021: Your Pelvic Floor, Diastasis Recti, And More! w/ Erica Ziel, FDNP, CPT, PPES


021: Your Pelvic Floor, Diastasis Recti, And More! w/ Erica Ziel, FDNP, CPT, PPES

Welcome to the Hey Mami podcast!

Our guest today is Erica Ziel. Erica, mom of three, received her Health and Human Performance degree from Iowa State University, is a Functional Diagnostic Nutrition Practitioner, certified personal trainer and Pilates instructor, deep core and pre/postnatal exercise specialist whose mission is to help women live a healthier life and heal their body through movement, wellness, intuition, and breathwork.

Erica is the founder and creator of Core Athletica®, The Core Rehab Program, Knocked-Up Fitness®, Pre/Postnatal instructor trainer course, and host of The Core Connections Podcast.

She believes that anything you want to improve about your health and life, you can!

Or listen on Apple Podcasts | Spotify | Stitcher | TuneIn | YouTube

In today’s episode we are talking about the pelvic floor, diastasis recti, and working out before, during, and after pregnancy.


  • Why does Erica do what she does?
  • What does the word “postpartum” mean to Erica?
  • What is the deep core?
  • The problem with kegels
  • How to strengthen the back of the pelvic floor
  • What is diastasis recti?

Important Links

Find Erica online | here as well

Find Erica on Instagram | Instagram | Facebook | Facebook

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021: Your Pelvic Floor, Diastasis Recti, And More! w/ Erica Ziel, FDNP, CPT, PPES TRANSCRIPT

Dr. Maren:                          Welcome back to the Hey Mami podcast. In today’s episode, we cover deep core, pelvic floor, diastasis recti, back pain, and all things exercise in pre and post pregnancy. Our guest today is the fabulous Erica Ziel. If you’ve been thinking about fitness and core strength in pregnancy, I can almost guarantee you’ve seen Erica’s work.

Dr. Maren:                          She’s known for helping women strengthen their deep core, including the pelvic floor in a safe and effective way. So Erica Ziel is mom of three, just like Alex and I. So we’ve got nine kids between the three of us. She received her health and human performance degree from Iowa State University. She’s a functional diagnostic nutrition practitioner. She’s a certified personal training and Pilate’s instructor, and she’s a deep core and pre postnatal exercise specialist whose mission is to help women live it healthier life and heal their body through movement wellness, intuition and breath work.

Dr. Maren:                          Erica is the founder and creator of Core Athletica, the Core Rehab Program, Knocked-Up Fitness, Pre Postnatal Instructor Training Course and host of the Core Connections podcast. She believes that everything you want to improve about your health and life, you can. So thank you so much for being here, Erica. We appreciate it.

Erica:                                     Well, thank you [crosstalk 00:01:15] so much.

Dr. Maren:                          You’re a busy lady.

Erica:                                     Yes, we all are.

Dr. Maren:                          Yeah. So one of the things we just like to start with is tell us why you do what you do.

Erica:                                     Well, I mean, my whole mission really kind of started as a kid. I’ll keep a really long story as short as possible. So started at the age of five. I actually had knee pain, which continued until I was 21 and basically rehabilitated myself. So that’s where I got into movement because I kept telling me when I was younger, my parents, right, that, “Oh, it was growing pains. It would just go away.”

Erica:                                     But I mean, I guarantee you today. I grew up taking way too much Motrin as a kid, which is something I strive to not give my children. And even when I was done growing, they kept saying, “Well, we don’t know.” They almost diagnosed me at one point with rheumatoid arthritis. And just it was craziness.

Erica:                                     And finally, at one point went to a specialist and they’re like, “Yeah, you need to strengthen your legs.” And I was like, “You’ve got to be kidding me.”

Dr. Maren:                          Like just in quad strength?

Erica:                                     Yeah, exactly. And I was like, I had seen so many people at that point. So that’s what got me in the gym when I was 17, starting to learn Olympic lifting and all that kind of stuff, right. And then went on to study exercise science and just fell in love with it and started really seeing the power and movement, not just from like, “Oh, let’s burn calories and stay fit.” I actually figured out really quickly from my own experience that wow movement it was very healing and we need movement.

Erica:                                     And then when I moved to California, and really dove in deep into Pilates, and started learning so much more about fascia and pelvic floor and all of that, which I had to go outside of the box to discover. It was more like following my intuition, right.

