Franziska Haydanek: we can just talk about the idea of Kegel exercises. You know, I think that that's a really easy exercise that, you know, well-meaning providers, well-meaning friends and family can say, ⁓ you're struggling with this. Yeah, I was told to do Kegels. You should try to do that too. The problem is with no other information, we don't know where you're starting on that spectrum. We don't know if your pelvic floor is too tense and needs to be able to relax. We don't know if it's too weak and needs to be able to strengthen. But the problem is what goes viral on the internet are these, you know, quick and easy things like Kegeling to the beat. without any kind of nuance to explain what's going on. Welcome back to I Did My Own Research. I'm Dr. Fran and today I'm joined by Alicia Jeffrey-Thomas, aka the Pelvic Dance Floor. Alicia received both her bachelor's in science as well as her doctorate in physical therapy from the University of Florida. She currently works as a pelvic floor physical therapist and educates online at the Pelvic Dance Floor on pelvic floor health for all genders, sex education, and reproductive justice. She also recently published her first book, which I keep in all of my exam rooms for my patients to flip through and so many have. So I'm very excited to talk about that and to have Alicia here on the show today. Welcome. Thank you so much for having me. Alicia, I followed you for years and years and I have learned so much from you. Many would think that I, as an OB-GYN, should know a lot more about the pelvic floor and how we can work on those conditions. But I, in fact, defer to my local pelvic floor physical therapist all the time. But because it took me years to figure out even what a pelvic floor physical therapist is, I would love for you to explain not only what a pelvic floor physical therapist is, but why you got into this field. So, a pelvic floor physical therapist is the person who is responsible for taking care of your pelvic floor, which is the set of muscles that run from basically your pubic bone in the front up underneath to your tailbone in the back. They're responsible for opening and closing for bowel and bladder and sexual function, being able to help support your internal organs. They work with your core for core stability. it's really, really important to know what those muscles are, to be able to have good control over those muscles because those can start to impact really, really intimate areas of your life. And so one of the big reasons that I got into this field is because I grew up in the South where we tend to not be given a lot of information about our bodies. And I started to see firsthand how that was really impacting people and how, you know, little things like having conversations about what to expect. with sex and, you know, whether there should be pain or not. That just wasn't happening. And so this was a way for me to be in a field where I could have these, you know, more taboo conversations with people and really help to give them more ownership about what's going on with their bodies. in your day to day, you work as a pelvic floor physical therapist. But like I said, you obviously also educate online. You have over a million followers across social media and really have become like the go-to for the pelvic floor. How did you get into making videos online? Oof. I mean, I feel like it's like a lot of people. kind of did it accidentally during the pandemic. I didn't have a lot of patients that I was seeing in the clinic at the time. And so I had a lot of free time to just start experimenting with what worked and what didn't. And originally these videos were just supposed to be for my patients that didn't feel comfortable coming into the clinic to kind of have reinforcement of educational topics and things that we had already covered and... then it kind of took off because there were a lot of people who were seeing this education and realizing that they saw themselves reflected in it and they'd never really heard anybody talking about those types of topics before. That's so interesting. And over the years, you continue to educate. And I think, you know, the great thing about you as a resource is that not everyone does have access to a pelvic floor physical therapist. In the city that I did my residency, we didn't have any. And so when I, you know, moved for my attending job and now I have like a plethora of pelvic floor physical therapists that I can easily get my patients into, it's ⁓ such a great thing for my patients here now because I have all these resources, but many people across the country don't, which I think kind of where Power to the Pelvis came in the book that you wrote. So tell us a little bit how we got to the book, because this is incredible. So, you know, the book really came about because it came from a place of recognizing that there are growing, you know, maternity care deserts. There have always been kind of pelvic floor care deserts. And so really trying to build a resource that gives people that information that maybe aren't going to be scrolling on TikTok and watching videos, but still might appreciate that same kind of, down-to-earth type of education. And it's a