How to Improve Your Pelvic Floor for Better Health with Alicia-Jeffrey Thomas [Episode #989]

 

This Week’s Episode: 

In this episode Kimberly interviews Alicia Jeffrey Thomas, a doctor of physical therapy, about the importance of pelvic health. They discuss the anatomy and function of the pelvic floor, factors that can weaken it, and how it relates to digestive and urinary health. Alicia shares insights on the interconnectedness of body systems, the impact of stress and trauma, and practical exercises for strengthening the pelvic floor. They also touch on the significance of pelvic health during pregnancy and the challenges faced by women experiencing painful sex due to hormonal changes. The conversation continues with the complexities of pelvic floor health, the role of posture and breathing, and the emotional aspects tied to pelvic therapy. They explore the significance of building trust with practitioners, and the interconnectedness of body mechanics. The discussion emphasizes the need for open conversations about pelvic health and the empowerment that comes from understanding one’s body.

 

About Alicia-Jeffrey Thomas

Dr. Alicia Jeffrey Thomas  has been a pelvic floor physical therapist since 2016 and treats people of all genders in the greater Boston area. She isn’t one to shy away from taboo topics. From bladder problems to bowel movements to sex, Alicia is always game to talk through the dirty details to help patients figure out what’s going on “down there.” To this end, she has created and directed multiple social media channels where she spreads evidence-based pelvic health information in humorous and relatable ways. Her page, @thepelvicdancefloor, has over 1.2 million combined followers, between Instagram and TikTok. She and her content have been featured in podcasts, magazines and blogs, and on television. Although born and raised in Florida, she now lives in Boston with her husband and their dog.

 

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Guest Resources 

Book: Power to the Pelvis: Improve Your Pelvic Floor for Better Digestive, Urinary, Reproductive and Sexual Health 

Website https://www.thepelvicdancefloor.com

 

Episode Chapters

00:00 Introduction to Pelvic Health
02:05 Factors Affecting Pelvic Floor Health
04:51 The Interconnectedness of Body Systems
05:56 The Role of Trauma and Stress
06:21 Pelvic Floor and Digestive Health
08:28 Personal Experiences with Pelvic Health
09:36 Common Bladder Issues
11:22 Time Commitment for Pelvic Floor Exercises
13:00 Effective Pelvic Floor Exercises
15:26 Preventive Care for Pelvic Health
16:14 Pelvic Health During Pregnancy
18:20 Painful Sex and Hormonal Changes
20:12 Understanding Pelvic Floor Challenges
22:23 The Importance of Posture and Breathing
24:43 Connecting Breath with Pelvic Health
27:13 Addressing Trauma and Sensitivity
30:12 Preventative Care During Pregnancy
31:40 Navigating Vulnerability in Therapy
33:18 The Interconnectedness of Body Mechanics
35:00 Empowering Conversations Around Pelvic Health

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OTHER PODCASTS YOU MAY ENJOY!

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• How the Power Foods Diet helps with Weight Loss with Dr. Neal Barnard EP. 877
• How Not to Age with New York Times best-selling author Dr. Michael Greger [Episode #873]
• How to eat to reduce anxiety with Harvard nutritional psychiatrist Dr. Uma Naidoo [Episode #867]

 

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Transcript:

Kimberly Snyder (00:00.526)
Hi loves and welcome back to our Monday interview show. I am so excited for our very special guest here with us today. Her name is Alicia Jeffrey Thomas. She is a doctor of physical therapy and a certified pelvic rehabilitation practitioner. She has a brand new book out called Power to the Pelvis, improve your pelvic floor for better digestive, urinary, reproductive and sexual health.

Alicia, thank you so much for being here with us today.

Alicia Jeffrey-Thomas (00:30.621)
Thank you so much for having me.

Kimberly Snyder (00:32.622)
It’s a really interesting topic. think a lot of us have heard about our pelvic floors. We’re always looking for new ways, especially when you’re talking about digestive health, which is such a big thing in our community, but also all these other aspects. Before we dive in, what is, I know this sounds really basic, but what is the pelvic floor? Because some of us are imagining the bones, but then you talk a lot in your book about muscles. So can we just give sort of a broad definition?

Alicia Jeffrey-Thomas (01:00.497)
Yeah. So, okay. So you think about the bones, right, you have your pelvis, there’s a hammock of muscles that run from the pubic bone in the front, all the way up and underneath to the tailbone in the back. So it basically is responsible for holding up your internal organs. So your bladder, your bowel, your, I mean, sort of kind of your uterus, right? And then, you know, opening and closing for those functions to be able to go to the bathroom, to be able to, you know,

have a child, be able to have sex, all of these ins and outs there. And then it also works with your core for core stability. It works as a stabilizing function there. So it’s this small set of muscles, relatively speaking, that we don’t see, so we don’t really think about, but it plays a big role in a lot of really integral parts in the body.

Kimberly Snyder (01:48.96)
And why might our pelvic floor be thrown off, especially in modern life? I know we’re sitting more, or what are some of the factors why, of course, having a baby, but what other reasons might our pelvic floor weaken and we don’t even realize what’s going on?

Alicia Jeffrey-Thomas (02:05.863)
Yeah, I mean, I think, you know, a big factor for a lot of people can be stress. you know, in, the same way that when you’re stressed, find yourself clenching your jaw or like, you know, squeezing your glutes, your pelvic floor is probably also kind of tensing up as a result. so for some people that can result in, you know, pelvic pain, which could be pain with sitting, it could be, you know, just pain with, you know, any kind of, like sexual activity or, exams or anything like that.

Kimberly Snyder (02:10.562)
Mm.

Kimberly Snyder (02:26.094)
Mm.

Alicia Jeffrey-Thomas (02:36.166)
It could be that pelvic floor issues could develop from repetitive bathroom habits that maybe aren’t the best. So people who strain to go to the bathroom a lot, they could develop like a prolapse or a weakening of the pelvic floor or different things that would kind of fall under that umbrella. There are tons of different little lifestyle factors that we don’t really even think about that over time doing things.

on a consistent basis can have those stacking negative effects.

Kimberly Snyder (03:09.27)
What about not breathing properly?

Alicia Jeffrey-Thomas (03:12.201)
my gosh, that’s a huge one. Yeah. mean, and that kind of comes into it. Yeah. Yeah. I mean, a lot of it, you know, if we, if we think about how we grew up, right, a lot of us were kind of told like suck it in, you know, try to look smaller, look skinnier. we’re constantly like pulling in a little bit. that over time is kind of changing your breathing patterns because if you’re not kind of having this full expansive breath happening,

Kimberly Snyder (03:14.574)
You’re not really taking your breaths.

Alicia Jeffrey-Thomas (03:37.969)
then your muscles are having to do weird things to compensate. They’re tensing up or weakening in different ways. And that can also have kind of a nervous system-wide effect. So it’s harder to get out of that fight or flight if we’re not able to take like really good deep breaths.

Kimberly Snyder (03:56.366)
Yeah. And what about, I’ve heard, you know, with fascia, Alicia, or fascia, that there’s a piece of fascia that’s connected to your jaw that runs all the way down. So let’s say you’re clenching in your mouth, which is something I used to do a lot. I used to be a mouth or a teeth grinder. And can that, I know it can affect your back. It’s also affect your pelvic floor. It’s all interconnected.

Alicia Jeffrey-Thomas (04:05.49)
Mm-hmm.

Alicia Jeffrey-Thomas (04:12.079)
Yeah.

Alicia Jeffrey-Thomas (04:15.837)
Mm-hmm.

Alicia Jeffrey-Thomas (04:19.315)
Right. There’s that whole frontal fascial plane that’s going to run all the way down like to like the front of the pelvis. And so, you know, we, we see that a lot, like people who have, you know, tension through here or, or, you know, gripping through their masseter muscle. we do release work here, we notice a change in their pelvic floor or vice versa. I’m working on somebody’s pelvic floor and they tell me, you know, I didn’t mention this before, but I’ve had jaw pain for a while. My jaw’s actually been feeling a lot better since we started doing this relaxation work for the pelvic floor. So there’s, there’s these kind of cool little.

Kimberly Snyder (04:36.174)
Yeah.

Kimberly Snyder (04:43.758)
Mmm.

Alicia Jeffrey-Thomas (04:48.847)
related effects that we can get. Little side quests.

Kimberly Snyder (04:51.234)
Well, I love how everything’s so related. And here we talk about really holistic approach with food and your body, your physical body and your emotions and also your spiritual growth. So one of the things you talk about in the book is trauma. You also talk about tension and stress. And from a yogic standpoint, this pelvic floor area is the Mooladhara chakra where we can hold fear. And when it’s balanced, we can feel more safe and secure, which is directly linked to our abundance.

Alicia Jeffrey-Thomas (05:18.397)
Yeah.

Kimberly Snyder (05:18.882)
There’s a lot that can happen energetically from feeling literally more rooted and more healthy down in that area.

Alicia Jeffrey-Thomas (05:26.609)
No, absolutely. And that totally makes sense with what I see clinically. I mean, if we’re holding a lot of tension, that creates this stress cycle that happens, like stress to tension cycle. so particularly, if we aren’t comfortable with moving that area of the body or talking about that area of the body, then it becomes this thing that we put into a little box. And so part of what I really love about working in pelvic floor therapy is giving people

Kimberly Snyder (05:30.862)
Mm-hmm.

Alicia Jeffrey-Thomas (05:56.477)
that freedom to be curious and explore and bring awareness to these areas.

Kimberly Snyder (06:03.438)
So I love how you, going back to the digestive health, which you lead in your subtitle, there’s many reasons our digestion can be off. Of course, what we’re eating, we’re not eating fiber, we’re eating a lot of junk food, we’re eating a lot of sugar, so on and so forth. Tell us how realigning your pelvic floor can optimize digestion as well.

Alicia Jeffrey-Thomas (06:21.361)
Yeah. So from the most simplistic standpoint, your pelvic floor is the last part of that whole system, right? That starts at your mouth when you take something into your body. so, you know, one of the ways that we can define constipation can be that the muscles there don’t do a good job kind of getting out of the way to allowing things to evacuate completely. So working on that ability to relax so that you’re not having to strain is going to result in

Kimberly Snyder (06:42.945)
and

Alicia Jeffrey-Thomas (06:51.335)
more complete elimination, which then can kind of cascade into other things, right? So if you’re more backed up, that can actually put pressure on your bladder and contribute to bladder symptoms. So there’s kind of those effects, but then also, thinking up the chain a little bit more, your pelvic floor is very, very related to your abdominal wall and things like that. And so if we work on kind of mobility of the abdominal fascia and things like that, that can also help to promote more gut motility.

so that things are moving through the system at a normal pace and not getting stuck somewhere along the path.

