Lilac Physical Therapy

05/15/2026

Thursday Thoughts: Impact of Cesarean Incison Closure on "Cesarean Apron"

A recent publication in the American Journal of Obstetrics and Gynecology highlighted a potential contribution to the development of the "cesarean apron" or shelf following Cesarean delivery. It proposes that if Scarpa's fascia, the fascial layer between subcutaneous and visceral fat, is not closed separately that scar tissue that develops effectively separates the migration/movement of fat between these areas above and below the in incisional scar, resulting in a line or a shelf.

So, if you've been struggling with still seeing a shelf despite lots of effort and a well-moving scar without restrictions, this could shed some light on why.

You can check out the publication here: The cesarean apron: description, proposed pathophysiology, classification, and prevention through scarpa fascia closure at cesarean delivery - American Journal of Obstetrics & Gynecology

The “cesarean apron,” also known as a cesarean bulge, pouch, or shelf, is a frequent but often overlooked postoperative deformity of the lower abdominal wall that may occur even after uncomplicated cesarean delivery. It is characterized by redundant skin and subcutaneous adipose tissue that over...

05/12/2026

Take Me Back Tuesday: Mother's Day

This time of year always stirs up all kinds of emotions and encourages reflection.

Personally, if I could go back to when I became a mother for the first time, I'd encourage myself to be more present in the moment, soak up the slow moments, not rush them, or myself, to the next milestone, and have more appreciation and grace for one another as we navigated new roles and all the firsts together.

When would you go back to? And what advice would you give to yourself (or others) navigating that phase of life?

Image from 3 AM with my first at six weeks old after trying to get him to sleep for the last hour while my husband worked night shift at the county jail.

05/08/2026

Friday Facts: Birth

Cesarean delivery: Incision through skin, subcutaneous fat, fascia with separation of re**us muscles (not cut), peritoneum, uterus, and amniotic sac.

Vaginal delivery: Cervix dilates from 0 to 10 centimeters and shortens from an average of 40 millimeters to 0 and levator ani muscles stretch to 3x their resting length.

No matter how you had your baby or babies, you and your body are amazing! All mothers deserve to have rehab after their bodies go through such an extraordinary feat to support their recovery and return to normal function.

Images used with permission from Pelvic Guru®, LLC as a Pelvic Global Member

05/07/2026

Wellness Wednesday: Normal Bladder Function

Voiding (urinating) frequency: going every 2-5 hours (8x or less in a 24 hour period)
Nighttime voids: 0-1 times a night (unless pregnant or over 65-then 1 time a night max)
No episodes of urinary urgency (needing to go right now and not being able to control the urge)
No episodes of incontinence (leaking)
No pain with voiding (urinating)
No blood in urine

Not sure about your habits? A bladder diary/log is a good way to look at bladder function to look for patterns and need for intervention or improvement.

Image used with permission from Pelvic Guru®, LLC as a Pelvic Global Member.

04/30/2026

Thoughts for a Thursday: What if your pelvic floor is the scapegoat?

Many times pelvic floor dysfunction shows up because other structures and systems are not functioning optimally. It relies of pelvic stability that comes from the trunk, hips, and lower extremities and effective force transfer between the trunk and lower extremities. It requires coordination of the muscles of the core canister to manage the pressure within the abdominopelvic cavity. Those muscles rely on good motion and mobility of the joints they move, so those muscles can shorten and lengthen to perform their jobs.

So, while the pelvic floor may drive the symptoms, it may not be the root cause, and looking outside of the pelvis, in addition to within it, can have profound impacts.

04/27/2026

Meet Your Provider Monday: My First Bouquet of Peonies

Two years ago, my husband and children gifted me peony plants for Mother's Day, and today I harvested my first bouquet.

It's been a minute since my last post, over four months to be exact, after posting regularly for the three previous years. Harvesting this first bouquet ahead of the storms today felt like a good reminder of how life actually works. You plant something, whether that be an actual plant, seed, idea, or habit, and it takes a lot longer to see the product of what you planted than you thought. It takes a lot more effort than you anticipated, and there is so much growth and change that occurs between those two time stamps. There's been a lot of change and growth, both professionally and personally, in the last nine months, let alone the last two years.

So, at the risk of failing spectacularly again, I am going to be posting more regularly over the next weeks, months, and years, planting seeds for growth, and looking back periodically to assess how much growth has occurred. I hope to support you in your pursuit of knowledge, growth, and outcomes related to your pelvic, perinatal, and orthopedic concerns.

Happy Monday, friends. I wish I could embed the scent of this beautiful display for you to enjoy as well. These will be gracing my office desk this week, if you want to drop by 💕

12/23/2025

Where to start?

I spent a lot of time reflecting on this journey over the weekend, the impetus, where it all started. On the surface it started six years ago when I enrolled in an EdD program with no prospect of a teaching role. I was in full-time clinical practice, working outpatient during the week and inpatient on weekends a few times a year. I was building clinical expertise but still felt far from an expert who would have the credentials to teach DPT students. Hybrid programs didn't exist, there were only brick and mortar programs in which to teach and we'd just finished building our forever home an hour and a half away from the nearest brick and mortar program. But the nudge was there. The quiet voice of the Spirit reminding me of a deeper calling I'd recognized during PT school as a teaching assistant, at the end of which I reflected on the experience and surmised I would return to education at some point in my career.

Had I known how hard it was going to be, I'm not sure I would have started. But those things that are the most difficult and require you to take a step into the dark and trust that voice when you don't understand the full depth of the commitment have resulted in some of the biggest periods of growth and fulfillment I've experienced.

Over those six years, we added three babies to our family, lost another, lost grandparents, changed jobs, pursued other certifications, started a business, took a leave of absence when my family needed me more, and everything in between. I collaborated on group projects while in labor at the hospital, finished papers while nursing a newborn hours after birth, got up early, used lunch hours, and stayed up late and so effectively hid the fact that I was in school from my kids that Caroline just recently realized I was in school and had been since before she was born.

So, was it worth it? Absolutely. Listen to that little voice that nudges you to do things you might think seem crazy or impossible. Faith will see you through.

I'm looking forward to the ignition that follows the spark resulting from my dissertation study for pelvic healthcare in rural areas. I'm looking for others who are interested in being the provokers of change. LMK if you're interested!

11/18/2025

Tip Tuesday: Upper Back Mobility

If, like me, you've been spending a lot of time sitting in front of a screen, your upper back might be stiff. Your upper back plays a role in many aches and pains, and exercises targeting improving the motion in that area can ease discomforts in your lower back, neck, and shoulders. I could go on about how improved thoracic motion creates a domino effect on so many things.

Try getting up half-way through your morning, over your lunch break, and half-way through your afternoon, to run through the two exercises in the video below. All you need is a wall.

Let me know what differences you notice with a small change like that. It's the gateway to sticking with regular movement, activity, and feeling better.

11/11/2025

After a long hiatus, I'm going to try to start sharing content more regularly again. More to come on that soon.

But today I want to thank those who have served our nation. The sacrifices of you and your loved ones are recognized and very much appreciated.

A special thank you to a couple of my favorite veterans, my husband and grandpa. Thank you to the town of Versailles for recognizing them and others around town.

Happy Veteran's Day!

08/05/2025

Tip Tuesday: Logging Your Habits

Tracking your bowel and bladder habits can be very insightful for you and very helpful for your pelvic floor therapist when discussing issues you may be encountering. Attached is a sample of things you can track and doing this for three days can help with pattern recognition and potential factors influencing your symptoms.

Guide for use:
1. Track the date/time that the events are occurring.
2. Record the volume of urine voided by tracking the number of seconds you are urinating.
3. Was there urgency that prompted going to the bathroom? 0 = no urge/went just in case, 1 = mild/first sensation of filling, 2 = moderate/stronger but could wait, 3 = strong/couldn't hold/get out of my way
4. Type and amount of liquid consumed
5. Type and amount of food consumed
6. Type and amount of leakage. U = urine & S = small/a few drops, M = medium/wet underwear, L = large/wet outerwear or floor. B = bowel & S = stain of underwear, P = partial movement, C = complete loss of control
7. Bowel movement # (see attached Bristol Stool Chart: https://commons.wikimedia.org/wiki/File:Bristol_stool_scale_neutral.png)

If you have an upcoming appointment with a provider to discuss these concerns, this information can be highly valuable in addressing your concerns.

07/21/2025

Meet Your Provider Monday: Upcoming Changes at Lilac Physical Therapy

Happy Monday to you!

Some changes are coming to LPT and current patients have already been notified, but I wanted to share publicly about those changes as well.

I have taken a full-time core faculty role in a Doctor of Physical Therapy program and will be starting in that role on August 1st!

While I will be continuing with clinical care, my available hours and flexibility will be going through a shift. In this early transition, I will be figuring out how to coordinate my teaching and clinical schedule and will therefore be doing sessions by appointment only and not doing online bookings for the time-being.

Once I have my feet under me a little more and know what my typical flow will be, I will re-open my online bookings. Until then, please contact me directly via phone (812-525-5230) or email (lilacphysicaltherapy@gmail.com) to arrange a time for your physical therapy needs.

Thank you for your continued support!