Let's get a little perspective.
Dr. Mel Cioffi, PT, answers my questions on the intersection of size, movement, and pelvic health
Happy late January!
The snow is slushy (if you have any at all), and it’s still cold and dreary, but hey, there are fewer New Year’s resolutions ads/podcasts/general propaganda by the day. I’m feeling it.
To celebrate and cap off the month, I invited Dr. Mel Cioffi (she/her) of New Quest Physical Therapy to come chat about her approach to health at every size.
Mel is a general badass, both as a clinician and a person on the internet. I’ve known about Mel for a few years (she lives in the best town I’ve ever lived in!) and I’ve always appreciated her approach to pelvic health for seeing the whole human. I wanted to get her take on weight, healthcare, and the pelvic floor, and am soooo thrilled she was down to talk!
It’s a treat to have Mel on here — I hope you enjoy her as much as I did!
Last note before we get into it: I’ll be hosting a live AMA/movement class for paid subscribers on this coming Thursday, February 1, at 8 pm Eastern! We’ll be talking all about abdominals — safe engagement, release, breath work connections, and more.
I’ll be sending out a link on Thursday morning. If you’d like to join us, you can become a member here!
Kk, let’s get this party started!
Hi Mel! Thanks for coming to hang on Adventures in Vaginas (and other parts). Can you please tell us a little bit about who you are and how you practice pelvic health?
Hi! Thank you SO much for having me! I am a mobile physical therapist specializing in the pelvic floor, orthopedics, and general fitness. I kinda fell into pelvic health by accident after being chosen for a clinical rotation in grad school; I remember the clinic director calling me weeks before my assignment and saying “Give the pelvic floor setting a month and if you’re absolutely not feeling it, we will switch you to straight ortho.” It didn’t even take a month for me to fall in love with working in pelvic floor health! After I graduated, I worked for a few different orthopedic clinics and made it super clear on each interview that I wanted to start a pelvic health program: all seemed excited about this, but not one of them actually followed through with it. After practicing for 4 years, I was like “welp, if no one is gonna help me get this thing started, I guess I’ll do it on my own,” and that’s how New Quest Physical Therapy was born! I not only treat the pelvic floor but I treat it within the entire system, the way I feel the pelvic floor SHOULD be treated, pulling in principles from orthopedics and general fitness to encompass a well-rounded program that goes way beyond kegels and squeezing balls between your knees.
One of the things I have always loved about you is the way you celebrate fitness and movement at all sizes. For anyone living under a rock, could you unpack how you see HAES (health at every size) connecting to pelvic health? What is your approach to unraveling the diet culture that is bound up in the fitness and pelvic health spaces?
OMG yes I could talk about this topic for days! People oftentimes get dismissed when they bring up pelvic floor symptoms to their MDs: it’s exacerbated when those people are living in larger bodies. It’s maddening when I hear a client say “I’ve been leaking for years but my MD told me to just lose weight, and everything will normalize.” It doesn’t work like that. The pelvic floor is so cool because it is SO interconnected with multiple muscle groups and multiple joints, so how strong, how flexible, how mobile all of those muscles and joints are ALL affect how well the pelvic floor performs and vice versa. This is why I always say we can’t just zero in on the pelvic floor and ignore the rest of the structures surrounding it: your pelvic floor is literally involved in EVERYTHING you do, EVERY time you move and use parts of your body. If there is some type of issue like leaking or increased urgency or really anything that screams “pelvic floor issue,” it means that there is a cog somewhere in the wheel of the musculoskeletal system, something that “just losing weight” is NEVER going to fix. We could save so many people so much time if we actually looked at how their body performs vs. what their body looks like.