Kimberly Snyder (07:26.786)
Well, I love your pictures in the book and there’s a picture in here of you sitting on a toilet with a little stool. And so there’s all these tips and hacks we can incorporate. And there’s also the exercises, which we’ll talk about in a moment, but also this lifting of your, or lining your knees can actually help you have more thorough bowel movements.

Alicia Jeffrey-Thomas (07:33.0)
Yeah.

Alicia Jeffrey-Thomas (07:38.973)
Totally.

Alicia Jeffrey-Thomas (07:42.578)
Mm-hmm.

Alicia Jeffrey-Thomas (07:46.107)
Yeah. So basically when you sit with your feet just flat on the floor, your pelvic floor kind of kinks around your large intestine. So instead of having, you know, a nice easy path, it kind of has to make an extra turn before everything comes out. if you elevate your feet so that your knees are a little bit higher than your hips, then all of a sudden that pelvic floor can relax. And so then your colon straightens out and you have a much more straightforward path to the exit.

Kimberly Snyder (08:10.594)
Leisha, on a personal note, did you struggle with bathroom problems or pelvic floor problems? I’m always interested how, I know in my line of work, you I write about the things that I’ve worked on myself and struggle with. So it’s really interesting that this is where your career, where your work focus has led you.

Alicia Jeffrey-Thomas (08:27.507)
It’s really interesting because before I’d been in the field for a couple of years, I wouldn’t have made that connection. It’s something that I kind of buried, right? But I realized, yeah, I was a really constipated kid. I joke all the time that my mom should have been the person to patent the squatty potty because she was the person that was always saying, just turn the trash can on its side, put your feet on top of that and stuff like that to help me. But there’s little things that I think what drew me to the field was realizing that

Kimberly Snyder (08:49.614)
Mm.

Alicia Jeffrey-Thomas (08:55.539)
I had these little internal conversations with myself that once I started seeing them play out in a clinical setting, I realized just how many people were not having these conversations because they didn’t have the language, because they didn’t feel comfortable, because they were embarrassed, whatever it was. And so that was just an opportunity to really give people their voice and to have them be able to take a little bit of that power and quality of life back.

Kimberly Snyder (09:19.084)
Yeah. You also talk about the bladder and sometimes again, this isn’t something that’s widely talked about. We think about, maybe when you’re, you know, older, seventies, eighties, nineties, you may have bladder issues. How common is it for women or people of all ages to sort of struggle?

Alicia Jeffrey-Thomas (09:36.527)
It, yeah, mean, you know, the statistics are super variable. mean, it’s kind of like, you know, urinary incontinence can be upwards of like, I think like one in three people. Yeah, can struggle with it. And I think to a certain degree, like everybody can kind of recall a moment that they almost had a problem, right? And it’s whether that then turns into something that

Kimberly Snyder (09:49.112)
Really?

Alicia Jeffrey-Thomas (10:04.807)
pushes over the edge to where, okay, I leaked a little bit when I coughed that time, but maybe that won’t happen again. And maybe we try to like, you know, hold off and say, okay, no, that was just a, that was a fluke. And then it happens a second time and you’re like, okay. And so whether that then becomes something that you report to your physician to try to get help for is, you know, I think a lot of these statistics could be a lot more common than we give them credit for because people are so afraid to bring this up.

Kimberly Snyder (10:30.293)
Yeah.

Alicia Jeffrey-Thomas (10:33.691)
It’s very common, but it doesn’t have to be your normal. You can have leakage with coughing, laughing, sneezing, running, jumping, that all kind of falls under stress incontinence. And it happens to people regardless of whether they’ve had children. It happens to people at any age. mean, you see elite athletes, gymnasts and people who do a lot of impact work that are starting to talk about their struggles with urinary incontinence.

all the way up to your older generation, post-menopausal, where we’re having weakening of the pelvic floor and decreased supporting structures and things like that. So it’s a conversation that I think we need to be comfortable with so that we can get the help that we need.

Kimberly Snyder (11:12.674)
Well, so, and you break this down by different topics and there’s different exercises. If someone’s listening to this or watching this and they say, hey, I do have a bladder issue that I want to address or digestive issue. How much time on average, and I know this is very individual, but how much time does one have to devote to these pelvic floor exercises on a regular basis?

Alicia Jeffrey-Thomas (11:22.835)
Yeah.

Alicia Jeffrey-Thomas (11:33.959)
Yeah, no, that is a really good question. you know, I try to make it when I’m developing a home exercise program for a patient, I don’t want it to be something that feels like it’s so overwhelming to their life. Like if I can give you bite sized things that like maybe you’re doing a couple of times a day that I’m going to try to do that versus saying, here’s an hour’s worth of exercises that you need to do. Right. We’re so busy and that’s just going to increase your stress level. And it’s kind of like, you know, there’s a

Kimberly Snyder (11:55.15)
We’re all so busy, you know.

