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Body Breaking Down in Midlife? A Performance PT Explains How to Build It Back Up with Casey Francis, DPT (Episode 270)

If you're an active woman in perimenopause or menopause and it feels like your body is suddenly falling apart — new injuries, recurring pain, workouts that just aren't working the way they used to — this episode is for you. This week we sat down with Casey Francis, DPT, a performance physical therapist who works with midlife women to understand why they’re getting hurt, and importantly, what to do about it, including movement assessment, prehab, rehab, lifestyle and nutrition practices, and much more. Plus, we have a special guest appearance from our very own resident menopause specialist Dr. Carla DiGirolamo — who not only recommended Casey for this episode but is also one of her patients.Casey Francis, DPT is a performance physical therapist and founder of MVMT MTHD. A former Penn State swimmer and graduate of the University of Florida’s physical therapy program, Casey specializes in root-cause–driven care for active individuals and athletes. Her approach integrates movement analysis, progressive strength, and regenerative therapies to help people heal from injury, build resilient bodies, and sustain high-level performance. You can learn more about her and her work at mvmt-mthd.comCarla DiGirolamo, MD, PhD, is a Double Board Certified Reproductive Endocrinologist and Obstetrician/Gynecologist specializing in women’s performance and menopausal medicine. She is also a Crossfit Level 1 trainer, Certified Nutrition Coach, and member of CrossFit Medical Society. She is a MedFit Care provider and provides weekly workouts and medical updates at her Substack Athletic Aging. She is an Endocrine Consultant for Wild Health and Women’s Health Director at Eternal Health. Dr. DiGirolamo is now seeing patients for virtual consultations for menopausal care and performance optimization. Visit her website drcarlad.com to learn more about her services and schedule an appointment.Resources:Crossover Symmetry SystemPerformance Physical Therapy - An investment in your Longevity, Athletic Aging blogSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/Follow Us on Instagram:Feisty Menopause: @feistymenopauseHit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099Support our Partners: Eternal - Get 15% off their services with code FEISTY15 at https://eternal.coMidi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/ Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr

BONUS: Another Mother Runner - Menopause + Active Women with Selene Yeager

Feisty Media is proud to welcome Another Mother Runner to the Feisty Media family. Enjoy this bonus crossover AMR episode starring, Selene Yeager!--Calling all 40+ women: This is a must-listen episode! The guest is Selene Yeager, host of the popular menopause-focused podcast called Hit Play Not Pause. Selene is the longtime health and science journalist who co-authored ROAR and Next Level with Dr. Stacy Sims. Along with hosts Sarah Bowen Shea and Tish Hamilton, Selene discusses:why a long run can exacerbate night sweats;the in’s and out’s of hormone therapy;dietary ways to possibly mitigate menopausal symptoms;realistic, actionable ways to strength train; and,how to keep running through midlife.Selene joins the show around 8:25, after Tish talks about her recent “super-secret marathon” and Sarah shares that a 26.2 isn’t going to be part of her 2026. (Psst: This episode kicks off a month of Feisty crossover episodes.)

Harden the F Up No More: Bioharmony for Midlife Athletes with Dr. Tamsin Lewis (Episode 269)

As athletic women, we often pride ourselves on grit—shoving down feelings, pushing through pain and measuring every metric in pursuit of optimization. But what does that cost us long-term? And how does it hold up in the chaos of midlife and menopause? This week, former Ironman champion and lifestyle medicine practitioner Dr. Tamsin Lewis joins us to explore the evolution from "harden the F up" culture toward bioharmony—a compassionate, context-driven alternative to the more rigid biohacking that’s popular today. Drawing from her high-performance athletic career and hard-won personal experience, she unpacks what she’s learned about female biology, hormones, and recovery. We also dig into hormone therapy, nervous system regulation, autophagy, regeneration, and embracing midlife as a "second spring"—a season for new pursuits that expand our identity, horizons, and even cognitive capacity. Prepare for a deep dive into the menopause transition through the lens of mindset, biology, and the nervous system.Dr Tamsin Lewis, also known as Dr Tam, is a physician, longevity expert, and human‑flourishing advocate. Graduating with honours in Medicine from King’s College London and Guy’s & St Thomas’ Hospitals, with a BSc in Neuroscience and the Biology of Ageing, her work bridges psychiatry, sports & exercise medicine, nutritional and functional medicine. As Founder and Medical Director of Wellgevity®, she leads a personalised, diagnostics‑driven approach to health and emotional regulation—the Wellgevity® Method—integrating biomarkers, brain‑body synchrony, and evidence‑based recovery, while consulting at Reborne Longevity in London, where she delivers longevity medicine through a bioharmony lens. You can learn more about her and her work at www.wellgevity.comResources:Progestogens and endometrial protection, BMS Tool for CliniciansSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/Follow Us on Instagram:Feisty Menopause: @feistymenopauseHit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099Support our Partners: Eternal - Get 15% off their services with code FEISTY15 at https://eternal.coMidi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/ Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr

The Core Truth: Incontinence, Intimacy, Pain, and Performance: Healing from the Inside Out with Leah Keller (Episode 268)

If you've ever leaked when you laughed, jumped, or sneezed–or felt like your core disappeared after pregnancy, injury, or into perimenopause–you're not alone. This week, fitness specialist Leah Keller joins us to unpack deep core dysfunction: what causes it, and why healing it changes far more than just your abs. Leah's breakthrough came when she realized she could help women actually heal the separation between their abdominal muscles–known as diastasis recti–even years after giving birth. Clients who came for core work started reporting that they'd stopped leaking, that sex felt better, that back pain eased, and that their bodies finally felt like their own again– issues they never mentioned at the start. She explains exactly how fixing the deep core resolves problems women didn't even know were connected. We’ll give detailed descriptions of the exercises. You can also watch this one on YouTube to see the exercise demonstrations as well as the anatomical illustrations referenced in this episode, showing the difference between a healthy midline and one with significant diastasis recti separation.Leah Keller is a certified personal trainer specializing in core and pelvic floor health, and co-founder of Every Mother (formerly The Dia Method). Her approach earned medical validation in a 2013 Weill Cornell pilot study — published in the American Journal of Obstetrics and Gynecology — and was further supported by a 2021 Hospital for Special Surgery trial in the Journal of Women's & Pelvic Health Physical Therapy. She has been featured as a women's health expert by NPR, Goop, and Good Morning America. You can find Leah’s published studies, resources, and learn more about her work at leahkeller.comSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/Follow Us on Instagram:Feisty Menopause: @feistymenopauseHit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099Support our Partners: Eternal - Get 15% off their services with code FEISTY15 at https://eternal.coMidi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/ Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr

Running into Your Best Midlife with Anna Troup (Episode 267)

Women in their 50s, 60s, and beyond are crushing courses around the world. At a time when we’ve been preconditioned to believe we’ll slow down, many women are holding strong—or even improving. This week’s guest Anna Troup, 56, who has clocked many of her greatest ultrarunning feats since turning 50, is a perfect example. Last year she took first overall (including the men) at the 268-mile (430K) Montane Summer Spine race—Britain’s toughest ultra marathon—in 84 hours, 56 minutes, and 37 seconds. This after a 2022 injury that left doctors questioning if she’d ever run again. This week, we talk about her most recent feat: completing the Montane Winter Spine Race this past January in 106 hours, 19 minutes, and 12 seconds—through brutal conditions including gale-force winds literally blowing runners off their feet. We dig into her journey to ultras, how she trains, races, and recovers, her menopause experience, and why more midlife women should line up and give it a go.Anna Troup took up ultra running in 2013 with the sole aim of completing the UTMB, which she did for the first time in 2014. Unexpected success followed, much of it after she turned 50, and she has since won and held course records for many of the UK’s toughest single stage ultras including the Arc of Attrition 100, the Lakeland 100, Exodus 100, Wendover Woods 100, the Oner and the Summer Spine and Winter Spine. She has run the women’s Fastest Known Time for the Pennine Way and was the first female British finisher in UTMB in 2022. Ultra running has been a family sport since the beginning and she normally competes with Richard Staite, her partner, whilst her two children can be found either running themselves or as volunteers in aid stations. She works as non executive director and has recently moved to the Lake District to be closer to the mountains she loves.Resources:Ultramarathon winner's 'tough and terrifying' race at BBCHow a 55-year-old woman won Britain's toughest ultra marathon outright at Running MattersSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/Follow Us on Instagram:Feisty Menopause: @feistymenopauseHit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099Support our Partners: Eternal - Get 15% off their services with code FEISTY15 at https://eternal.coMidi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/ Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr