Pelvic Floor Physical Therapy

Pelvic Floor Therapy

As specialists in pelvic floor and core disorders, our team at Advanced Pelvic Surgery in West Chester understands the need for modesty and privacy. When arriving at our office, you will meet your therapist and receive a thorough physical therapy evaluation in a private treatment room. You may be given a surface EMG evaluation, which is a painless test that indicates how your pelvic floor muscles are functioning. The physical therapist will explain in detail the results of the evaluation and how they relate to your problems and what specific steps are needed to correct them.

Physical Therapy Treatment May Include:

  • Biofeedback
  • Pelvic Floor and Core Muscle Exercise
  • Dry Needling
  • Massage, myofascial release, trigger point release
  • Electrical stimulation
  • Bladder/Bowel Training
  • Home Exercise
  • Ultrasound

Our evaluation and treatment procedures are evidence-based. We integrate our findings with the recommendations of your personal physicians and/or other health care providers to provide the most complete and individualized treatment plan so that you may achieve your goals.

Pelvic Floor and Core Muscle Exercise

Pelvic floor and core exercise is an important part of pelvic floor physical therapy. Muscle weakness, tightness, spasm, and/or imbalances can make it difficult for you to control your bladder or bowel. Or it may be a cause of your pelvic pain. Your physical therapist will identify your specific problem areas and design an individualized home exercise program to correct them. You will be expected to perform the exercise daily at home and will be progressed each time you see the therapist if you are compliant with the home program.

What is Dry Needling?

Lisa Johnstone, PT, is certified to perform dry needling

Dry needling is a technique physical therapists use to treat myofascial pain. The technique uses a thin, sterile, disposable filiform needle, without medication, inserted through the skin into areas, known as trigger points. It is typically just one technique that's part of a larger treatment plan.

A trigger point is a taut band of fascia and/or muscle. Trigger points can be tender to the touch, and touching a trigger point may cause pain to other parts of the body. Research supports that dry needling improves pain control, reduces muscle tension, and normalizes dysfunction of the motor end plates, the sites at which nerve impulses are transmitted to muscles. This can help speed up the patient's physical therapy rehabilitation.

Many patients do not feel the insertion of the needle. A local twitch response in the trigger point occurs which elicits a brief painful response. Some patients describe this as a little electrical shock; others perceive it more like a cramp.

How is it different from acupuncture?

"The practice of acupuncture by acupuncturists and the performance of dry needling by physical therapists differ in terms of historical, philosophical, indicative, and practical context. The performance of modern dry needling by physical therapists is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system. Physical therapists who perform dry needling do not use traditional acupuncture theories or acupuncture terminology."

Physical therapists who perform dry needling obtain specific and advanced education and training.

Source: APTA document Physical Therapists & the Performance of Dry Needling: An Educational Resource Paper.


Ultrasound may be used to improve scar tissue flexibility and/or reduce muscle guarding and pain. It is a painless technique that uses sound waves at specific intensities. The sound waves are delivered to the pelvic floor through a small sound head or wand. A gel that allows the ultrasound to make a seamless contact to the pelvic floor will be placed on the ultrasound head. The sound head will be moved slowly over the pelvic floor to direct the sound waves to the necessary areas.

Electrical Stimulation Therapy

Electrical stimulation therapy is a non-invasive painless treatment that activates the body’s natural nerve and muscles of the pelvic floor. It is provided through either adhesive pads placed on the skin near the vagina and anus or through a tampon-shaped form placed in the vagina. Electrical stimulation, depending on the settings, may be used to assist you in rehabilitating weak pelvic floor muscles especially during stress urinary and/or fecal incontinence. It may also be used to calm involuntary bladder muscle contractions in the case of urinary incontinence. Or if you are having pelvic pain, electrical stimulation can also be set to reduce pain and decrease muscle guarding.

Pelvic floor physical therapy can help treat a number of different issues. If you have pelvic pain, incontinence, or other pelvic issues, be sure to contact our team about physical therapy. We can help find the right treatment for you.