Alicia Jeffrey-Thomas (12:02.013)
There’s a level at which somebody says, if I can’t do all 10 of these things, then I’m not just going to, I’m just not going to do any of them instead of maybe I’ll do three. And so if I set it as here’s a little module that you can do, right? Of like two or three things. And if we try to incorporate those, you know, when you take a break at work or right before you go to sleep, like little things that are easier to integrate into your life. I tend to see that working better for people. but again, it’s, all going to be individualized to what that person.

Kimberly Snyder (12:08.974)
Great.

Kimberly Snyder (12:26.007)
Yes.

Alicia Jeffrey-Thomas (12:30.397)
feels like they can commit and maybe that changes the amount of time that they’re working on this for, know, different things like that.

Kimberly Snyder (12:37.026)
Can you give an example of a general pelvic floor exercise that might be great for, I know it’s individual, but someone who’s just looking to strengthen their pelvic floor in general, like a simple exercise so someone can get an idea of what it feels like. I know there’s a chapter in your book where you talk about going beyond key goals, which is what most of us hear about with exercises in this area.

Alicia Jeffrey-Thomas (13:00.091)
Yeah. So, so right. So a Kegel is a contraction of the pelvic floor and it’s just that very isolated activation of the pelvic floor, which is great to know how to do, but it doesn’t translate to function. I want to know more about what the pelvic floor is doing when you’re doing a squat or a deadlift or a bridge or something like that. So if we take a bridge, for example, right, because this is one that most people can do. so you’re lying on your back with your knees bent and you’re trying to like squeeze your glutes to lift your hips up.

I want you to be able to kind of get in tune with what your pelvic floor is doing. When you lift up, do you find that you’re holding your breath, right? Which might be putting pressure downward onto your pelvic floor. Then I’m trying to tell somebody, okay, maybe we’re exhaling as we do that. What’s happening with the position of your spine to make sure that you’re not like overly flattening your back, but also that you don’t have some big arch in your back. That’s also kind of throwing off the whole mechanics of the system. And whether we then additionally cue for contracting the pelvic floor as you do that.

depends on what’s happening with the person because a lot of times these motor patterns are happening automatically where if I have you do certain movements, your pelvic floor is going to protectively to say, okay, yep, we need to make sure we support the organs when you’re doing this more loaded exercise. So it’s layering in all of those pieces so that you’re not having to kegel, do the thing, relax kegel. That’s not how I want it to have to function in the long term.

Kimberly Snyder (14:24.93)
got it. So it’s not as simple as, do 10 Kegels while you’re driving your car and you can work it into your day while you’re sitting there with your clothes. It’s more nuanced is what I’m hearing you say.

Alicia Jeffrey-Thomas (14:29.434)
No.

Alicia Jeffrey-Thomas (14:36.755)
Totally. The Kegel thing, it’s great because it’s an exercise that is really accessible. It doesn’t require any equipment. You can kind of do it anywhere. But it’s like medication, right? We want to make sure that we have the right medication at the right dosage at the right time for the right person. We talk about exercise as medicine, and this is one of those instances where I’m like, okay, well, not everybody needs to be taking the Kegel medicine.

Kimberly Snyder (15:05.772)
Right. Well, let’s say someone is going to the bathroom pretty well and they don’t have bladder issues. Are these signs that we have a healthy pelvic floor? And in that case, do we still need to do pelvic exercises sort of preventively for the future? Or is this more like you feel that there’s an issue and you want to explore it deeper?

Alicia Jeffrey-Thomas (15:26.227)
So, I I am never going to tell somebody like, just forget about your pelvic floor, right? Like I think it needs to be something that we need to be, you know, aware of and have knowledge of. And so in an ideal world, what I would encourage people to do is to get their pelvic floor muscles assessed by a professional who can say, you know, yes, you’re not feeling XYZ symptoms, but

Kimberly Snyder (15:37.923)
Right.

Alicia Jeffrey-Thomas (15:49.489)
I noticed that when you do this, you are bearing down or that you’re doing something you’re not supposed to. So like, here’s a couple of things that you can individually work on, right? But it’s in, in an asymptomatic person, it’s, it’s going to be like particularly nuanced because I don’t want to have them then like kegel themselves into a pelvic floor issue, you know, where then their muscles get too tense and then they start having issues, you know, relaxing to like go to go to the bathroom or something like that.

Kimberly Snyder (16:08.205)
Right.

Kimberly Snyder (16:14.51)
Well, and when there’s a life changing circumstance, let’s say pregnancy. So let’s break it down, Alicia, pre, during, post, because I love you talk about reproductive health. How can healthy pelvic floor even help potentially with fertility?

Alicia Jeffrey-Thomas (16:18.545)
Mm-hmm. Yeah. Yep.

Alicia Jeffrey-Thomas (16:30.547)
No, definitely. In the earlier stages, so pre-pregnancy, the vast majority of people are not going to have a pelvic floor issue unless they have that pelvic floor tension. Usually we’re seeing frequent urination or pain with sex or something like that. Once you are pregnant, you can do strengthening and awareness training for your pelvic floor because you’re going to

Kimberly Snyder (16:59.16)
while you’re pregnant.