way to maybe not replace a pelvic floor physical therapist, but at least start to get the conversation going to where if somebody then wants to seek virtual care or if they, you know, do want to try to figure out what's available in their area, they at least now know, ⁓ I might actually benefit from these things because I do see myself reflected in this book. I think it's also important to say, like you said, it's not really replacing someone, but it is can be something in conjunction with a pelvic floor physical therapist. or if you're too nervous to go see a pelvic floor physical therapist and are interested in what even the basics of that look like, I think that's a really great resource. Okay, I wanna dig a little into the misinformation on the pelvic floor, because not only do we see this online, but we see this in real life. And so I'm gonna go right into the conversation of dilators. All right, let's hit it. Okay, so dilators are a big topic for you, obviously. Explain to the listeners what dilators are. So dilators are progressively sized cylindrical devices. They start as small as your pinky and they work up to the size of a larger than average partner size, let's say. So you have kind of this whole spectrum and they're made for people who are having issues with entry in the myriad ways that that can present. So there are some people who can't even insert a Q-tip. Their pelvic floor muscles are so clenched up that they, you know, don't have that ability to relax to allow for a tampon to be inserted or to be able to have a speculum exam or to be able to have intercourse with a partner. And so this is a way, one of the ways, right? Not the only way, but one of the tools that we can use to help to kind of have almost graded exposure to the idea of entry to be able to help the nervous system acclimate to that, to be able to help the muscles to acclimate to that so that they can have these experiences be pain-free. Yeah, I most often talk to my patients about dilators when I encounter a patient who cannot tolerate a speculum exam. That's when I usually say like, listen, I think you would really benefit from talking to a pelvic PT about dilators. And then I send them to you guys and you do all the work. I bring this up because yesterday I was tagged in this video like five times about this young girl, like a young woman. She's a young woman in Utah and she's going to the OB-GYN for her premarital exam, which I'm going to tell you. is not a thing, but it is a thing in Utah. And at this pre-marital exam, she was given a goody bag and inside that goody bag were dilators, but they were like plasticky looking. They don't look like the nice ones, the silicone ones that you always talk about. And I just feel like there's probably some good intention there by like her doctor's office to be like, here's a resource that you're about to, you know, engage in the first time. And, but I feel like also that that is not... always appropriate. Like, dilators aren't for everyone, and sex shouldn't always be painful that everyone, like, gets dilators from the get-go, right? Right. It's almost kind of starting with the assumption that, like, yeah, you're gonna have pain and you need to, like, prep for this. So it's creating a sense of, you know, this anticipatory muscle clenching that might happen. I do see what they're trying to do, right? They're trying to say, hey... you've probably never even like explored this area. And so it might be worth doing that on your own before you're in a partnered situation and there's, you know, the stress of feeling like you need to make something happen on that first night. However, I would do it with a little bit more guidance and a little bit more of an individualized care approach. Yeah, I agree. I mean, not everyone has pelvic floor dysfunction in that way. I do appreciate that they're even trying to have the conversations rather than, you know, the traditional, just drink some wine and relax, right? Like that is really doing so many of our patients a disservice. Do you see a lot of those conversations online where people are kind of just saying like, ⁓ just relax or just, you know, just drink some wine and you'll be fine? Yeah. I mean, I think it's... I want to say that it's getting better or maybe my algorithm is realizing that it shouldn't show me those things because I get mad. But I do feel like that conversation is at least starting to be recognized as like, this is not the end of the conversation. If somebody says that to me, I'm at least knowing to push back on it. But there are still plenty of providers out there that are giving this really poor advice to people. there will be people that are just going to take that as fact and be like, ⁓ well, there's something... about me or wrong with me because I can't do this very inherent natural thing because I'm just too uptight. And it lets people, like, or it forces them to, like, have this ownership of it and the shame around it as opposed to looking at it from a really multifaceted perspective of why they might be having this pain or this issue. Yeah. I mean, I think that's a good point, right? That it's not always, like, usually a singular cause. For a lot of my patients, find