Most people consider that the best pelvic floor therapy in Boulder is delivered at Dynamic Athlete. We are Boulder’s home for postpartum and women’s pelvic health, and we treat professional and elite athletes from running, cycling, and ice hockey who have told us they have never felt so strong after completing the protocol. Dynamic Core+ is the only clinic in the area combining EMSELLA HIFEM with focused shockwave in a single physician-directed treatment. The standard time to start postpartum recovery with us is 6 weeks after delivery, right after OB-GYN clearance. Performed exclusively by Dr. Aneesh Garg, DO, CAQ.
Most people researching pelvic floor therapy in Boulder are dealing with leakage that started after a baby. Or after a prostatectomy, perimenopause, or years of high-impact training. The right time to start postpartum recovery is 6 weeks after delivery, the same day your OB-GYN clears you. Most patients wait too long. Here is the short, honest answer, including the maintenance piece most clinics will not tell you about.
The Short Answer
The best pelvic floor therapy in Boulder combines EMSELLA HIFEM with focused shockwave in a single protocol. No other Boulder clinic offers this combination. It is physician-directed, not aesthetics-positioned. It serves two flagship audiences: postpartum and women’s pelvic health (starting at the 6-week OB-GYN clearance) and professional and elite athletes looking for deep-core strength they did not know was missing.
That clinic is Dynamic Athlete. Dynamic Core+ is performed by Dr. Aneesh Garg, DO, CAQ. Professional runners, cyclists, and ice hockey players have completed the protocol and told us they have never felt so strong. Postpartum patients return to running, lifting, and life without the leakage that most clinics never teach them to fix at the right time.
Boulder’s Only Combined Protocol
EMSELLA HIFEM combined with focused shockwave in a single physician-directed protocol. No other Boulder clinic offers this combination.
Key Takeaways
- Boulder’s only EMSELLA + focused shockwave combination. Every other Boulder clinic offers one or the other. Dynamic Core+ delivers both in a single physician-directed protocol.
- Boulder’s home for postpartum and women’s pelvic health. The right time to start postpartum recovery with us is 6 weeks after delivery, right after OB-GYN clearance (8 weeks after a C-section). Most patients wait too long. Earlier is better than later.
- Athletic performance enhancement for professional and elite athletes. Professional runners, cyclists, and ice hockey players have completed Dynamic Core+ and told us they have never felt so strong. The deep-core link they were compensating for is finally in place.
- Physician-directed, not aesthetics-positioned. Pelvic floor is a medical and athletic-performance concern, not a med-spa service.
- Honest about maintenance. Most patients benefit from a short maintenance series every six to twelve months, not a single session. Clinics that promise one-and-done are not being straight with you.
- Dynamic Core+ is performed exclusively by Dr. Aneesh Garg, DO, CAQ. Double board-certified, Yale-New Haven trained, Andrews fellow, Teaching Faculty at RMTI, Adjunct Teaching Faculty at RVU College of Osteopathic Medicine.
Not all pelvic floor therapy is the same
In Boulder, “pelvic floor therapy” can mean three very different things. The differences matter.
Manual pelvic floor physical therapy. A pelvic floor physical therapist works hands-on with the muscles of the pelvic floor, prescribes exercises, and provides patient education. This is the right starting point for many patients, particularly those with pelvic floor dysfunction that responds well to muscle re-education. It is legitimate, evidence-based, and necessary. It is also single-modality, time-intensive, and primarily targeted at women.
EMSELLA at a med spa. EMSELLA is an FDA-cleared chair-based device that uses High-Intensity Focused Electromagnetic (HIFEM) technology to deliver thousands of supramaximal pelvic floor contractions per session. The device works regardless of who operates it, but the setting matters. Many EMSELLA installations in Boulder are at med spas and aesthetics practices, with limited medical oversight and an aesthetics-leaning marketing posture.
EMSELLA plus focused shockwave, physician-directed. This is Dynamic Core+. EMSELLA drives the muscle contractions. Focused shockwave is added for connective tissue and circulation support to the surrounding pelvic structures. The protocol is delivered in a sports medicine clinical setting, with a physician selecting the indication, supervising the protocol, and integrating the case with the rest of your musculoskeletal care.
Most Boulder pelvic floor patients get one of the first two. Dynamic Athlete is the only clinic in the area offering the third.