Alicia Jeffrey-Thomas (17:00.081)
while you’re pregnant in the earlier trimesters, right? So, because as the pregnancy is growing, we’re getting more load placed on top of the pelvic floor. So it’s almost kind of like you’re like strapping more and more dumbbells to the pelvic floor muscles. And so training that and having that awareness can be really good for reducing urinary incontinence in pregnancy to decreasing back pain, you know, especially if we’re incorporating it alongside other, you know, core exercises and

body awareness, postural training, things like that. Once we get into the later stages of pregnancy and we’re getting closer to delivery, then we start thinking about the opposite end of the spectrum where we say, okay, the pelvic floor needs to be able to get out of the way for that baby to come out because the pelvic floor doesn’t push the baby out, the uterus does that. But if you’re always clenching the pelvic floor and we’ve only been working on strengthening, then sometimes it doesn’t necessarily have that like…

ability to let go on its own, and especially to be able to keep the pelvic floor relaxed through something as painful as labor or a contraction or whatever. And so we do that kind of training. do, know, perineal stretching training, labor positioning training, things like that.

Kimberly Snyder (18:07.392)
If someone’s clenching though, let’s say sex is painful, is there any way that could, and I’m just asking, really don’t know, but prevent, let’s say the sperm from going all the way, actually prevent pregnancy, is that possible?

Alicia Jeffrey-Thomas (18:13.787)
Mm-hmm. Yeah.

Alicia Jeffrey-Thomas (18:20.603)
No, I wouldn’t say that. As long as penetration is possible, then that’s not going to be the inhibiting factor. There are people who have a condition like vaginismus, for example, where the pelvic floor muscles are so tense that nothing can go in. There are people who can’t even get a Q-tip in or have a speculum exam or something like that. so there are people who work with…

Kimberly Snyder (18:25.559)
Okay.

Kimberly Snyder (18:30.38)
Okay.

Kimberly Snyder (18:42.669)
What?

Alicia Jeffrey-Thomas (18:47.313)
reproductive endocrinologists who will do artificial insemination because they’re not able to achieve it that way. But from a pelvic floor perspective, it’s not necessarily going to interfere with insemination otherwise.

Kimberly Snyder (19:01.204)
Speaking of painful sex, was having a conversation with my hairdresser who just went through menopause and she’s like, sex is really painful now. And of course there’s hormonal shifts, but how can this work help women that are, you know, at that stage and really noticing a physical difference in their sexual life?

Alicia Jeffrey-Thomas (19:05.744)
Mm-hmm. Mm-hmm.

Yeah.

Alicia Jeffrey-Thomas (19:20.775)
Yeah, mean, and well, the hormonal shift goes right hand in hand with what’s happening to the pelvic floor. So estrogen is a really, really protective hormone for the whole vulvovaginal region, but especially the pelvic floor muscles. As we start to have that drop in estrogen, we start to lose muscle mass. And so that can result in things that we think about like urinary incontinence, but also just the…

basically like a stiffening of the tissue that happens that can that, yeah, it’s like the dryness, then also like like a stiffening of the tissue, which can result in pain with sex. and so in pelvic floor therapy, right, we can do gentle mobilization to those muscles to try to get some of that elasticity back. we can do dilator training. can do a bunch of different things, to try to get to the point where sex is not painful anymore because

this may be the first time that somebody’s dealt with that and they don’t necessarily have the tools in their toolbox to know how to address it other than like, try lube, you know, which doesn’t necessarily solve the issue.

Kimberly Snyder (20:24.282)
Right, exactly. So are these, again, back to the exercises and I love the pictures, are these, because I remember when I had, you know, I went to a fascia expert, I had some hip pain after pregnancy and they were giving me some exercises and I, to be honest, I didn’t do them all the time, but it was a few times a week. When you’re working with the pelvic floor and there is an issue, is this a daily focus or can it be a few times a week? And I know this is, you know, it’s hard to answer general questions.

But I just mean practically speaking because there’s so many exercises in there. And that was one of the things I was like, do I have to do this every day? Do people have to do this every day?

Alicia Jeffrey-Thomas (20:59.675)
No. Yeah. So I like the idea of establishing a routine, but that routine looks different for everybody. And also different exercises can be done at different frequencies. So like the one that you were on where it was like the self-release with the peanut ball, that one I don’t have people do every day unless they’re really like, wow, I find a lot of benefit out of this and I’m going to do it every day. And they’re volunteering to do that. That one I’m more like, let’s maybe do this like two, maybe three times a week if you’re feeling up to it.

Kimberly Snyder (21:14.219)
Yeah.

Alicia Jeffrey-Thomas (21:27.303)
but then we’re interspersing some of the other things like a different type of hip flexor stretch on the other days. I like the idea of giving your nervous system some kind of stimulus on a regular basis, but again, it doesn’t have to be a jam packed list of 20 things that you have to do. It can be a little module of like two or three things.

Kimberly Snyder (21:48.334)
Well, it’s almost like neuroplasticity in the pelvic floor. You’re retraining into a different pattern of being of, you know, not going to this old pattern, even when you do feel stressed. You’re of teaching yourself how to be open and aligned.

Alicia Jeffrey-Thomas (21:58.579)
Absolutely.

Alicia Jeffrey-Thomas (22:03.729)
Yes, yes, exactly. That neuroplasticity piece is huge, if we’re, I mean, it takes time for your nervous system to see those changes and to rewire like that. And so that’s where we really want to have those consistent inputs in order to see that change.

Kimberly Snyder (22:23.352)
Well, this really spoke to me. I saw it in the table of contents and I went right to this page on 37 called Close the Easter Egg. And this feels very doable because it’s awareness. Can you tell us what you’re talking about here?

Alicia Jeffrey-Thomas (22:28.507)
Mm-hmm. Mm-hmm.

Alicia Jeffrey-Thomas (22:36.027)
Yeah. So if you think about your rib cage and your pelvis as kind of the top and the bottom of an Easter egg, your diaphragm sits right underneath your rib cage and your pelvic floor sits in your pelvis, obviously. So they’re supposed to function kind of like a piston. So one right on top of the other one moving in the same plane as the other. If we set that posture up in kind of that optimal alignment, that’s where we tend to see that.

muscle action working the best. So if you look at yourself from the side and you see that your rib cage is really flared out, or you see that your back is really swayed or the opposite really tucked under, that’s influencing the parts of your pelvic floor that are going to activate. It’s influencing your breathing patterns. It’s influencing all of these little things that are going to feed into how well you’re able to stabilize.

Kimberly Snyder (23:07.778)
Hmm.

Kimberly Snyder (23:29.154)
Right. So you can see it visually in the mirror and then self-correct.

Alicia Jeffrey-Thomas (23:33.243)
Yep. And I also really like what you can do is you can like set yourself up against a wall and you can kind of feel for that tactile stimulation of like, where is my rib cage? Where is my back? Where are my shoulder blades? Where’s my pelvis? And, you know, get different parts to kind of come into contact with the wall and say, okay, now can I step away from the wall and maintain that positioning?

Kimberly Snyder (23:55.052)
and ideally start to have that as your go-to posture.

Alicia Jeffrey-Thomas (23:58.757)
Yeah, not every single second of every single day because there’s no such thing as perfect posture. We’re not always going to be, I mean, I’m sitting here in a crisscross applesauce position. We’re not always going to be in those optimal postures, but especially if we’re thinking about if we tend to leak when we do a certain type of lift or for some other type of activity, what can we do to optimize that so that these muscles are able to function the way that they should to prevent a leak or to prevent pain?

Kimberly Snyder (24:28.066)
Mm. Well, and I love how you just said how the diaphragm is there and you talk about in the book as well, like what is supposed to happen when we breathe? Can you just take us through like a healthy breath and how your diaphragm and your ribs in your pelvic floor?

Alicia Jeffrey-Thomas (24:39.708)
chat.

Alicia Jeffrey-Thomas (24:43.249)
Right. So like I said before, your diaphragm and your pelvic floor are supposed to move synergistically together. So the way that I’ll cue people to do this is ideally in a seated position so that you can feel what’s happening with the pelvic floor. You want to place one hand over your heart and one hand over your lower belly, right above your pubic bone. And when you inhale, you should feel more movement in your belly hand where it’s kind of expanding outward as you. Imaginarily fill it up with air, right?

And at the same time, your pelvic floor is just very gently resting down onto the surface that you’re sitting on. You’re not pushing it down, but it’s just kind of riding the elevator. And then when you exhale, you should feel all of that kind of happen in reverse. So your belly should deflate, your pelvic floor should kind of return to that neutral resting position. But if we tend to breathe more up in the upper chest and we’re not getting that expansion down in the lower part, then that pelvic floor loses its range of motion.

which can mean that it can develop that like tension and tightness and stuff that we were talking about before. It’s a learned skill, right? Like it’s, again, it’s not something that’s intuitively coming to us, especially when society has conditioned us to do, you know, a different type of breathing pattern our entire lives. So.

Kimberly Snyder (25:42.732)
click.

Kimberly Snyder (25:55.01)
I love that and also a lot of my work Alicia is heart coherence and something as simple as touching your heart can bring you back to this heart, and training energy. That feels really good and just checking in on a really deep level because no one can feel what’s going on except for you.

Alicia Jeffrey-Thomas (25:58.451)
Mm-hmm.

Alicia Jeffrey-Thomas (26:02.418)
Yeah.

Alicia Jeffrey-Thomas (26:10.995)
Right. And using your own body to feel your own body, right? So that tactile piece of like, okay, can take a breath and I can think that I’m doing all of these things, but to be able to feel something expand underneath your hand, it just helps to reinforce, okay, yes, I am doing these things that are putting me more in tune with my body.

Kimberly Snyder (26:31.038)
Mmm, and the diaphragm working in its fullest capacity imagine more oxygen more prana more energy Day by day So let’s say we do feel like gosh. This is tense. This is like there’s a lot in there

Alicia Jeffrey-Thomas (26:36.915)
Exactly.

Alicia Jeffrey-Thomas (26:42.856)
Hmm.

Yeah. Yeah. I mean, there, there is for most people, right? Because that’s just how the world is set up today. Like we have so much going on. Everybody’s so stressed. so your, your public floor is kind of holding onto a lot of that to try to kind of hold you together. I mean, the, the, I’ll start out with, with most people, I’m not going to go into, know, here are all of these, you know, yoga based stretches that I want you to do. The first thing I want people to do is get this breathing. so whether that’s in a seated position in

Kimberly Snyder (26:50.038)
Yeah.

Alicia Jeffrey-Thomas (27:13.041)
you know, something like Child’s Pose or lying on their back or whatever kind of helps them to make that connection. That’s the first piece that I want to make sure that people get in tune with.