the combination of pelvic floor physical therapy and therapy is helpful because that mind-body connection is there for some patients. And working through that is a lot more helpful than just drinking some wine and moving on. So it's not just misinformation online that our patients are getting it, but they're getting from their doctors as well, which is really unfortunate. Yep, definitely. I'm gonna give you the platform to discuss hovering in public bathrooms. Yes. Okay, so, I literally just yesterday with my work partner had a conversation about how someone he knows was a lifelong hover and I was like, I have a friend who's going to lose their mind when they hear this. So you have the floor, tell us why hovering is the worst thing you could ever do for your pelvic floor. All right guys, it is so important to remain seated for the entire performance. So your pelvic floor and your bladder muscle are supposed to work opposite of each other. So when you go to empty your bladder, your bladder contracts. your pelvic floor is supposed to get out of the way for the urine to flow through. If you're hovering, that's not really gonna happen because your muscles in your legs and your glutes and your abs are all clenched to try to hold you in that squat position. And so your pelvic floor is not getting out of the way. And so subconsciously or consciously, you're having to kind of push a little bit more to make that happen. And that pushing... is weakening your pelvic floor over time. So that can lead to things like urinary incontinence. It can lead to things like prolapse. It can lead to things like a mismatch of where your muscles knowing when to relax and when not to relax is also very important for being able to have sex. If your muscles can't relax, things aren't going to be able to go in. So, you know, let's take away the fact that like then those of us that are going to sit have to clean up after you if you come, if we're coming behind you, right? Because your aim is not as good as you think it is. It's just, you know, it's... really, really important that we're making these little teeny tiny changes for our overall health. And people are like, ⁓ but that doesn't happen that often, it? I know plenty of people, I know college-age women who have told me that they hovered every single day in their dorm bathroom. ⁓ no, for years. For years. ⁓ no. And that is like cumulative trauma that's happening there, right? And you also have to think too, right, about like folks who maybe don't have the ability to squat, right? Like we're sharing these public restrooms with... you know, people of varying physical abilities and like, yeah, I do squats at the gym, but there's people who maybe can't hold that position. They need to be able to sit all the way down and they shouldn't have to be cleaning up your mess. So make a toilet paper nest if that is what makes you feel comfortable to sit down, right? But like, sit, you'll be fine. You're not gonna catch anything. STD stands for sexually transmitted disease, not seat transmitted disease. So I don't want anybody coming in here and saying like... Oh, I got crabs from a toilet. See, no, you didn't. Yeah. I think you made a really good point, because you made a video about this once, and you were saying, like, when you sit on the toilet, it's really your thighs that are touching the toilet as is. So it's not like you're even exposing your actual external genitalia to anything but air when you're sitting. Yeah. Okay, anything else you want to say about hovering other than don't do it? No, I think that pretty much covers it. You covered it? Okay, perfect. I also want you to discuss how, in your book, you were talking about... So... So I am biased because I'm an OBGYN who takes care of the female body. So I send patients with the female body to the pelvic floor physical therapist. But men can also, first of all, men have a pelvic floor. So, right, so. You have a pelvic floor. What are some conditions that you have found that a pelvic floor physical therapist can help for our male patients out there? So the really interesting one is this kind of idea of a chronic prostatitis. There's actually like four subcategories of prostatitis. There's certainly the bacterial kind, right? Sure. I'm an OB-GYN, but I believe you. I worked in a urology office for a few years, and so I ended up getting kind of a deep crash course in this. So there are some people where they'll get these symptoms of... know, testicular pain or like difficulty emptying their bladder, they're feeling like they have to go all the time and it's an infection around their prostate. And so they take antibiotics, they feel better. There are some people, they have those exact same symptoms. They take antibiotics, they maybe feel a little bit better temporarily, but then it comes back and they have this kind of chronic pelvic pain, chronic urinary symptoms developing. And that actually is their pelvic floor muscles that have kind of gone into spasm or into this like freak out mode. that are then sending these weird signals to their brain and their bladder. They're sending, you know, all of these pain signals. It's just then becoming, you know, pain with ejaculation. It's then