Guest Expert: Erica O’Neal with Trailhead PT Discusses Pregnancy Health & Postpartum Care:

I’m so excited to welcome today’s guest—Erica O’Neal, a passionate pelvic health physical therapist and the founder of Trailhead Physical Therapy right here in the Traverse City area.

Erica is a mom of two, and brings both clinical expertise and lived experience to her work supporting women through pregnancy, postpartum, and beyond. She’s known for her compassionate, evidence-based approach to pelvic floor care, and for making women feel truly seen, heard, and supported in their healing journey.

Whether you’re pregnant, newly postpartum, or years into motherhood—Erica is here to remind us that pelvic health matters, and that it’s never too early—or too late—to seek support.

Erica, I’m so glad you’re here. Welcome!

Jess: Why did you choose to focus on pelvic health as a physical therapist?

Erica: I didn’t originally choose pelvic health - I started my career in neurological PT working with those with strokes and brain injuries. After having my two kids, and feeling like my body ripped in half (I had terrible prolapse, leakage, constipation issues!), I went to a pelvic floor PT as a patient. Changed my life and I decided I wanted to help other moms with not only preventing issues that I had, but helping to not have to live with the issues most deem “normal”. 

Jess: When you’re not supporting new families, how do you like to spend your time? What brings you joy?

Erica: Well, being in my mid-thirties, I am starting to be on team garden and plants! I have my first vegetable garden and starting to grow more garden areas around my house - we have honey bees as well which are fun to have buzzing around. I have two awesome kiddos and a great hubby, and we spend a lot of time camping, playing, going to the beach. I have a lot of joy when I go camping and explore new areas, especially with waterfalls, and looking for stones on the beach.

Jess: What’s something that always makes you laugh, what’s your go-to thing to do or watch when you just want to laugh and feel good? 

Erica: Honestly, seeing my kids do silly things. Being a mom can be so challenging in so many ways, but my kids are ALWAYS good for a laugh when they’re being silly, making up funny words or games, and they make me laugh every single day.

Jess: What is pelvic floor physical therapy, and when during pregnancy might someone benefit from it?

Erica: This is a loaded question - pelvic floor therapy is a holistic approach to help manage any pelvic floor symptoms, or any condition that is surrounding the pelvic region. This can include the obvious like urinary leakage, heaviness like prolapse, but can be extrapolated to things like bowel constipation or leaking, painful intercourse, endometriosis or interstitial cystitis issues. And guess what? Everything attaches to the pelvis! So I also treat a lot of back, hip, tailbone pain, as well as treating individuals with headaches, neck tension and so much more - it’s all connected.

In my VERY biased opinion, everyone needs to at least have a pelvic floor screen, almost like going to the dentist. We go through so many changes in our bodies with periods, pregnancy and postpartum (however many times we do this), and also peri-menopause and menopause changes. Pelvic health is so vital to so many functions, and everyone should see someone, especially if you have any symptoms.

Jess: How does the pelvic floor change during pregnancy, and what are some signs that it's under stress?

Erica: Your whole core system, including your breathing and ribcage, abdominals, pelvic floor, and back/glutes all have huge shifts and changes during pregnancy, and this disruption of the natural functioning of your system can impact pelvic floor in particular. Signs it may be under stress can include leaking, uncomfortable intercourse, SI joint pain, back pain, tailbone pain, constipation or bowel changes, lightening crotch, pressure or heaviness and more!

Jess: Can pelvic PT help prepare for labor and delivery? What kinds of things do you work on in the third trimester?

Erica: This is exactly what I teach in my Pregnancy Program - it is basically all of the information that I wish I had as a pregnancy mama that I truly think would have written a different birth and recovery story for myself. We can help improve pain and functioning throughout pregnancy, and can help prep for birth. The pelvis, hip range of motion, and pelvic floor play a vital role in how your labor and delivery goes, and the better we can assess and optimize these areas, the less complications you may have. For example, learning birth positions that are not laying on your back can drastically improve time of pushing, prolapse complications, and reduce severity of perineal tearing.

Jess: What are a few small things pregnant people can do daily to support their pelvic health?

Erica: It’s hard to generalize, however, if you start by focusing on 360 degree breathing (meaning breathing down and into your belly, sides, and back), this can help many things including pelvic floor. Certain stretches may also help, however until we assess, it’s hard to give blanket statements for what is best!

Jess: What are some common pelvic floor concerns you see in the early postpartum period?

