Specialty Services

Advanced Work Rehabilitation

We understand the stress, discomfort and fear associated with workplace injuries. Unexpected injuries in the workplace can bring on a wave of negative feelings – including fear of the unknown, pressure to return to work in a timely manner, and financial stress.

Aquatic Therapy

Pivot’s aquatic rehabilitation program delivers multiple unique benefits, such as accelerated healing time, decreased swelling, and improved circulation and mobility. The healing properties of the water offer an engaging and enjoyable environment, while achieving your health and wellness goals.

How does it work? While immersed in water, your buoyancy is elevated, relieving the tension on your joints. The exercises available in aquatic therapy are dynamic and aimed to strengthen your muscles, providing increased mobility.

Blood Flow Restriction Therapy

Blood Flow Restriction Therapy (BFR) or also known as occlusion therapy is one of the fastest growing evidence-based techniques available today.  BFR is the act of safely restricting venous blood flow from a working muscle, while still allowing arterial blood flow to that working muscle. This technique is normally done in conjuncture with low intensity resistance training.  Since the ability of that blood to escape is dramatically reduced, metabolic stress and cellular swelling are greatly increased.  This technique is only performed by our Doctors of Physical Therapy that are certified in BFR.

So what does this mean for the client?

  • Drastically improve your post-surgical recovery time
  • Treat muscle atrophy in both acute and chronic pain
  • Less stress on joints and tendons
  • Increase your endurance/ VO2 Max with as little as two BFR training sessions per week
  • Uses the latest evidenced-based rehab/exercise programming available

Pivot Physical Therapy has highly trained clinicians that specialize in Blood Flow Restriction. To accelerate your road to recovery, call a clinic near you and ask about this advanced technique.

Certified Hand Therapy (CHT)

Many life obstacles may result in the need for critical and immediate hand therapy. Whether your hindered hand mobility is because of an accident, illness, or repetitive activity, our therapists will help you heal.

If you’re recovering from an injury or want to prevent an injury from getting worse, finding the right splint can be difficult. Nevertheless, it is incredibly important. Our hand experts can create a form-fitting, dynamic splint built to help protect your injured area, while providing you maximum mobility.

Concussion Rehabilitation & Management

A concussion is a complex process affecting the brain, induced by traumatic biomechani­cal forces secondary to direct or indirect forces to the head. Concussion injuries can result in a wide variety of physical, cognitive, emotional and/or sleep-related symptoms and may or may not involve a loss of consciousness (LOC). The duration of symptoms is different for each individual and may last from several minutes to days, weeks, months, or even longer in some cases.

Concussions do occur on the athletic field, but this is not the only place. Falls are the most common cause of a traumatic brain injury in those over the age of 64. Concussions can also occur after a motor vehicle accident or impact to the head/neck/jaw.

Pivot Physical Therapy has over 500 Physical Therapists who can provide extensive diagnosis, management, and treatment of mild Traumatic Brain Injuries (mTBI).  We understand every concussion is significant, unique, and potentially complex. At Pivot, we offer the following:

  • Detailed initial exam
  • Individualized treatment program
  • Administer the Buffalo Concussion Treadmill Test
  • Consistent communication with your core medical team for proper management of symptoms
  • Return-to-play and/or return-to-work protocols

To accelerate your road to recovery, call a clinic near you and ask about Pivot’s Concussion Rehabilitation & Management services.

Dry Needling

Dry needling is a treatment technique often used by Physical Therapists to eliminate muscle pain. This technique uses a sterile, filiform needle that is inserted into the muscle belly, causing an immediate “release” of the trigger point. A trigger point is a taut band within the muscle that can reproduce pain, decrease function and strength of the muscle, and limit your range of motion. Dry needling treatment reduces pain, lessens muscle tension, and increases mobility.

Pivot Physical Therapy has over 100 certified dry needling clinicians. Our certified clinicians have a minimum of 2 years’ experience and over 80 hours of direct training by world-renowned instructors. Are you interested learning whether dry needling is appropriate for you? Call a clinic near you to ask about this treatment technique.

Early Intervention

As a child grows, all parents look for milestones and expect children to learn naturally by doing, watching, and by being taught. While all children grow and change at their own rate, some children can experience delays in their development. You might notice that your child’s development seems different from other children of the same age. Our Early Intervention program helps parents better understand and interact with their child. Early Intervention is a team effort, coordinated with our caring physical, occupational, and speech therapists who respect your family’s strengths, independence, values and diversity. Our experts will answer questions about your child’s development, help you interact with your child in daily routines at home and in the community, enhance your child’s developmental and educational growth, and support your child’s growing independence. Early Intervention services are available infants/toddlers (0-3 years old). If you have questions about Pivot’s early intervention program, please email EI@PivotHS.com.

Pivot Physical Therapy contracts Early Intervention services with the following organizations:


  • Bedford/Somerset Counties Early Intervention
  • Cambria County Early Intervention


  • Chesterfield County Infant Program
  • Henrico County Infant Program
  • Richmond Behavioral Health Authority
  • Crater District 19 Community Services Board

Functional Capacity Evaluations

The Functional Capacity Evaluation (FCE) is a comprehensive assessment of a client’s overall functional abilities. The evaluation measures range of motion, strength, endurance and tolerance to work-related tasks.

Functional Movement Screenings (FMS)

If you are struggling to figure out what is holding you back from performing your best, our Functional Movement Screen (FMS) combines clinical expertise and experience with the Functional Movement System program. The FMS is a ranking and grading system that documents movement patterns that are key to normal function. By screening these patterns, the FMS readily identifies functional limitations and asymmetries. These issues can reduce the effects of functional training, physical conditioning, and distort body awareness.

The FMS is a tool that rates injury risk, identifies problems in the fundamentals of movement, and provides a baseline to get you on the right track. The tool consists of seven movement patterns that are common dynamic movement patterns (squat, high step, lunge) to assess mobility, strength and flexibility of both the upper and lower body as well as the trunk and core. The power of the FMS allows for quick screening of relative symmetry of your body through functional movement patterns. Our Physical Therapists perform free injury evaluations every day. We quickly get to the source of your pain and make recommendations so you can feel better faster.

Golf Rehabilitation - Titleist Performance Institute (TPI)

Are you having trouble with your golf game or leaving the course with aches and pains? Or do you hope to improve your game, increase distance and lower your score? A movement screen can help identify areas lacking mobility and stability, which lead to the three most common swing faults: loss of posture, early extension, and casting/early release.

Pivot Physical Therapy offers a golf rehab program that utilizes the Titleist Performance Institute (TPI) assessment model. The physical screen includes:

Core Control Tests

  • Lower body disassociation tests
  • Upper body disassociation tests
  • Maintain posture with hands overhead tests
  • Ability to set and release the golf club tests

After the physical screen, your therapist will be able to develop a comprehensive individualized program to help you hit the ball longer, lower your scores, improve your game, and prevent injuries.

Impairment Ratings

Our certified clinicians perform Impairment Rating work-ups, which provide objective functional data and significantly reduce the time the attending physician needs to complete an evaluation.

Instrument Assisted Soft Tissue Mobilization (IASTM)

Instrument Assisted Soft Tissue Mobilization (IASTM) is another option to resolve pain and tightness in the body. IASTM is a treatment utilizing hand held instruments to break down scar tissue and fascial restrictions in soft tissues (muscles, ligaments, tendons, fascia, and nerves). Many of our locations have skilled clinicians certified in the most common techniques for IASTM including:

  • Graston
  • Hawkgrips

Kinesio Taping

Kinesio Taping is a rehabilitative taping technique for treating a variety of orthopedic, neuromuscular, neurological and other medical conditions. It facilitates the body’s natural healing process while allowing support and stability to muscles and joints without restricting the body’s range of motion.

Lymphedema Management

Lymphedema refers to swelling that generally occurs in your arms or legs. The most common cause is the removal of or damage to lymph nodes, often times as a part of cancer treatment. Swelling can cause the skin to feel tight, hard, or thicker than normal. This type of swelling can also lead to joint pain, weakness in the leg or arm, achiness and/or feeling of heaviness in the limb.

At Pivot, we have certified lymphedema therapists who specialize in the treatment of lymphedema and other types of swelling. Physical therapy is an effective treatment option during all stages of lymphedema and early detection is a key component to success. Lymphedema treatment includes manual lymph drainage, compression therapy, therapeutic exercises, compression garments, education, and self-management.