Kimberly Snyder (27:23.086)
beautiful. Well, you know, I think about how I had two, you know, pretty traumatic births. One in which I was, you know, rushed into the hospital after attempted home birth. It was like 50 hour labor and my baby’s head wouldn’t fit. And then my second birth was really traumatic too, where I did go in for a C-section and as soon as I got the epidural, I just started having like crazy anxiety and just feeling like out of control of my body. So,

Alicia Jeffrey-Thomas (27:36.779)
my gosh.

Kimberly Snyder (27:50.862)
I wonder, you know, because I never really did pelvic floor work after my pregnancies, if there’s, you know, energy and things that are still held in there.

Alicia Jeffrey-Thomas (28:00.787)
Totally. First of all, it’s never too late to do pelvic floor therapy after you have a baby. I see people who come in 10, 15, 20 years after they’ve had a C-section and they still have lot of either sensitivity around their scar or they have avoidance to even touching their scar. Yeah. There’s plenty that you can do there. We want to work on

Kimberly Snyder (28:08.835)
So.

Alicia Jeffrey-Thomas (28:29.285)
Again, there can be those emotional processes that we’re working through as we’re doing this manual work because a lot of that feeling of being out of control can come up when we’re working on these scars and on these areas of the body where we were just kind of like passengers to the experience. as physical therapists, we know to expect that and so we try to leave space for that, knowing that we are…

people are trusting us to work with areas of the body that hold a lot of potentially trauma and sensitivity and things like that.

Kimberly Snyder (29:06.094)
Well, I think there’s an interesting line between this area feeling strong, but not rigid and clamped. And it’s hard sometimes as a layman to feel the difference. It’s not weak, it’s strong, but it’s also not, like again, overly rigid.

Alicia Jeffrey-Thomas (29:11.557)
Mm-hmm. Yeah.

Alicia Jeffrey-Thomas (29:17.265)
Right, it’s.

Alicia Jeffrey-Thomas (29:21.509)
So I like to use the example of a trampoline, right? So your pelvic floor should be more like a trampoline in that it’s cradling and responding to the changes in pressure and the changes in activity so that it can help to support those internal organs versus if you were trying to hold those internal organs next to like a concrete floor or something, like throwing pressure against that, that’s just gonna put a lot of impact onto those organs and things like that.

Kimberly Snyder (29:47.842)
Right.

Alicia Jeffrey-Thomas (29:48.667)
It’s that dynamic aspect that you’re looking for, the ability to respond to whatever you throw at it.

Kimberly Snyder (29:55.726)
Can this work help? I have a friend who most of her pregnancy has been bedridden because it’s called prolapsed uterus or there’s a sagging. Can this help preventatively? let’s say you have that in pregnancy, can you do this work to help mitigate it?

Alicia Jeffrey-Thomas (30:03.475)
Mm-hmm. Mm-hmm.

Alicia Jeffrey-Thomas (30:12.893)
So you can definitely have pelvic floor therapy in pregnancy. With certain conditions, we want to make sure that we’re being mindful of restrictions that have been placed by the OB or something like that. So if they say, hey, you’re on pelvic rest, you shouldn’t be having sex, or you shouldn’t be putting anything in there, then I’m probably not going to be doing any internal work, because we want to respect that. But at the same time, I think that there are

even if it’s just in some like awareness training of what’s happening with your pelvic floor or what’s, you know, if we’re trying to avoid more sensation of prolapse and pressure and discomfort there, like even just working with your breathing patterns when you’re moving around, you know, when you’re changing positions in bed or when you’re getting out of your car, what can we do to optimize those movement patterns so that we’re not starting from so far behind once you’re, you know,

Kimberly Snyder (30:56.781)
Yeah.

Alicia Jeffrey-Thomas (31:09.405)
cleared of pelvic rest and have the baby and we’re moving forward with the strengthening piece.

Kimberly Snyder (31:14.53)
mean, when you talk about the internal work, Alicia, it just, feels so vulnerable.

Alicia Jeffrey-Thomas (31:19.805)
That’s fair. That’s a super like common concern that a lot of people have. And I will say that it’s never required to do internal work, right? I don’t want anybody to think, I can’t do pelvic floor therapy because I don’t think that I could do the internal work piece. It’s a piece of the information, but it’s certainly not the only way that we can get that information. I have people who…

you know, we don’t do the internal assessment on the first visit or the second visit, or, know, they tell me they don’t want to do it at all, or I teach them how to do a self-assessment at home. They do it themselves and then kind of report back what they find. It’s just the more that we’re able to assess, the more information we have and the more we can make accurate assessments about what’s going on. But it’s, it’s really like, I absolutely respect that this is a vulnerable area of the body to be having treatment done to, you know,

For me personally, I make sure that I’m always in communication with my patients. They’re always in the driver’s seat. You can start an exam and then remove consent in the middle of that exam if you want. And like it is always your world that we are living in. And my whole thing is like, I don’t want to be the person causing you more trauma and more harm, right?

Kimberly Snyder (32:25.974)
Right. So it’s really important, obviously, to work with a practitioner that you trust, you feel good with. So when you’re assessing, you’re feeling how the muscles are relating to each other.

Alicia Jeffrey-Thomas (32:36.635)
Yeah. So, you know, my exam, right, just for listeners, is not like a pelvic exam at the OB-GYN. So we’re not using stirrups. We’re not using a speculum. It’s not like the scary stuff, right? It’s a single digit vaginal exam that’s allowing me to assess the tone of the muscles. So does it feel really tense? Does it feel really lax? I’ll try to maybe have you try to contract, relax, or bear down. That way I can see how those muscles are functioning. So it’s sensing and information gathering.

