice though, and I’d like to mention it. A tight pelvic floor can make intercourse very painful for women. It is usually accompanied by anxiety and can really be a problem for women that are otherwise healthy. As you can imagine, this is difficult to talk about. Just as there are exercises to help strengthen the pelvic floor, there are also exercises to help relax the pelvic floor. Without going into great detail, just know if this is happening to you, it’s fixable.
I am often reminded by my patients that the things I help them with are so very simple and very effective. They often ask, “why didn’t I know all this before?” “I can’t believe how these simple things work!”
Then, I head home to my newly established empty nest. Great Day! 