Erica:                                     And I just really discovered that the body is absolutely amazing and we’re looking at movement all wrong in the fitness industry. So basically, what I do today is help women heal their bodies because we’ve learned improper techniques starting from really, really young. I see it now as I have a teenager and I see what she’s taught, and she comes home and she’s like, “Mom,” she’s like, “You tell us not to tuck your butt, but they’re telling me to tuck my butt when I’m doing squats and all this stuff, right.”

Erica:                                     So there’s a lot of things that, and I always want women to know like, hey, just because we learned these techniques when we were young, it’s never too late to change them. And so really that’s where I’ve come to teach women about their bodies, and I love it.

Dr. Maren:                          So you’re not supposed to tuck your butt when you do squats? Like wait this is a whole other…

Erica:                                     Yes.

Dr. Maren:                          Well, we’ll talk about that later, but…

Erica:                                     So yeah, so I mean, long story short, it’s just an evolution of one thing after the other and myself having three babies, working with a lot of pre and postpartum women, as well as I also trained men and professional athletes, it’s kind of an all over. I worked with so many amazing clients and really discovered that the foundation that I teach works for everyone. But I love working with moms and during pregnancy and stuff too, because it’s such just a transformative time in life.

Erica:                                     And a lot of it’s not taught right out there. So that’s why I’m here to really help change, so that when we can feel strong and empowered and not deal with so much dysfunction that we’re just kind of told, “Oh honey, that’s normal, you’ve had a couple babies, cross your legs when you sneeze, you’ll be fine.” And I’m like, “No, no, no.”

Dr. Maren:                          Yeah. There’s something to be done about that. I think the other thing that we’ve talked about before is just like postpartum doesn’t mean that you had a baby three months ago, right? Like what does postpartum mean to you?

Erica:                                     I mean, postpartum, I always say, which is hard for women to understand and moms to understand, but honestly, once you’re postpartum ladies, you’re always postpartum. But I find that most women once they’re past about six months post, they don’t resonate with the word postpartum. But if you’ve ever had a baby it’s never too late to learn. I’m sure the stuff that we’re going to talk about today, so.

Dr. Maren:                          Yeah, for sure. All right. So let’s just start out talking about core. When you say deep core, what does that mean?

Erica:                                     So when I talk about deep core, I’m really talking about everything from the base of your pelvis, which includes your pelvic floor, which is why we’re we talk so much about pelvic floor, all the way through your abdominal cavity, which includes really all the fascia, the layers of fascia of your abdominal wall, along with the musculature, of course. But I do a lot of fascia teaching, because when we learn and understand how to tap into our fascial system better, like it is amazing how it transforms our health and how we feel.

Erica:                                     But also we have fascia that goes around our organs and we have fascia and our deep muscular system along our spine. So when I’m talking deep core, we’re also talking along the spine, not just abdominals, which is where a lot of people think, oh, core is just abs it’s not.

Erica:                                     And deep core to me is like the deeper layers, but it includes your diaphragm, and includes the intercostal muscles which go in between your ribs, underneath your rib cage, and basically everything that goes up to underneath your shoulders, so basically your entire torso.

Erica:                                     And so [inaudible 00:06:19] core, we’re really not addressing our core correctly. It’s really everything. And that’s where no matter what’s going on with someone’s body or what you’re dealing with, if you haven’t addressed pelvic floor function, then we’re missing something.

Dr. Maren:                          Yeah, 100%. So when I hear pelvic floor, and I think a lot of women probably resonate with this, we think kegels. So talk to us about kegels. And I think part of what you preach is why sometimes that might do more harm than good.

Erica:                                     Yeah. The problem with kegels is that we’ve discovered over the years of so many conversations with women that they’re imbalanced in their pelvic floor, meaning that most likely they could be too tight in their pelvic floor because they’re actually overdoing them.

Erica:                                     And so this whole notion and this conversation that, gosh, we’re too weak in our pelvic floor might be partly the case and maybe the case for some women. But my experience is for women who are active and have a history of doing athletics. Even as a child, even if you’re not super active as an adult, but you were an athlete when you were younger, you’re probably really tight in parts of your pelvic floor. Most likely the front part of the pelvic floor or one side of the pelvic floor.

Erica:                                     But if you’re just doing kegels, we’re just really addressing more of the middle to front of pelvic floor. And most women don’t know how to activate in the back half of their pelvic floor because ladies, your pelvic floor goes essentially from your pubic bone all the way back to underneath your tailbone and then sits bones to sits bone.

Erica:                                     So if you’re sitting up right now and you kind of wiggle around, make sure your legs aren’t crossed and you can like feel those four points, right. So I see all of that really is pelvic floor musculature. It’s not just one muscle, like there are separate muscles. And I think that also confuses women, they think it’s just one muscle. It’s multiple muscles.