Manual Therapy

Manual therapy is the hands-on treatment specifically designed to aid in the mobilization of joints, muscles, connective tissue, and nerves. Manual therapy treats a wide variety of health conditions ranging from arthritis to back pain. Pivot Physical Therapy has an extensive training program for our therapists designed to optimize manual therapy skills and enhance therapeutic outcomes.

McKenzie Method

The McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) is an internationally researched and acclaimed system of assessment and management for spinal and extremity musculoskeletal disorders developed by New Zealand Physiotherapist Robin McKenzie. The primary purpose of the McKenzie Method of treatment is to centralize the patient’s pain in the core back structures rather than treat pain localized in a specific area.

Following a detailed evaluation, a Physical Therapist trained in MDT will prescribe specific exercises and advice regarding postural changes. Your instructions will be clear and simple. Our clinicians may incorporate hands-on procedures until the individual learns the techniques to self-manage. The aim is to be as effective as possible in very few sessions by having the client perform treatment techniques five or six times per day. The key to success is you, the patient, being actively involved. This helps to minimize the number of physical therapy sessions. The eventual goal is for most patients to manage themselves after provided with the necessary knowledge and tools.

Myofascial Decompression (Cupping)

The benefits of cupping include local pain relief and muscle relaxation. Cupping also improves overall health by increasing blood flow to a particular muscle region and releasing myofascial restrictions throughout the body. The results are reduced pain and tension. Cupping is a highly effective treatment when incorporated in a program, which includes manual therapy, massage and myofascial release techniques. It is quick, effective and a pain free option to help reduce myofascial pain symptoms.

Optimal Aging Program

What are your goals? What is keeping you from the things you want to do? How can you maintain your independence and activities as you age?

We recognize the complexities that come with aging and are confident that we can be an integral part of your wellness team. Regardless of age or ability, our skilled clinicians are here to help you not only feel better, but also help you move better and optimize your daily function.

Our Functional Evaluation for Seniors makes certain our patients are maintaining their optimal physical function to prevent falls and injuries and maintain independence. This evaluation is an annual or semi-annual check to ensure you are staying safe and strong. You take your car in for regular service, you should treat your body the same!

Call a Pivot location near you to learn more about the Functional Evaluation for Seniors.

Orthopedic Clinical Specialists (OCS)

Pivot Physical Therapy has one of the nation’s largest Orthopedic Residency Programs and over 100 OCS clinicians throughout our network of clinics.

The American Board of Physical Therapy Specialties recognizes Orthopedic Clinical Specialists as individuals whose clinical specialization in orthopedic physical therapy demonstrates knowledge, skill and experience exceeding that of an entry-level Physical Therapist. Board-certified therapists truly stand out from their peers, considering fewer than 10 percent of the roughly 66,000 members of the American Physical Therapy Association (APTA) have obtained this advancement.  Pivot Physical Therapy is one of our country’s leaders in the number of OCS therapists we employ. This number grows every year!

Pain Neuroscience Education (PNE)

PNE is a personalized treatment option for those suffering from persistent pain. Following a comprehensive examination, your Physical Therapist will personalize a program to your unique needs. Together, you will set goals and a plan of care. Treatment may include manual therapy, trigger point therapy, Graded Motor Imagery, neurodynamics, therapeutic exercise, coping strategies, and much more.

PNE is the most advanced conservative treatment available for people suffering from persistent pain. Research data supports that PNE helps people experience less pain over time.

Parkinson’s Disease Treatment

Our LSVT BIG trained therapists help people with Parkinson disease (PD) by training them to use their body more normally. People living with PD or other neurological conditions often move differently, with gestures and actions that become smaller and slower. They may have trouble with getting around, getting dressed and other daily activities.  LSVT BIG training effectively improves movements for any activity, whether small motor tasks like buttoning a shirt or large motor tasks like getting up from sitting or maintaining balance while walking.

LSVT BIG treatment is customized to each person’s specific needs and goals and can help regardless of the stage or severity of your condition. It’s never too late to start LSVT BIG treatment, but it is most beneficial when symptoms begin.

We also have Speech Language Pathologists trained in LSVT LOUD treatment. Parkinson Disease often affects communication with voice and speech issues. LSVT LOUD improves communication by helping you speak with a voice and volume that’s easy for others to hear and understand. The treatment is built on tailored exercises that strengthen the voice box (larynx) and speech system.