Erica: Heaviness and pressure is a common concern I hear, as well as urinary urgency and leakage, bowel changes, and painful intercourse. It’s common to hear that pregnancy symptoms will go away once you have the baby, but it’s often not true. Even if you had a c-section, you can absolutely still have pelvic floor issues.

Jess: How soon after birth can someone start pelvic floor physical therapy, and what does that first visit usually look like?

Erica: Typically we like to see mamas back around 6 weeks postpartum - this allows the tissues time to heal, while also trying to get some rest and time with baby. The first visit we discuss the birth and delivery, any symptoms the mama may be having, things like feeding positions, body mechanics for lifting toddlers and carseats, as well as physical examination of core system. This may include an internal exam, but also may include assessment of diastasis recti, back muscles, neck/shoulder tension and more.

Jess: Can you talk about how pelvic PT helps with recovery from different types of birth—vaginal, assisted, or C-section?

Erica: No matter your birth story, every person who has a baby can benefit. From body mechanics and lifting kids and groceries, to pelvic floor coordination and manual therapy. With pregnancy in general, our core system becomes much less balanced, and we often have difficulties reconnecting. C-section mamas don’t automatically get a free pass on pelvic floor issues either, unfortunately, as they also were pregnant with a lot of changes and pressure over the time of their pregnancies.

Jess: We hear a lot about diastasis recti—how is that connected to pelvic health, and how do you support it?

Erica: The theme of this interview seems to be the core as a system, and an abdominal separation is part of that system, and is impacted by the other pieces. Our pelvic floors and cores are like best buddies - when one has an issue, it can lead to them having more difficulty communicating. Abdominal separations seem to lead to a lot of fear - they can be scary, painful, and linked to things like back pain, pelvic floor issues, leakage and more. However, there is so much we can do to help maximize this area, allow it to connect and function with the other pieces of our core system, and to not be afraid to run, jump, workout, lift, and play!

Jess: What do you wish more new moms knew about healing after birth?

Erica: Firstly, you don’t have to live with it! All of the issues that people deal with all the time, like leaking, pain, constipation, and anything else, doesn’t have to be that way. And it’s never too late. I think the other piece is knowing that every mama has a different story - just because Sally down the road is back to running at 12 weeks, doesn’t mean that’s what’s good for you, or that she’s doing it without symptoms.

Jess: How can someone tell the difference between what’s “normal” postpartum and what’s worth getting checked out?

Erica: That’s a tough one - there are things that are to be expected postpartum, like some heaviness in the first few days or weeks, however, if pressure, pain, leaking last after the first few weeks, it’s likely something that needs to be at least assessed. I have a lot of moms come to me 6+ months postpartum, hoping that their issues would have resolved, but they kept waiting and they only got worse. The best time to help something heal, is to get to it as early as possible!

Jess: What’s one myth about pelvic health or postpartum recovery that you’d love to bust?

Erica: “Everything will just go back to normal on its own.” or “That’s normal you’re [pregnant] or [had a baby].  Many people are told that leaking, pain with sex, core weakness, or heaviness are “just part of being a mom” and that things will get better with time. But while the body is incredibly resilient, these symptoms often don’t fully resolve without support—especially if there are underlying issues like pelvic floor dysfunction, diastasis recti, or scar tissue. Postpartum healing is a process, not a timeline. Just like any major injury or surgery, the body deserves rehab—and pelvic health therapy can help you reconnect with your core, eliminate pain and leaking, and actually feel strong again. Recovery isn’t about bouncing back—it’s about moving forward with knowledge, support, and confidence.

Jess: For someone listening who feels nervous or unsure, what would you say to encourage them to reach out for pelvic PT support?

Erica: Just reach out and give us a call - we’d love to just chat about what you’re experiencing, how we could help, and just allow you to talk about what you’ve gone through. The transition to motherhood is so challenging in so many ways, so beautiful and incredible, but also so challenging whether it’s the physical changes, lifestyle, relationship, or mental health. There are things that you can do to help live your life to the fullest!

Erica, thank you so much for sharing your time, your insight, and your heart with us today. Your work is such an important reminder that healing doesn’t have to be something we figure out alone—and that every woman deserves care that honors her body and her story.

If you’re listening and something resonated with you—whether you’re navigating pregnancy, postpartum, or just starting to ask questions about your pelvic health—I hope you feel encouraged to reach out, ask for help, and take that next step.

You can find Erica at Trailhead Physical Therapy in Traverse City or online at https://www.trailheadptandwellness.com/