Erica:                                     Fascia too, like I was mentioning, it goes around all of our muscles. It goes through our muscle fibers. So it’s very all integrated in our body. And so the other thing too with kegels is, it’s really just teaching women to tighten, tighten, tighten, and tighten. And we have to actually learn how to release and relax in order to effectively tighten.

Erica:                                     So when I teach women about their pelvic floor, I typically teach them that we really need to set the word keel off to the side. And it’s because we have to retrain our brain. It’s not as much sometimes about retraining the pelvic floor, it’s actually more about retraining the brain because at the first, if you’ve been practicing kegels for years, right, as most women have to some degree, then your brain hears that word keel, and all of a sudden you tighten, right? It’s like, “Oh, I know how to do that”

Erica:                                     But that’s not actually what I want you to do. So I really, really encourage them and start thinking of your pelvic floor as your pelvic floor and not as kegels. I just think it’s very misleading. So that’s my whole philosophy in kegels.

Erica:                                     And actually I saw a study the other day. I need to keep it pulled up. I want to do a whole episode on it. That was basically saying to the degree that 80% of females, by the time they’re like, it was either 18 or 20, something like that, experience incontinence. And I was blown away because it’s happening really young and we’re not talking about it.

Erica:                                     I mean, that’s why a lot of women wear black pants to work out, right. No one can see if you peed your pants a little bit.

Dr. Maren:                          Yeah, it’s a good point.

Erica:                                     It’s astonishing to me that goes on in the fitness world. No, it’s really like, I’ve heard that from a lot of people and people that have done like the intense workouts and even on video sets, because I have a friend of mine who does, who has been involved in all of that world as I have a little bit too. But in the high intensity world and women, they wear their black leggings and at the end of filming, it’s like the janitors are out there cleaning up all the pee on the ground. And I’m like, “That’s a problem. That’s a problem.”

Erica:                                     But we talk about it, right. Societally, if it even gets talked about, it’s like, “Oh, well that’s okay because you’ve had a couple babies.” So that’s just going to happen. But the reality of it is it shouldn’t be happening. Or I should say, if it is happening, I like to frame it in the way that that’s, it’s your body’s way of telling you like, “Hey, hello, look at me down here.” Trying to get your attention and then let’s do something about it.

Dr. Maren:                          Yeah. There’s some imbalance. It’s interesting because you just think about like leg strength, right? You’ve got to strengthen your quads, but you also have to strengthen your hamstrings and glutes. And if you don’t do that, you’re going to be out of balance. And so we know that when we think about, or I think about legs and I know that, right. But when I think about the core, like you might not always think about that all those different layers and that it involves a lot of [crosstalk 00:10:51].

Dr. Carrasco:                      Sorry. I was going to say, how do you focus on strengthening the back of the pelvic floor?

Erica:                                     So there’s obviously different exercises. You can do really gentle ones, but something to just initially, even if you’re sitting is I have seen that if women try to activate their pelvic floor. So when you exhale, we’re thinking about lightly drawing, like those four points together and up. If you go to squeeze your glutes, you’re not using your pelvic floor correctly, you’re actually shutting off your pelvic floor.

Erica:                                     So that’s a really good sign to women to let them know like, “Oh, I’ve actually cheating by using my glutes.” So we have to learn to separate glute activation from pelvic floor activation. I want to say it’s simple but complex at the same time. And it’s really a brain training thing. At the end of the day, I realize like I’m really just helping women retrain their brain, wiring of the brain because we’ve learned certain habits and techniques.

Erica:                                     So it’s from that whole kegel idea, setting that inside, right? We think of our pelvic flues as diamond shape, and then exhale as we draw the four points, meaning from the tailbone also in and up. And for women that notice they clench their glutes, you need to relax that first off.

Erica:                                     And typically what’s going to happen is you’ll end up in this space of feeling nothing. And you have to like actually kind of embrace this space of feeling nothing and actually visualize. I do a lot of visualization techniques to teach women how to find and how to activate their pelvic floor correctly.

Erica:                                     And we have to stay out of the space of trying to avoid getting frustrated with ourself if we don’t feel it. And also knowing that it feels typically lighter and less of an activation once you get it correct than what you think it should be.

Erica:                                     Because we get so used to like, “Oh, squeeze those abs or squeeze those glutes, right. Or do that kegel really intense.” And the way that I teach is actually the opposite of that. It has to be gentle. It has to be less. So it’s some of it is just this a nervous system thing, that brain train of your body relearning of like, “Oh, I didn’t even know. I didn’t even know I had that area of my body that I could activate.”

