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Content provided by Dr Alec Spano, PT, DPT, CSCS, Cert DN, Dr Alec Spano, PT, DPT, CSCS, and Cert DN. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Dr Alec Spano, PT, DPT, CSCS, Cert DN, Dr Alec Spano, PT, DPT, CSCS, and Cert DN or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.

Leaking during double-unders, sharp glute pain at the bottom of a deadlift, or waking to pee all night? We sat down with Ashley from Breeze Pelvic Health to unpack what’s really going on when the pelvic floor keeps stealing your PRs and your peace of mind. Her story starts as a driven teen runner balancing hard training with academic pressure and not nearly enough food—cue missed periods, stress fractures, and pelvic symptoms that birth control couldn’t fix. That experience shaped a career devoted to treating the whole system, not just prescribing more Kegels.
Ashley explains why the pelvic floor rarely acts alone. Tight, overactive muscles often masquerade as “weakness,” especially in lifters and runners who brace through every rep. She shows how breath, ribs, hips, and the spine share load so the floor doesn’t overwork, and why the first step is often lengthening and downtraining before building strength and timing. We dig into REDs—relative energy deficiency in sport—and how underfueling, poor sleep, and high stress derail periods, bone health, and performance while amplifying urgency, frequency, and pain.
You’ll learn the real benchmarks of “normal”: peeing every two to four hours, zero to one nighttime wake-up, daily easy bowel movements, and pain-free sex. We cover why social media shortcuts fall short, how to assess leaks with jumping and lifting, and when to bring in nutrition pros. We also explore the growing breadth of pelvic PT—from postpartum return to sport and high-tone dysfunctions to men’s pelvic pain, nerve-driven symptoms, and even pessary fitting for prolapse and incontinence.
If your back pain isn’t responding, your training leaks energy, or you’re tired of planning workouts around the bathroom, this conversation offers clear next steps and real hope. Subscribe, share with a teammate, and leave a review telling us what surprised you most—your story might be the key that helps someone else get their life back.

Book a discovery call today with Hercules Performance and Physical Therapy in Vero Beach, FL
https://www.herculesppt.com/contact
Also check us out on Facebook and Instagram:
@herculesppt
@dralecspanodpt
https://www.facebook.com/profile.php?id=100088835923718
Call, text, or email us at:
(772) 291- 5164
[email protected]

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Chapters

1. Meet Ashley And Her Mission (00:00:00)

2. Teenage Running, Stress, And Underfueling (00:00:41)

3. Birth Control, Missed Periods, And Injuries (00:02:34)

4. Choosing Pelvic PT As A Career (00:04:03)

5. Leaving High-Volume Care For Quality (00:06:09)

6. Why Privacy And Safety Matter In Pelvic PT (00:07:24)

7. The Biggest Myth: It’s Not Just Kegels (00:08:50)

8. Pelvic Pain Plus Leaking In Lifters (00:10:40)

9. Coaching Form, Hips, And Load Transfer (00:12:20)

10. Social Media Advice And Qualifications (00:13:59)

11. Top Reasons Patients Seek Help (00:15:23)

12. Chronic Symptoms, Prolapse, And Delays (00:17:13)

13. Women Demanding Better Care (00:19:13)

14. Yes, Men Have Pelvic Issues Too (00:20:35)

15. Nerves, Core Stability, And Pain (00:22:09)

16. Sports That Spike Pelvic Tension (00:23:45)

17. Assessing Leaks With Jumping And Lifting (00:25:09)

18. Video, Posture, And Real-Time Feedback (00:27:03)

19. REDs: Energy Deficiency Explained (00:28:05)

20. Periods, Bone Health, And Stress (00:29:35)

21. Lifestyle Levers: Sleep, Water, Screens (00:31:00)

22. Early Red Flags Clinicians Should Ask (00:32:17)

23. Teaming With Nutrition And Referrals (00:33:34)

24. Toileting Habits And Daily Mechanics (00:34:44)

25. What’s Normal Pee, Poop, And Sex (00:36:03)

26. Screening Tools And Back Pain Links (00:38:04)

27. The Future: Specialization And Pessaries (00:39:53)

28. Who Ashley Treats And Why It Matters (00:41:45)

29. How To Find Breeze Pelvic Health (00:43:14)

23 episodes