Pelvic Health

Pelvic floor disorders commonly affects both women and men’s daily lives, but frequently these issues are neither discussed nor addressed correctly. Pelvic floor conditions may include, but aren’t limited to postpartum issues (including pelvic organ prolapse), stress urinary incontinence, pelvic pain, endometriosis, chronic constipation, pudendal neuralgia, and pain with intercourse/vaginal penetration. Males also have a pelvic floor and can develop pelvic floor issues, including pudendal neuralgia, chronic prostatitis, or pelvic floor weakness post-prostatectomy. Many patients benefit from pelvic floor therapy following abdominal surgeries when scar tissue inhibits their ability to move normally.

Our pelvic floor Physical Therapists assess your pelvic floor strength, ability to relax the muscle, and pelvic posture as well as provide manual therapy for pain and educate on lifestyle changes to help urinary, bowel, or sexual function. If you experience symptoms of pelvic floor disorders, you don’t have to live with them. Physical therapy is a conservative and effective treatment option.

Contact us to find a pelvic floor specialist near you.

Percussive Therapy

Percussive Therapy is the rapid and repetitive burst of pressure and vibration to the body using a hand-held device.  Its application assists in pain relief, increasing blood flow, improving range of motion to help restore movement, and aid in recovery.

Performing Arts Rehabilitation

Our clinicians provide services to dancers, gymnasts, cheerleaders, musicians, and performing artists. Our goal is to evaluate, treat and educate artists and athletes in the prevention of performance/event-related injuries. Technical evaluations are also performed to maximize the abilities of each artist/athlete. Our staff is well trained to address the physical and psychological needs of the artist/athlete. We stress the importance of balancing athletic abilities with artistic expression through generalized conditioning and technical training. This proactive approach to performing arts rehabilitation promotes wellness with rapid recovery from injury and prompt return to performing. Our services include:

  • Onsite performance coverage (consultations, injury screenings, injury management, technique evaluation)
  • Outpatient services including manual (hands-on) techniques and personalized exercise prescription
  • Education lectures and workshops

Pre and Post-Operative Care

Whether preparing for surgery or recovering from surgery, you need a comprehensive physical therapy program customized for you. Pivot is here to help deliver the best possible outcomes for you!

When preparing for your surgery, our pre-operative care is specially designed by our therapists to help you optimize your outcome after surgery. Prior to your operation, we work with you to maximize strength, range of motion, and function, as well as provide education and help you prepare mentally.

Following surgery, our goal is to return you to your prior level of physical function including successfully returning to work, recreation, and other activities. We customize a post-operative care program for you to promote healing, reduce pain and swelling, and restore joint mobility, flexibility and strength. After a thorough evaluation, our therapists will work with you to set functional goals as well as restore normal movement, flexibility, and function.

Running Analysis and Advanced Treatment

Running is one of the most innate survival skills we all possess. It has amazing effects on the body including cardiovascular health, strength, endurance and various mental health benefits. The top four running injuries are runner’s knee, Achilles tendinopathy, plantar fasciitis, and shin splints. There are many different running techniques; however, the ultimate goal is utilizing your technique in the most efficient way. It is important that your Physical Therapists uses a movement based evaluation to identify areas lacking mobility and stability and may be breaking down your running cycle.

At Pivot, we utilize a video gait analysis to visually observe major deviations while running. We customize a home exercise program with corrective exercises and gait retraining to restore and improve motion in the running cycle.  We have many clinicians throughout our network that specialize in running analysis and injuries.

Vestibular/Balance Therapy

Dizziness is the second most common complaint heard in the doctors’ office and the number one complaint of those over 70 years old.  It effects millions of people and can impede your ability to perform your everyday tasks.  Many times, dizziness is a symptom of a vestibular disorder. The vestibular system includes parts of the inner ear and brain that process information involved in controlling balance and eye movements.  The most common type of vestibular disorder is benign paroxysmal positional vertigo (BPPV); however, dizziness can also be a symptom of vestibular neuritis, labyrinthitis, or Meniere’s disease. To diagnose the cause of dizziness, it is important to have a thorough evaluation of your symptoms.

At Pivot, we have more than 150 certified vestibular therapy clinicians who help individuals manage their dizziness and other vestibular disorders.

Work Performance/Work Conditioning

If a work-related injury has hindered your workplace performance, our Work Conditioning/Work Performance program is the solution. Through an intensive work-related and goal-oriented approach, we will help get you back to work quickly and at an optimum performance level.