Erica:                                     So I mean, it’s absolutely possible to find it, but for most women it doesn’t happen right away. And we just have to get out of the glute creeping. First, I was going to ask Christine that you were saying about strengthening your legs. I just wanted to add a piece on this that I think is really fascinating with our pelvic floor.

Erica:                                     Is that what I teach is yes, it’s important to understand our pelvic floor as a standalone muscle, but for optimal function, we also have to understand how our leg strength or lack thereof or imbalances through the legs and pelvis, hip bone in particular can play a role in our pelvic floor.

Erica:                                     So if someone’s really restricted through the inner line of their hamstrings or inner thighs, that all plays a role on how that side of the pelvic floor function. So my example I always use is if someone’s really tight, say on the right side of their inner line, they’re very likely really restricted in that side of her pelvic floor as well.

Erica:                                     But she may have pain on the opposite side of her pelvic floor or her hip or her SI joint, because we get a lot of oppositions in the body trying to balance us and hold us. And many times I see women going to people to get rid of the pain. And it’s like, well, if you have SI joint pain on the left side and no one’s looking at the right side of your body or the right side of your pelvic floor or the right side of your shoulder, right. Or whatever it might be, we might be missing something.

Erica:                                     So my biggest thing I really always want to get across to everybody is that well, yes, we can look at individual areas of the body. For optimal function, we have to look at the body together. And that’s something that I’m really big on teaching all of my ladies to do. We start with pelvis, we start with decor, but we continue to just evolve and work through the whole body because you have to for optimal function.

Dr. Maren:                          Yeah, that’s a great point. It also makes me wonder, do you have any particular sort of body movement, technique or philosophies that you like? This just reminds me of rolfing or some of those. Is there any particular one that you recommend or like yourself?

Erica:                                     Like to see, yeah, like if you were to go to someone.

Dr. Maren:                          Yeah.

Erica:                                     Yeah. I love cranial sacral work, because it’s very general. It works the facial system. I’ve had amazing cranial sacral work over the years. So yeah, from a body work perspective, that’s what I would always recommend. They can be hard to find, although it’s becoming more common, which is great.

Erica:                                     But at the same time, I always tell people as much as you can go to certain therapist and things to have body work done, that’s amazing and great. You also still have to train your body. You still can’t cheat your way out of dysfunction in the body. You can go to a chiropractor, you can go to cranial sacral and you can do all these different modalities, which are absolutely can be amazing.

Erica:                                     But at the end of the day, you have to train your body. You have to train your brain. You have to train your nervous system as well. So it’s like the whole package is what’s going to give you the best results.

Dr. Maren:                          It makes me think of like root cause in medicine, right?

Erica:                                     Exactly.

Dr. Maren:                          We can give you something to treat your gut, make the infection go away, but if you still have all the things that set you up to why you got there in the first place, it’s just going to come right back, so, yeah, we got to address all that stuff, cool. Okay, so Alex, do you have anything you want to add?

Dr. Carrasco:                      Yeah, I was just going to ask. So you started out doing Olympic weight lifting now?

Erica:                                     I did, yeah.

Dr. Carrasco:                      And so how does weight training integrate into your programming or your philosophy?

Erica:                                     So where I am today, because I have ended up in this space of really teaching women how to basically rehabilitate, re-strengthen, find the right muscle activation, fascial connections. We start with body weights or really light weights. I do a lot of ball work, really soft ball work, not hard tennis ball, any of that stuff. Don’t use that stuff, ladies.

Erica:                                     I feel like the hard stuff triggers the nervous system to tighten and become more stressed. And at the end of the day, we want to call our nervous system. So my goal for women is that many times in the beginning, I have to pull her back from the high intensity, from the heavy lifting in order to, for her to learn how to make these connections again with her body.

Erica:                                     But then what’s really cool when she does that, she pulls her training back and we are then basically rebuilding the body up from this amazing foundational layer. And then as she gets stronger and rebalances everything, we start to work back into the high intensity and the heavy lifting and whatever it is that she desires. Because my goal for women is that they can do what they want to do, whether that’s running, hiking, CrossFit, Olympic lifting, whatever it is, but without pain, without dysfunction, without peeing her pants and it works.

Erica:                                     And it really, really works really well. It’s just, we have to also get out of that mindset of the go hard or go home mentality, which I’m always docking my ladies down from. And it’s really, really neat to see when I see women who, when she finally is like, “Okay, are I’m going to trust you. I’m going to listen to you and I’m going to do less, right.” Which is what I get a lot of my ladies to do.

Erica:                                     We’re doing less actual movement. We’re moving slower. We’re really mind body connected, or body mind connected, as I like to say it sometimes. And we’re improving our oxygenation of our body, right. And so what that does when she actually slows down, many times believe it or not her stress melts away a lot of it. Women may even lose weight. I don’t promote myself as weight loss by any means, but it’s amazing, right, what stress does.

Erica:                                     And so, so many times I think we get in this mindset, especially with around losing the baby weight or whatever it is. And it’s like we have to get weight off as quick as possible and do all this stuff. And it’s like, or we want to get back to our pre baby body or pre baby exercise as soon as possible. But what happens so many times is that actually is an added stressor to her life and can then be a big part that causes a lot of dysfunction.

Erica:                                     So then with the next pregnancy, she’s going into it with incontinence, with diastasis, with back pain, with all these things, which we can reverse during pregnancy. I do it all the time. But if we could just start to learn this stuff like right away, it would be amazing because my goal for women is that we have longevity of mobility because I mean, I know you ladies see it all the time, right?

Erica:                                     There’s a lot of other factors too, but from a mobility perspective that with aging, right, we don’t think about it when we’re a little younger having babies and stuff like that. But I’ve worked with women that are a lot older, and if we can really prioritize our mobility in a way that is very nourishing to our body, just like the food we eat, just like all the non-toxic products we use and things like that, it really can go such a long way for that. Just encapsulating that healthy lifestyle and not feeling like, “Oh, we got to go hard and make work up a big sweat every day.” Or whatever it is to burn the calories and do all that kind of stuff because that’s kind of a load of crap.

Dr. Maren:                          Yeah, totally. I love that. All right, so-

Dr. Carrasco:                      Yeah.

Dr. Maren:                          Go ahead ask.

Dr. Carrasco:                      I’m just going to say, sorry, can you, so diastasis recti is such a big topic for, well, definitely, I would say for me, because there’s been really no rehab.

Dr. Maren:                          Me too girl.

Dr. Carrasco:                      So I’m really curious. And there’s a lot of programs out there and people talk about it, and then there’s people that say, “Oh, you can’t heal it.” And then there’s people that go get surgeries. So can you talk a little bit more about what it is? How people can diagnose it and then what you have done in your work to help women reverse it.

Erica:                                     Yeah. So diastasis recti is when we get that separation of the six pack muscles, basically, right? So everyone knows one finger width is very normal. We should have one finger width spacing. I would say, if you look at some of the six pack, right, the muscles don’t just come right together, right? There’s that thicker fascial line in the middle.

Erica:                                     So let’s start with testing for a second if we could. Ladies, if you’re pregnant, don’t test for diastasis please. There’s no reason. But when you are pregnant, what I always encourage everyone to keep an eye out for is the coning of the belly.

Erica:                                     So in any exercises we’re doing, any functional moves, any movement throughout the day, lifting another kiddo at home, carrying groceries, whatever it is, our belly should be more rounded. And if we ever see where it creates more of a point, or like there’s an alien coming out of your belly, like something like that, that means you are gripping in your obliques and we’re putting too much intro abdominal, or creating too much intra abdominal pressure.

Erica:                                     It also can be an indication that we have some pelvic floor dysfunction going on. Most likely you’re too tight in your pelvic floor with diastasis. Because if you’re too tight in your obliques, you’re probably a glute gripper. You may tuck your glutes a lot, which again, then can cause all this tightness, right?

Erica:                                     So we want to stay out of movements that create coning during pregnancy, as well as postpartum. Now ladies, when it comes to testing for it, I always just say, wait till you’re eight to 10 weeks postpartum. Do not test right away because your uterus is still expanded, right? And even with baby number three, what our uterus can stay expanded well beyond six weeks. It could take, I don’t know what the exact number are, but it can definitely take more.

Erica:                                     They say a minimum of six weeks, and then it could take even longer for your uterus to go down, which can give you a false reading that your diastasis is way worse than it really is. And we want some of that natural healing postpartum to just happen naturally on its own.

Erica:                                     But if you do then test and determine you have diastasis, which we have two different numbers or two different measurements to kind of be aware of. One is the width, right? So as you’re measuring, you want to try to activate your core. And so you palpate along your midline and scene.

Erica:                                     And most women have the biggest space around their belly button, right, which makes sense. This is a space that gets stretched the most. And so one finger with space is normal. So don’t come to me and be like, “Oh my gosh, I have one finger with space. My diastasis is bad, I hear it.” And I’m like, “No, that’s okay. That’s normal spacing.”

Erica:                                     But anything beyond that can indicate you have diastasis. If you’re someone who feels like you can put your whole fist inside your abdomen, that’s okay. I’ve worked with those women. We can definitely heal that to a degree. And we’ll talk about what healing is, I knew you ask that in that question.

Erica:                                     But the most important thing ladies is that I want you to be aware with diastasis when we’re testing is how far down can you push into your abdomen. As in, do you get any feedback from that fascial tissue? Remember that I said, we have these layers of fascia in our abdominal wall. This is why we do a lot of fascial training in my world because that’s where we learn to strengthen our core, deep core abdominal wall.

Erica:                                     And it helps to hold our organs in. It helps in healing diastasis. It helps in prevention of diocese or minimizing it. So even if you have one finger width space, but you’re like, “Wow, I can really feel the ridges of my abdomen in the middle and I can push my fingers quite away is down.” Never do it to a point of pain. Please stay out of pain ladies, when you’re testing. It’s just to give you an idea. It’s not like it has to be like perfect.

Erica:                                     That can indicate that, okay, we’ve got, we don’t have as good a connective tissue strength through the abdominal walls. So let’s work with it, right. And again, if you’re someone on the other end that you’re like, wow, if I can really push my fist all the way down in my abdomen that’s okay. In some part, what some of that is too, I believe is that we don’t know how to actually even start to connect our core, right. We just don’t. And so we have to learn that.

Erica:                                     So from a healing perspective, can you truly heal diastasis? Well, it’s kind of a gray area. What is healing? Right. So for a lot of women, yeah, they’ll end up back with a normal one finger width space, nice strong, deep core, including pelvic floor. And for other women, they may end up with what’s called a functional diastasis, where their belly comes back strong and flat, but they still have a bigger than a one width spacing. Which actually that’s what I have after my third, I got diastasis.

Erica:                                     I thought I knew a lot. And actually that taught me that I was like, “Oh, you still have a lot to learn.” Because I was doing the old school way of healing diastasis, and it wasn’t working. And so that’s when I really was like, “Oh, we’ve got to, something has to shift and change.” But the cool thing is, is even if you have, what’s called a functional diastasis is like, I’m back to doing all my advanced Pilate stuff and everything, and there’s no problem.

Erica:                                     So we kind have to get away from like, what is the space? What is the gap? What is like that to me is just like, it’s a piece of information. And then all it does is it’s just our body giving us feedback. And it shows room for healing is what it does. But I will tell ladies with diastasis that you cannot just heal your abs.

Erica:                                     We have to get out of this mindset of getting our abs back and healing our abs, even if you don’t have diastasis, honestly, after having babies, because of all the stretching that’s happened, all that laxity, we’ve got to learn how to become more facially strong. And in order to have a properly strengthened core, notice I say properly, not too strong of a core, because we have to address the pelvic floor.

Erica:                                     Because I’ll get women that come to me and she’s like, “Erica, all I care about is healing my diastasis, I don’t care anything about my pelvic floor.” I’m like, “Okay, well that’s the wrong way to look at it, number one.” But we cannot optimally heal diastasis recti, or even heal it to a place where it’s a functional when we can do everything in our life that we want to do without addressing our pelvic floor, it is so important.

Erica:                                     This is where the pelvic floor conversation comes up. Whether we’re talking about pelvic floor dysfunction, we’re talking about diastasis recti or back pain or neck pain or knee pain. It doesn’t matter. We have to address pelvic floor function.

Erica:                                     And so there’s so much we can do when it comes to healing diastasis, it’s absolutely amazing. That’s actually where my Core Rehab program that I created initially was a diastasis recovery program or healing program. And then out of it, we started getting all this pelvic floor conversation. Women’s incontinence was going away. Her pelvic organ prolapse sometimes were feeling better. Her back pain was gone. It was like all these things.

Erica:                                     And it really showed me when I was able to just teach masses of women, which is amazing to me. They like, “Wow.” It’s really comes back to these fundamentals. We have to stop compartmentalizing, pelvic floor over here, diastasis over here. You know what I mean? It’s just [crosstalk 00:27:21]-

Dr. Carrasco:                      It’s more consistent.

Erica:                                     It’s just functional health, right?

Dr. Carrasco:                      Yeah.

Erica:                                     It’s all connected and we’re going to the root and that’s what’s going to get you the best results.

Dr. Carrasco:                      Yeah. I mean, I think it’s very similar to what Christine and I do in medicine in that you can’t compartmentalize the body as we often do. And we send people to specialists for these things, but the truth is that the whole system’s connected, so.

Erica:                                     Absolutely.

Dr. Carrasco:                      That’s fascinating. So I think something that a lot of women deal with and kind of just ascribed a motherhood and pregnancy is back pain. And it sounds like there are some ways when you do deep core work, that maybe that’s not a normal thing.

Erica:                                     Yeah. The back pain is absolutely something that’s just like, “Oh, it’s normal. It comes with the territory.” Well, a lot of it starts with postural shifts during pregnancy. I do a lot of teaching women how to hold their body correctly about posture. We start to get that tucked butt, right? Like how many women listening feel like after having even their first baby, they’re like my butt disappeared, right?

Dr. Carrasco:                      Yeah.

Erica:                                     And so what happens is then our body, if we’re not aware of it, we really get that tucked pelvis to try to help compensate for growing expanding hips, growing baby, all that kind of stuff. But when we’re actually aware that we don’t want our butt to tuck. We don’t also want to overcompensate and overarch in our low back either. We have to find this nice kind of at all ground.

Erica:                                     And we learn how to connect correctly through our deep core. We learn how to hold our body. We learn how to connect with our mid back. A lot of women, when they first start working with me, she’ll start really feeling her mid back, like it’ll be sore. And it’s because those muscles have been kind of dormant for a while.

Erica:                                     And so it’s amazing just bringing awareness to your posture, how that can enhance your life. But with back pain in particular, I find that so many people with back pain and moms in particular, right? So you have pain in your back. And so you’re maybe going to this person or that person, then they’re looking at your back. That is the biggest mistake, right?

Erica:                                     I say all the time, rarely where you feel your pain is actually where it’s caused from, again, going back to the root, right. So what happens a lot is we get all this tightness on the inside and it’s pulling forward. And so many times that low back pain is from not amazing posture, imbalances for whatever reason and really tight through the front of the belly.

Erica:                                     Now, of course, when you’re pregnant, this looks hard to work out on your own, but we can do stuff with lengthening, stretching your quads more and stuff like that and posture, and keeping your hips strong. That’s huge. You need amazing amount of women, but they teach when they’re pregnant. And she, instead of actually shying away from her movement, as she gets farther along in her pregnancy, she’s like, “Oh my gosh, I have to do my squats every day because it’s what keeps my SI joint from hurting.” And it’s almost, it’s like the opposite, right?

Erica:                                     Because what we have to focus on is the right movements and strength to stabilize our body, instead of always stretching, ladies. Most of you’re probably overstretching your low back, and then it’s actually contributing to more pain. And we get really tight through like that, so as facial line, right, because of the stuff that happened in the postural shift during pregnancy.

Erica:                                     And so I do a lot of, so as releasing and stuff with my clients. Once it’s okay, you can’t do it. I don’t recommend doing it to at least three months postpartum, unless you’re doing a lot of, having someone do some manual work, you could do a little manual work on yourself. But you have to be kind of cautious with that area.

Erica:                                     But it is amazing how many people, once I teach them once or in outside of that range of window where I’m like, “Okay, we can start doing some more so as really stuff.” Like, “Oh man, sometimes instant relief of their low back.” They’re like, “Oh, I’ve been barking up the wrong tree, [inaudible 00:31:06] many times rarely.”

Erica:                                     I mean, if someone’s had an accident or something traumatic that happened to their low back, that’s an outlier, but it still many times can be because somewhere else in the body like took off on them. It was spasming to try to stabilize the body, always like it once to compensate. And so again, the deep core with low back pain, SI joint stuff, right. It comes down to, we have to understand pelvic floor, how our pelvic floor is functioning.

Erica:                                     Because you could have, like I said in the beginning, your left SI could be trying so hard to hang on for dear life. And it is causing you so much pain because maybe it’s rotated or pinching something because you’re really tight in the right side of the pelvic floor, inner thigh, like blue, all that kind of stuff. So it just really comes back to looking at the body as a whole and working to rebalance it.

Dr. Carrasco:                      And what about when women say they find out that they’re pregnant and they’re like, “Oh my gosh, I’ve never done any core work.” Is pregnancy a good time to start doing core, like working on deep core? Is it too late, or [crosstalk 00:32:11] work on it.

Erica:                                     Yeah. I always say pregnancy is the best time to learn how to safely and effectively strengthen your deep core. Now ladies are not talking about going out and doing AB crunches. Please, please, please, all of you can stop doing that no matter where you’re at.

Erica:                                     But especially during pregnancy, no crunches. Really everything you’re doing is a form of a deep core exercise. Even just holding your body up during the day, we just have to learn how to tap into it, to engage the right muscles, the right facial lines.

Erica:                                     And one thing with pregnancy that I love is because you have a couple superpowers. One of those is that you have a baby inside your belly. So it’s the only time in your life. You’re going to get that tactile feedback to be able to feel what you’re doing, and you’re going to get feedback from your pelvic floor. And so it’s really incredible.

Erica:                                     And I see time and time again, when women learn how to effectively strengthen their deep core during pregnancy, it dramatically can have a positive effect on their postpartum recovery. Because everything comes back so much quicker because they’ve got that, the wiring of the brain is stronger, right? They know it’s there.

Erica:                                     And then another superpower is our collagen synthesis goes up when we are pregnant. So we can essentially get stronger, faster with doing less, which, oh amazing!

Dr. Carrasco:                      That’s awesome.

Erica:                                     So you don’t have to be going and lifting heavy or even lifting much of anything. To strengthen your core, a lot of it ladies, comes down to breath work. And we also have to relax. Learn to relax, especially for those of you that are really tight.

Erica:                                     So those of you that are major athletes or runners or doing the high intensity stuff, I’m going to tell you all right, now if you’re pregnant or when you’re pregnant, you’ve got to learn how to release the tight areas of your core because it can work against you when it comes to diastasis and back pain, and pelvic floor stuff. So it’s about learning how to be the right kind of strong in our body.

Dr. Carrasco:                      Yeah, that’s amazing. So it sounds like if people can connect to the right exercise techniques during pregnancy and postpartum, they’ll just have a much easier road.

Erica:                                     Yeah. It makes a huge difference and it can even I even help teach our pregnant moms, some stuff she can do in preparation for birth specifically like the pushing stage of labor.

Dr. Carrasco:                      Oh that’s [crosstalk 00:34:40].

Erica:                                     Because, yeah, our uterus does most of the work obviously, but they say how many hours is it that a lot of first time moms will spend pushing. And so because of the training that she learns about her core when she’s pregnant, she has a backup plan to help her be a more effective pusher.

Erica:                                     My goal is not for my moms to push out, and need two pushes it happens sometimes, but it’s not the goal. I always I’m clear on that because we actually want to allow our body to ease into it. But yeah, we go into all that.

Erica:                                     And when our moms, as I know you know, when we can have a easier birth and we minimize or prevent tearing even.

Dr. Carrasco:                      Absolutely, just makes everything seems better.

Erica:                                     Oh my gosh! The postpartum recovery is so much different. Yeah. I mean, from my first I had an episiotomy that I should not have had. So my last experience and tearing, I was like, “Oh my gosh, this is amazing.” I didn’t know that that’s what it could be like. And I was like, “Wow, I want all moms to be able to experience this as much as possible.” Because it makes your recovery [crosstalk 00:35:46] so much more enjoyable, yeah.

Dr. Carrasco:                      Yeah, that’s so true. Well, I want you to share with our, our audience where people can find you.

Erica:                                     Well, thank you Alex. So you ladies can find everything that I do. It’s on my website, I also have my prenatal website and brand, which is called, Knocked- Up Fitness.

Dr. Carrasco:                      That’s awesome.

Erica:                                     So there, and I guess, and on my podcast, we do a lot of conversation about so many things around women’s health and movement, and pelvic floor. Lots of pelvic floor conversations over there.

Dr. Carrasco:                      That’s awesome. And I think that you’re also going to give our listeners a gift.

Erica:                                     Yeah. So everything comes back to the pelvic floor in one way, shape, form or another. So on my website,, you can get yourself a free guide about how to activate your pelvic floor, so.

Erica:                                     And then there’ll be some more stuff that I’ll send you after that too. So it’s really, really effective ways of, and queuing to teach you how to properly strengthen your pelvic floor, set the kegels to the side and start feeling better.

Dr. Carrasco:                      That’s awesome. Well, thank you so much for joining us today. This is amazing information. And yeah, I think it just ties into the root cause approach. So I love that. I love the work that you’re doing in the world. And Christine and I were so happy to have you on the show.

Erica:                                     Well, thank you both. This has been so great to chat with you ladies.

Alejandra Carrasco M.D. and Christine Maren D.O.

Hello! We are Alejandra Carrasco M.D. and Christine Maren D.O. We founded Hey Mami because we felt a lack of support for fellow mamis. As physicians, we see women every day who struggle with fertility, are forgotten about postpartum, and have put their health on hold for years while they raise a family. We’re here to change that.

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