Kimberly Snyder (32:49.304)
Right.

Kimberly Snyder (33:06.892)
I see. Wow. I mean, again, it’s just such this part of the body that we need to take care of, but it’s most very foreign and new to so many of us.

Alicia Jeffrey-Thomas (33:15.463)
Yeah, absolutely.

Right, no, exactly, exactly. And that’s why I say like, so like on the first visit at therapy, like we spend so much time just talking because people don’t know what’s going on with their bodies. Like they may have never seen a diagram of the pelvic floor before. So I want to make sure that I have a good understanding of what you’re telling me that you’re coming in for, but also that like, you know, the parts of the body that we’re dealing with that you, you can kind of start to see the relationships between what might be a back.

pain issue and a bladder issue and a X, and Z thing.

Kimberly Snyder (33:52.536)
So all these muscles, as you start to work with them correctly, can actually realign your bones.

Alicia Jeffrey-Thomas (33:59.251)
So I wouldn’t necessarily say that we’re like realigning bones unless we’re dealing with somebody who has, you know, like a hypermobility disorder or something like that, like where they do have that, you know, ability to kind of sublux and things like that. But, you know, we are definitely improving kind of the proprioception of how everything is able to kind of stack on top of each other, right? Because if you…

Kimberly Snyder (34:01.923)
Yes.

Kimberly Snyder (34:09.976)
Okay.

Kimberly Snyder (34:24.398)
Yeah.

Alicia Jeffrey-Thomas (34:25.767)
you know, for example, like if you have a lot of tightness in your shoulders and you don’t have very, you know, good strength in your back, then everything is going to pull forward like this. And over time, right? Like that can certainly cause more shoulder issues and things like that. So if we start to like strengthen the back, am I changing the position of the bones or am I just improving the body’s ability to kind of settle into these more normal postures?

Kimberly Snyder (34:46.05)
Right. Yeah, I guess when I was looking at the diagrams, it just felt like everything was, you know, stacking and filling this alignment. Again, from an energetic yogic standpoint, it means there’s more energy going up and down your spine, your Kundalini energy. So it all works together. Well, is there anything that we didn’t cover, Alicia, about your new book or anyone you or anything you would want?

Alicia Jeffrey-Thomas (34:55.837)
Yeah!

Alicia Jeffrey-Thomas (35:00.104)
Yeah.

Alicia Jeffrey-Thomas (35:04.371)
Absolutely.

Kimberly Snyder (35:12.106)
everyone to know about the importance of pelvic health that we didn’t cover.

Alicia Jeffrey-Thomas (35:17.185)
my gosh. No, mean, I think the idea with the book is that I want it to be a resource for people to get started, right? The people that maybe are nervous about trying pelvic floor therapy because of any of the issues that we’ve already talked about, right? Or maybe they don’t have geographical or financial access to pelvic floor therapy. I want this to be something that they feel like they can reach for and…

Hopefully that then opens up conversations that they can have with their providers. I hope that this book helps people to be able to have conversations with their friends, with their family members, so that these topics can be less taboo and more commonly talked about so that we’re not just accepting them as normal.

Kimberly Snyder (35:47.639)
Yes.

Kimberly Snyder (36:01.344)
Right. Well, it’s beautifully laid out. And if anyone is listening to this, please check out our YouTube as well. You could get a little peek at the book. It’s colored. It’s got a lot of information. I mean, this is it’s a good it’s a guide and I really appreciate that. It’s very practical. So congratulations on your new beautiful book, Alicia. Thank you so much for talking with us.

Alicia Jeffrey-Thomas (36:13.063)
lot of information.

Kimberly Snyder (36:26.072)
Can you share a little bit about where we can get the book, Power to the Pelvis, and learn more about your work?

Alicia Jeffrey-Thomas (36:31.515)
Absolutely. So Power to the Pelvis is available at all your major book retailers. You can get it at Barnes and Noble. You can get it on bookshop.org, which supports local indie bookstores, and you can also get it on Amazon. And then you can also follow me on social media. I’m at The Pelvic Dance Floor on Instagram and TikTok.

Kimberly Snyder (36:48.354)
And with this kind of book, did you read it? Did you do the audio as well?

Alicia Jeffrey-Thomas (36:52.397)
I really want to do an audio book, but they haven’t optioned for it yet. So.

Kimberly Snyder (36:56.398)
It’s interesting because a lot of it’s visual, but it could also be paired with a guide, which is great.

Alicia Jeffrey-Thomas (37:02.065)
I yeah, think even just talking on podcasts about this stuff, I’m like, yeah, this would actually translate really well to…

Kimberly Snyder (37:05.219)
Yeah.

Kimberly Snyder (37:09.474)
Well, thank you so much for sharing some of your wisdom with us today. And thank you everyone so much for tuning in at our show notes, mysaloon.com. We will also link directly to Alicia’s book and her handles. We will be back here as always next week for our next show. You can find me on social media as well at underscore Kimberly Snyder. Thank you so much. Look forward to connecting with you more until then sending you so much love.

Alicia Jeffrey-Thomas (37:34.365)
Thank you.