becoming like an ability to sit for long periods of time. It's very, very similar to how these muscles present in our female presenting clients. Like, we're a lot more similar than we are different. just... call it different things. That is so interesting. Do you find that there's any, I assume that most men who have chronic prostatitis are probably not spending too much time on social media, but have you seen anyone even share their experience with that? On Reddit, they do. It's not gonna be on your, like, video-facing platforms, but there are a lot of men and male-bodied individuals in the Reddit forums because they are desperate. They're like, something is going wrong with my body. What's interesting is that... You know, I feel like a lot of women and, you know, people in female bodies are... They're conditioned almost to expect that something is going to go wrong here. And I hate that, right? Because that puts us in this vacuum of not getting care for a really long time. On the other end, you have these guys who are just like, nope, I recognize something is going on and like, we need to solve this right now. And they almost get like too perseverated on it at times, but at the same time, they're seeking care. Like, I'm not faulting them for that. It's just, you know, it's... they're coming out in different subsections of the internet. Yeah, that's so interesting. I never would have thought. I I always forget about Reddit because I'm not a Redditor, but it makes sense that that's a very nice anonymous platform where everyone can go search for things and find a community. I find sometimes it goes a little too far where it's kind of a... I have found this in like private Facebook groups too, right? Where it's kind of like an echo chamber and then everyone just tells each other... the same thing that they just heard from someone else on the same Reddit thread. And so it kind of can become like an echo chamber, it also is a support group. And there's a lot to be said for that, especially if it's something a little bit more rare, maybe that practitioners don't know as much about or aren't as good at figuring out. I imagine something like vaginismus, right? Like if they are one, embarrassed, two, don't know that it's something that's like not correct about their bodies, but then their doctor doesn't really know what to do about it, they're gonna go seek those conversations elsewhere. Totally, exactly. Yeah, it's, you know... And like he said, the Facebook groups are really nice because they can give people direction. They can also sometimes though become those echo chambers for misinformation. And so it's really important that like, yes, I love that we have these communities, but also we want to like everything that we're consuming in this world today be very, very, what is the word I'm looking for? Like. really dig in deep into what you're reading and don't just take this one singular comment that you get at face value. What are some of those things that you're seeing where there's like misunderstandings or, you know, misinformation being unintentionally shared? ⁓ I mean, I think, you know, from the simplest perspective, right, we can just talk about the idea of Kegel exercises. You know, I think that that's a really... easy exercise that well-meaning providers, well-meaning friends and family can say, oh, you're struggling with this. Yeah, I was told to do Kegels. You should try to do that too. And to a certain degree, right, there's a degree of truth in that, in that your pelvic floor needs to be able to contract, relax, bear down. You need to have that full range of motion there. The problem is with no other information, we don't know where you're starting on that spectrum. We don't know if your pelvic floor is too tense and needs to be able to relax. We don't know if it's too weak and needs to be able to strengthen. We don't know... if we're focusing more on endurance versus power versus all of these little individual things. But the problem is what goes viral on the internet are these, you know, quick and easy things like kegling to the beat without any kind of nuance to explain what's going on. Yeah, I was gonna ask you your opinion on those because, so to get like a little personal, I did go to pelvic floor physical therapy after my third child. I felt a lot of like heaviness in my pelvis and I was like, I need someone to like teach me or like verify that I'm... activating the correct muscles to make this feel better. And then I personally didn't mind those videos. So usually it's someone like holding a pelvis and there's a song and they're going like, squeeze, squeeze, yeah, squeeze. And like, I personally kind of found it helpful. Cause every time that person came across my feet, I was like, ⁓ okay, should, yeah, I'm supposed to do my exercises. So I'm just gonna like squeeze along to the beat or whatever. But one, should I have not done that for my specific condition or... Are there some people who would benefit as long as you know that you are someone who should be doing those specific exercises, but if you have, for example, vaginismus, this is only gonna make things worse? Right, I think it's more the latter, right? Like, if you know what subcategory you're falling into, then yeah, sure, like, it's not going to necessarily harm anything to squeeze along to the beat. Again, so long as it's not just like quick squeeze, relax, squeeze, relax over and over again. But, you know, it's really hard to even know what bucket you're in unless you've kind of been assessed because there are people who have... know, feelings of pressure and heaviness or people who have leakage. And the reason is because their pelvic floor is too tight, not because they need to like work on strengthening. So it's really, really tough. I mean, because I love the idea of anything that's going to keep people, you know, doing their exercises and doing their homework. I mean, that's why like I'm not gonna, you know, poo-poo the PeriFit and those other things, you know, the ones that like make you play Flappy Bird as you like play across your screen or whatever with your pelvic I actually don't know. What is that? ⁓ Okay, so in concept, they're very cool, right? It's a biofeedback device. So you insert this thing vaginally and it Bluetooths to your phone and it tells you to do different exercises. And sometimes it's just, you know, squeezed to raise it to the bar and then relax. Sometimes they gamify it. you're... you know, your bird is like flapping along and then when you need to jump over the wall, you squeeze your pelvic floor and then you it back down. is kind of fun. And again, like for the right person, I think that that's genius, right? Because it's just going to keep that longevity going. That's so interesting. So, I mean, I think very important and we talk about, you know, a lot online about the things that the consumer see online, the important thing is to see it and then take it to your own practitioner and say like... does this apply to me, right? I see this with like medicines or surgeries or whatever, things in birth, like they see a video and really what anyone should do is take that to the person who knows them and their medical conditions and their bodies and go, does a video like this make sense for me to like squeeze along to the music or is this absolutely not something I should do? And I think... That's the important thing when it comes to consuming social media when it is in relation to your health, is that like none of this is individualized. As much as you, like we can all say like, is not individualized medical advice, well, you should go talk to your own practitioner. Like everyone has to continue to remember that because we are not your doctor or your pelvic floor physical therapist. But there are plenty of people on the internet who won't give those disclaimers and will just be pumping out this, you know, very kind of one size fits all information. That's very interesting and I... I guess I was seeing it from just like my individualized point of view, but I can definitely step, once you step outside yourself, realize that that can actually be very harmful for a lot of people. Which kind of brings me into my next question for you is, I was thinking about people in my life who have seen public floor physical therapists over the years. And I had a friend who was a diver growing up. And she really felt that the act of diving, like competitive diving and the muscles that she engaged with that, engaged her pelvic floor so much that it led to pelvic floor dysfunction. Do you find, when I thought about that and how it relates to like exercise online and the people who talk about different types of exercises in my mind, I go to like CrossFit and those kinds of things. Is there any overlap with like, especially like niche types of exercise related to the pelvic floor that really can lead to dysfunction? So we do see a lot of pelvic floor dysfunction in high-impact athletes, for sure. So you think gymnasts, for example, there's a lot of reports of stress urinary incontinence. And it ends up being because their pelvic floor is taking on these massive loads. Their muscles are engaging to do these really incredible things. ⁓ And so we do tend to see patterns like that. see that in elite athletes throughout the spectrum, right? But it's not. Because you're doing this sport, you're going to have this issue, right? It's just, you know, we want to make sure we're looking at specific patterns related to their sport. Because if I look at, you know, average 20-year-old who's coming into me with these symptoms and I look at elite athlete with these symptoms, like, their presentations are probably going to be very, very different. That makes sense. When you think about, I was thinking back to what you were saying about practitioners who maybe meant well, but... were not correct. Are there things that you, knowing especially that many of our patients across the country don't have access to public floor physical therapists, are there things that you wish that like doctors just do more about one, your job and two, the conditions that you treat? I'm gonna stick with like female conditions, right? Especially like OB-GYN residents, those kinds of people. Like what do you wish that you, we were better about? You know, I think the thing that would really... kind of improve the conversation would be if there was more standardization