By Erin Jester
A little humor can go a long way in combating stigma around sensitive topics in health care.
Alicia Jeffrey-Thomas, D.P.T., would know.
The two-time alumna of the University of Florida’s College of Public Health and Health Professions has made levity part of her approach as a pelvic health physical therapist using her popular social media platforms @ThePelvicDanceFloor and now a book.
“If you have pelvic floor dysfunction, it tends to rob you of a lot of life’s little joys,” Jeffrey-Thomas said, such as being able to exercise for fear of bladder leaks or limiting socialization because of chronic pain.
Through her practice and internet presence, she hopes to show people that they deserve to know how their bodies work and get the care they need to live full lives.
Jeffrey-Thomas completed her Bachelor of Health Science in 2013 and her Doctor of Physical Therapy in 2016.
Her interest in pelvic health was piqued while she was already applying for physical therapy school. She learned about a study on chronic pelvic pain being led by Meryl Alappattu, Ph.D., research associate professor in the Department of Physical Therapy, and later decided to do a clinical rotation in pelvic health.
After graduation, Jeffrey-Thomas moved back to her hometown of Pensacola for a few years and worked in an outpatient clinic, doing some pelvic care and some orthopedic therapy.
She moved to Boston in 2018 and began working as in-house pelvic physical therapist for a urology group.
Working alongside urologists and urogynecologists gave her new perspectives on more complex pelvic pain and new demographics of patients, such as older adults with incontinence, people undergoing gender transition and men experiencing pelvic pain.
In the early days of the COVID-19 pandemic, when the operating rooms at the urology clinic were closed, Jeffrey-Thomas and a urogynecologist started making humorous social media reels to encourage patients to keep up with their physical therapy exercises at home.
At first, they called themselves The Pelvic Health Ladies. When patients returned to the clinic and her colleague became busy again, Jeffrey-Thomas decided to keep the accounts going by herself, using trending dances and sound clips to keep the content fun and light.
To her surprise, the account took off on TikTok, which Jeffrey-Thomas said she never intended to use as a platform.
It was around then that someone in the comments of a video depicting her doing a trending TikTok dance referred to the account as “the pelvic dance floor.”
“I thought, ‘That’s so cool. I’m going to roll with that,’” she said.
Jeffrey-Thomas has since left that clinic and transitioned to working out of a private physical therapy office.
Many of her clients found her through her social media channels. Pelvic floor therapists in other areas have contacted Jeffrey-Thomas to say they have clients who sought care because of her.
While she’s enjoyed watching her platform grow and reach more people, the real reward is in pulling back the curtain on essential health topics that many people find difficult to discuss.
“It’s really cool to be able to help people with these very basic things like toileting and sexual function … all of these things that are very taboo to talk about,” she said.
Patients experiencing pelvic health-related issues might feel like they’ve done something wrong or are broken in some way. Some come from religious communities where they didn’t receive sex education. Others simply don’t know where to look for help managing their condition.
Much of Jeffrey-Thomas’ work is combating shame so patients can learn their bodies and find ways to feel better.
“I try to integrate situationally appropriate humor to try to encourage people to feel more comfortable talking about these topics,” she said. “It’s lots of reframing.”
There are “tons” of myths around pelvic health, she said.
“The big one is that people think that everybody should be doing Kegel exercises, and that is really not the case,” she said, referring to an exercise that involves contracting and relaxing the muscles of the pelvic floor. “It’s really kind of an individualized thing.”
Other popular misconceptions are that you should always try to urinate before leaving the house (this can weaken the bladder, leading to increased frequency of urination), you shouldn’t sit on a public toilet (hovering creates undue strain on the pelvic floor) and even that men don’t have a pelvic floor (they do).
“A lot of these beliefs are very deeply entrenched,” she said, but getting correct information into popular internet platforms could make a difference over time.
It boils down to stigma, Jeffrey-Thomas said. In the absence of frank discussions, people go to friends and the internet to get answers, but a lot of that information is incorrect.
“I think a lot of this could be resolved by incorporating pelvic health information into seventh-grade health class,” setting the tone before misinformation can get in, she said.
“I think it’s so important to create visibility around pelvic health because issues like urinary leakage and painful sex are still taboo topics in healthcare and in society,” Alappattu said. “Creators on platforms like TikTok and Instagram have undeniably changed the way these discussions are happening. Content creators have established an environment where openly talking about these ‘taboo’ topics is not only welcome but expected. People are learning what’s typical versus not typical when it comes to their pelvic health and becoming empowered to bring these issues up to their healthcare providers.”
Social media was in its infancy when Alappattu first started practicing as a pelvic physical therapist 17 years ago. If someone ended up at a pelvic health clinic, it was usually on the recommendation of another health care provider, not because it was a commonly known option.
“I’m so proud of clinicians like Alicia who have excelled in content creation over the last 10-plus years to spread these important messages to the general public,” Alappattu said.
This year, Jeffrey-Thomas expanded her mission to a new medium.
After going viral and amassing more than a million followers across TikTok and Instagram, a publisher reached out about the possibility of writing a book.
Initially, she wasn’t sure. She didn’t know if she could translate her work into written word without losing nuance.
Ultimately, Jeffrey-Thomas agreed to start writing a book under the stipulation that it would be for a general audience and include people and scenarios that she considered to be on the margins for pelvic health care. “Power to the Pelvis” was published in March.
On a recent trip to Gainesville, Jeffrey-Thomas visited The Lynx bookstore to discuss her book with Vicki Lukert, a physical therapist and Jeffrey-Thomas’ clinical instructor at UF Health Rehab – Magnolia Parke.
She said she has no plans for more writing at this time, but maybe someday.
“I’m probably going to try to dabble into fiction before I write another book about pelvic health,” she said.