in OB-GYNs and nurse practitioners and the like, knowing how to assess the pelvic floor muscles, right? Just a quick assessment of like, okay, can I like palpate for tone of these muscles while I'm doing a pelvic exam? To be able to kind of put people into different stratospheres of where they might fall and then knowing like, okay, maybe I'm not gonna tell this person to do Kegels because like it's like Fort Knox in there, right? That makes sense. I feel also like when I think about it is when patients come to us for an exam, that's like their one touch point, obviously with the healthcare system. And if we just like ignore something and don't address it with them, then they're not gonna, that touch point is gone. And so for my examples, I always say to like my residents and medical students, like a speculum exam should not hurt. It might be pressure, you may not like love the experience, but it should not really be painful. And if we are not addressing it with the patient at that time, she's gonna go a whole nother year, five years without someone saying like, hey, I think there's something going on with your pelvic floor and ⁓ you also can't use tampons and you've never not had painful sex. Like she's gonna go five more years having painful sex when in reality she could go to pelvic floor PT, get assessed. have a treatment plan and maybe in six months, in a year, can one, tolerate a speculum exam with me, but have a non-painful sex life. Yeah, no, exactly. And two, mean, there are certainly those people who have these painful experiences and if that touch point is not met at the time, know, there's plenty of people telling their stories about how they've just stopped going. Like, they're not getting these preventative health screens because they're painful and because they've had these previous bad experiences. Yeah, I mean, I see that all the time with people being like, I would rather die than get another pap smear. I'm like, that... is telling me that there's a dysfunction there. That like something is, needs to be addressed by experts so that you could not feel that way. Like I'm not saying that Pap smear should be like an enjoyable experience for everyone, but it should not be so distressing that you'd rather accept cervical cancer than a two minute exam. And that's, know, that is the touch point I think I would want people growing up in medicine to... here is that if there is something like you can't tolerate a speculum exam, please don't just leave it at that point. Refer them, at least talk to them about, you know, what something like that might look like. I mean, even if they're not ready to do that at that point, it's at least still putting the little worm in their brain that tells them, ⁓ okay, there is a path when I want to pursue helping this. I feel the other area in the world of pelvic floor PT that maybe one people don't even know so much that you guys help with is like a diastasis after pregnancy. But I also feel that that is like a place of misinformation online. All these recently postpartum people, obviously their body went through a lot and now they're looking for like the fix. What are you seeing online related to that that just is like feels incorrect when it comes to the information that's presented? Yeah, I mean, again, I think it's because there's so many people to... awking on this topic. What we're kind of struggling with as a profession a little bit is folks who have had a baby and have their own personal experience of repairing their diastasis and then they put out a program, right? This is how you heal your diastasis. And it's like, what are your qualifications for telling us what to do and what not to do? There's a lot of nuance. We're looking not only at like the width of the gap. just so that everybody knows, diastasis is a separation between the two sides of your six pack. And so we're looking at what's happening with the width of that gap, sure, but also the depth. Like, does it, you know, are we able to like press in and literally like feel your organs when you do a head lift? Is it coning up in the middle? You know, we're looking at how your body is managing pressure. And so... the exercises that we're giving there are going to be very different depending on the person, depending on their fitness level, depending on the muscle control. And, you know, we also want to make sure that we're talking about realistic goals. You know, if you are able to, you know, engage the deeper layers of your core and you're not having this like bulging and you're not having symptoms, I'm way less concerned with like the pulling together of the width of the gap. that's, you know, some of that is going to be very... genetically based. there's a lot of different things that you can be talking about when it comes to diastasis. And to simplify it into a one size fits all fix, I think, is really the thing that we want to be kind of combating against. especially if they give them, gave themselves like a coach name and they're going to charge you a $400 course that they created without telling you any sort of credentialing in that. I would feel very, I would just have like your little like spidey senses up and be like, you know what, maybe I can just go to the pelvic floor PT that hopefully my insurance pays for and they can actually give me individualized care. If only everyone in this country, you know, really saw the benefits of pelvic floor PT and paid for it. Yeah, if only our insurance companies would kind of get with the program there. Yeah, someday maybe. Well, and you know, the interesting thing that's now happening is there's a lot of these... online, you know, I don't want to call anybody out by name, but there's a couple of online physical therapy companies that are partnering with, you know, employer-based insurance plans. And so instead of providing coverage for physical therapy, they're like, we'll give you this app where you can talk to a PT and they'll give you exercises. It's not the same. They're not assessing anything. I mean, they, sometimes they give you a little, like one of those little Bluetooth devices that's like, you know, up in your pelvic floor and is supposed to measure what's going on. But like the technology... to actually measure what's going on is not there to be able to ⁓ strategize you on what you should be doing. Yeah, not everything in healthcare can be telehealth. No. Pelvic floor, probably not. I think there's some things that can be, right? But I think for that to be your only option that your insurance is, well, we cover pelvic floor physical therapy if you do it this way. That's not the same. It's not the same at all. I mean, I was like, like, for me, I do a lot of telehealth for menopause care. because I don't need to put my hands on a person for menopause care, but you still have to come see me if you're having a baby. Yeah, exactly. ⁓ Haven't figured that one out yet, how to do that over the phone. You know. Maybe someday. Yeah. Okay, I wanna go into a little rapid fire with you. Okay, if you could only wear one of these for the rest of your life, what would you choose? Your poop costume or your vulva costume? ⁓ the poop costume's way comfier. really? Yeah, it's like a onesie. The vulva costume's got like pool noodles, I love it. Shout out to my friend Kay, she made that for me by hand. But like, it's a little tough to navigate. It's like wearing a canoe. Okay, so poop costume for life. Yes. Okay, what is the worst thing that we could do for our pelvic floor? Hover over the toilet. ⁓ Constantly be sucking in your stomach all the time. ⁓ tell us more. Again, this is kind of that whole relationship between your pelvic floor and other muscles in your body. Your diaphragm, your core, and your pelvic floor are all supposed to be working synergistically. If we're constantly sucking it in, it's going to put that pelvic floor into a tense position as well. And we know all the things that come from the pelvic floor not being able to move through its full range of motion. OK, but how am I going to look thin in pictures? You can do it for a picture and then just relax. Just not forever. Just don't do it all the time. Yeah. OK, perfect. What is one thing that you wish every OB-GYN asked their patients about when it comes to their pelvic floor? Are you leaking urine and does it hurt when you have sex? Perfect. What is your advice for someone who needs to make a DIY squatty potty? Make sure that your knees are higher than your hips and make sure that it's cutely decorated. Perfect. What is the biggest misconception about kegels? We already talked about this a little bit. Yeah, biggest misconception is that everybody needs to do them. Everybody needs control over their pelvic floor, but that doesn't mean kegel exercises for everybody. Yeah. And what is your favorite social media platform right now for you to consume content on? Probably TikTok still. I think the algorithm still has me locked down to a T pretty well. ⁓ really? Because mine is just trying to, like, sell me things every single video. I'm trying to, like, force it to stop doing that. The content in between is really good. I'm just like, well, I'm just, this is an ad, this is an ad, this is an ad, and then I'm back to the actual things I want. Yeah. Who are three people that you love following right now on social media do not have to be medical at all? Okay. Public PT Rise, I really love Rachel Selman. She's been showing up really, really authentically in the public floor space. She actually has a book coming out later this fall. There is Margaret Duncan, who's bed art every day. She's a psychiatrist who works in kind of the like reproductive healthcare space. And then, ooh, who else? ⁓ and always, of course, Karen Tang. She's, you know, she's the goat when it comes to OB-GYN stuff. It's so true. All right, Alicia, where can people find your book, Power to the Pulvis? You can find it anywhere books are sold. I always tell people to buy through their local indie bookstores because that's going to help the economy way more. It's also available at Barnes & Noble. And if you want to support that other company, it's also available on that website where you can get... the exhibitic website. Yeah, perfect. And where can people find you online? I am at The Public Dance Floor on Instagram and TikTok and also thepublicdancefloor.com. Thank you so much for being here. Yeah, thank you so much for having me.