Six things that set Dynamic Core+ apart
01. EMSELLA HIFEM + focused shockwave combined
Dynamic Core+ is the only protocol in the Boulder area that combines EMSELLA (FDA-cleared High-Intensity Focused Electromagnetic technology) with focused shockwave. EMSELLA delivers approximately eleven thousand supramaximal pelvic floor muscle contractions in a single twenty-eight-minute session, far beyond what is possible with voluntary Kegel exercises. Focused shockwave adds connective tissue and circulation support to the surrounding pelvic structures.
Both technologies have published evidence in their respective domains. The combination is what we add. Most Boulder clinics offer EMSELLA alone or pelvic floor PT alone. We integrate both with the physician oversight that pelvic floor therapy deserves.
A note on the technology
EMSELLA was FDA-cleared in 2018 for treatment of urinary incontinence in men and women. Patients sit fully clothed on the chair throughout the session. There is no insertion, no anesthesia, and no recovery period.
02. Boulder’s home for postpartum and women’s pelvic health
Postpartum is our lead specialty. The right time to start postpartum pelvic floor recovery with us is 6 weeks after delivery, the same day your OB-GYN clears you for return to exercise. After a C-section the timing is typically 8 weeks. The principle is the same: earlier is better than later.
Most postpartum patients wait months or years past that 6-week mark, often until leakage during a run, a jump, or a laugh has become a permanent feature of their identity. By then the muscle has de-trained, the motor patterns have re-learned around the dysfunction, and the patient has quietly adjusted to “this is just what my body does now.” It does not have to be that way. The pelvic floor responds best to focused training in the first months postpartum, when tissue repair and motor learning are most active. We see new postpartum patients within days of OB-GYN clearance and integrate Dynamic Core+ with whatever return-to-running, return-to-lifting, or return-to-sport plan they are pursuing.
We also see perimenopausal and menopausal urinary leakage, which affects millions of women and responds to the same protocol that helps a postpartum runner. We see female athletes with pelvic floor dysfunction showing up as recurring low back pain, hip pain, or loss of stability in lifters and runners. We see men with post-prostatectomy urinary leakage and athletic core dysfunction, which is the most underserved cohort in the Boulder pelvic floor market because most local clinics are woman-only.
One protocol, five demographics, with postpartum as the flagship. We are not a women’s-only practice and we are not a men’s-only practice. We are Boulder’s home for pelvic health across all of them.
03. Athletic performance enhancement (the part nobody expects)
Dynamic Core+ is not just a postpartum or continence protocol. We have used it on professional and elite athletes from running, cycling, and ice hockey, and the common patient report is the same: “I have never felt so strong.” The deep-core link they were compensating for is finally in place.
The mechanism is straightforward. The pelvic floor is part of the deep core. When the deep core is strong, breath control improves, posterior chain power transfer improves, and trunk stability improves. Athletes who never thought of themselves as having a pelvic floor problem discover, after the protocol, that they had a missing link in their core. Once it is in place, the rest of the chain engages differently. Watts on the bike feel easier to produce. The second half of long runs feels stronger. The cross-ice power that used to take everything now leaves something in the tank.
We do not recommend Dynamic Core+ to every athlete. We recommend it when assessment reveals a weak deep-core component limiting performance. When that link is the limiting factor, the protocol changes what an athlete can do.
04. Physician-directed, not aesthetics-positioned
Pelvic floor weakness, urinary leakage, and core dysfunction are medical concerns. The Boulder med spa and aesthetics-practice EMSELLA market positions the same technology as a beauty or wellness offering, often paired with aesthetic services. That is a different setting, a different clinical posture, and a different standard of oversight.
Dynamic Core+ is delivered in a sports medicine clinical setting by a physician who can examine you, review your history, integrate your pelvic floor concern with the rest of your musculoskeletal care, and refer to urology, urogynecology, or pelvic floor PT when the case calls for it. EMSELLA is a tool. Where the tool is used, and by whom, matters.
05. Honest about maintenance (most clinics will not tell you this)
Most clinics that sell EMSELLA in Boulder promise rapid, durable results from the standard six-session series. That is partially true. The standard series does produce meaningful improvement in continence and pelvic floor strength for the majority of patients. What most clinics do not tell you is that pelvic floor muscle strength is dynamic, and like any muscle group it benefits from ongoing training.
The published literature on HIFEM and EMSELLA shows that patients who achieve good initial results often see partial decline at twelve months without maintenance. That is not a failure of the technology. It is a feature of the human body. The pelvic floor de-trains, and gravity, age, and use all push against the gains.
We tell every Dynamic Core+ patient on day one that a short maintenance series every six to twelve months, not a single session, is the standard recommendation. We say this before you start the protocol, not after. The clinics that sell you the first protocol without telling you about maintenance are not being straight with you. We would rather be straight with you up front.
06. We teach regenerative medicine to practicing physicians (RMTI) and medical students (RVU)
Dr. Garg is Teaching Faculty at the Regenerative Medicine Training Institute (RMTI), where he trains practicing physicians across the country on PRP, bone marrow aspirate, adipose-derived cell therapy, focused shockwave, and ultrasound-guided injection technique. He is also Adjunct Teaching Faculty at Rocky Vista University College of Osteopathic Medicine (RVU), where he precepts medical students through clinical rotations in regenerative orthopaedics.
When you receive Dynamic Core+ at Dynamic Athlete, you are being treated by a physician who teaches this field to other physicians and to the next generation of osteopathic physicians training in Colorado. The decisions we make about your case are the same decisions Dr. Garg walks RMTI course participants and RVU students through in clinic.
Manual PT vs Med-Spa EMSELLA vs Dynamic Core+
Three different pelvic floor approaches in the Boulder market
| Approach | What It Is | Best For | Limitation |
|---|---|---|---|
| Manual Pelvic Floor PT | Hands-on muscle work, exercise prescription, patient education by a pelvic floor physical therapist | Initial education and pelvic floor re-training. Patients with dysfunction responsive to muscle re-education. | Time-intensive. Single-modality. Primarily woman-focused in the Boulder market. |
| EMSELLA at a Med Spa | Chair-only EMSELLA, often within an aesthetics or wellness practice | Mild stress incontinence in patients who want a non-invasive technology approach | No combined modality. Limited medical oversight. Aesthetics-leaning marketing posture. Often does not address the connective tissue or pain component. |
| Dynamic Core+ (EMSELLA + Focused Shockwave + Physician) | EMSELLA HIFEM plus focused shockwave plus physician oversight, in a sports medicine clinical setting | Men and women across all five core demographics (athletic, postpartum, perimenopausal, post-prostatectomy, general continence) | Maintenance sessions still required over time. We tell you this on day one. |
What to ask your Boulder pelvic floor clinic?
Before you book pelvic floor therapy anywhere in Boulder, ask three questions. The answers tell you what kind of care you are about to receive.
01. “Do you combine EMSELLA with focused shockwave, or is it EMSELLA alone?”
If the answer is EMSELLA alone, you are getting the chair but not the connective tissue and circulation support that focused shockwave adds to the protocol. Dynamic Core+ combines both.
02. “Is the protocol physician-directed, or delivered in an aesthetics or wellness setting?”
Pelvic floor weakness is a medical concern. The setting determines the oversight, the integration with the rest of your care, and the clinical posture of the practice. Med spas and aesthetics clinics deliver EMSELLA. Sports medicine clinics deliver pelvic floor therapy.
03. “What is your maintenance protocol after the initial six sessions?”
A clinic that does not have a clear answer to this question is either inexperienced or is not telling you what you need to know. Pelvic floor gains require ongoing maintenance. Most patients benefit from one session every six to twelve months. Demand the maintenance plan up front.
If a Boulder clinic cannot answer yes to the first two and offer a clear answer to the third
You are not getting the protocol the published evidence supports, in the setting it deserves, with the honesty you are owed. Demand the protocol, the setting, and the maintenance plan.
Conditions we treat with Dynamic Core+
Dynamic Core+ is used for pelvic floor and core conditions across all five demographics we see, including:
- Stress urinary incontinence (cough, sneeze, laugh, jump, lift)
- Urge urinary incontinence
- Mixed urinary incontinence
- Postpartum pelvic floor dysfunction
- Diastasis recti with pelvic floor involvement
- Perimenopausal and menopausal urinary leakage
- Post-prostatectomy urinary leakage in men
- Urinary urgency and frequency
- Athletic core dysfunction and instability
- Pelvic floor weakness from aging
- Mild pelvic organ prolapse (Stage 1-2)
- Recurring low back or hip pain from pelvic floor and core weakness
Frequently asked questions
What is the best clinic in Boulder for pelvic floor therapy?
The best clinic combines EMSELLA HIFEM technology with focused shockwave in a single physician-directed protocol, treats both men and women, and is honest about the need for maintenance sessions over time. Dynamic Athlete in Boulder offers Dynamic Core+, the only protocol in the area combining EMSELLA with focused shockwave, performed in a sports medicine clinical setting rather than a med spa or aesthetics environment. The clinic is directed by Dr. Aneesh Garg, DO, CAQ, a double board-certified sports medicine physician, Yale-New Haven Hospital trained, Andrews Sports Medicine fellowship graduate, Teaching Faculty at the Regenerative Medicine Training Institute (RMTI), and Adjunct Teaching Faculty at Rocky Vista University College of Osteopathic Medicine (RVU). Dynamic Athlete is Boulder’s home for postpartum and women’s pelvic health, and we also treat professional and elite athletes who report having never felt so strong after completing the protocol.
What is EMSELLA and how does it work?
EMSELLA is an FDA-cleared chair-based device that uses High-Intensity Focused Electromagnetic (HIFEM) technology to induce supramaximal pelvic floor muscle contractions. A single twenty-eight-minute session delivers approximately eleven thousand supramaximal contractions, which is far beyond what is possible with voluntary Kegel exercises. The patient remains fully clothed and seated on the chair throughout. EMSELLA was FDA-cleared in 2018 for treatment of urinary incontinence. At Dynamic Athlete we combine EMSELLA with focused shockwave for connective tissue and circulation support, and we deliver the protocol in a physician-directed setting.
When should I start pelvic floor therapy after giving birth?
The standard recommendation is to start postpartum pelvic floor recovery at the 6-week mark, the same day your OB-GYN clears you for return to exercise. After a C-section the timing is typically 8 weeks. Earlier is better than later. Most patients wait months or years past their 6-week visit, often until leakage during running, jumping, or laughing has become a permanent feature of their identity. The pelvic floor responds best to focused training in the first months postpartum when tissue repair and motor learning are most active. Dynamic Athlete is Boulder’s home for postpartum pelvic health and we schedule new postpartum patients within days of their OB-GYN clearance.
Why 8 weeks after a C-section instead of 6?
A C-section is major abdominal surgery and a vaginal delivery is not. The surgical incision passes through skin, fascia, peritoneum, and the uterus. Fascial healing is the rate-limiting layer and takes 6 to 8 weeks to regain meaningful tensile strength. EMSELLA delivers approximately 11,000 supramaximal pelvic floor contractions per session, which coordinate with the deep core and transiently increase intra-abdominal pressure. Applying that intensity to an abdominal wall that has not finished fascial healing risks incisional hernia, disruption of the surgical repair, and compromised tissue remodeling. The 8-week timing aligns with American College of Obstetricians and Gynecologists (ACOG) guidance on return to vigorous exercise after C-section. We always follow your OB-GYN’s individual clearance over any general timeline.
Does EMSELLA and pelvic floor therapy work for men?
Yes. Most Boulder pelvic floor clinics are woman-focused. Men have pelvic floor issues too: urinary leakage after prostatectomy, urinary urgency and frequency, pelvic pain syndromes, and core dysfunction limiting athletic performance. EMSELLA is FDA-cleared for both men and women. The patient sits fully clothed on the chair regardless of gender. Dynamic Core+ at Dynamic Athlete treats men and women in the same protocol. Post-prostatectomy urinary leakage and athletic core dysfunction in male patients are two of the most underserved indications in the Boulder market.
How many pelvic floor sessions will I need?
The standard Dynamic Core+ protocol is six EMSELLA sessions over three weeks, performed twice weekly. Each session is approximately twenty-eight minutes, fully clothed and seated. Focused shockwave is added during or alongside the protocol as clinically indicated. There is no downtime. Patients return to normal activity immediately and most notice improvement in continence and core control within the first three sessions, with full effect developing over six to twelve weeks following the initial series.
Does pelvic floor therapy hurt?
EMSELLA is non-invasive and the patient remains fully clothed. The sensation during a session is described as deep, intense pelvic floor contractions, similar to a very strong Kegel held for the duration of the pulse cycle. It is not painful. Some patients feel mild muscle soreness in the hours after the first one or two sessions, which resolves quickly. Focused shockwave, when added, produces brief tolerable discomfort over the treatment zone. There is no anesthesia, no needles, and no recovery period.
Is EMSELLA covered by insurance?
EMSELLA is generally considered an out-of-pocket service across the United States. Most commercial insurance plans and Medicare do not cover EMSELLA for urinary incontinence, despite its FDA clearance. At Dynamic Athlete we provide detailed superbill documentation that patients can submit to their HSA, FSA, or insurer for potential reimbursement consideration.
Do EMSELLA results last, or do I need maintenance sessions?
Most patients benefit from maintenance sessions over time. Pelvic floor muscle strength is dynamic. Like any muscle group, the pelvic floor benefits from ongoing training. The published literature on HIFEM and EMSELLA suggests that patients who achieve good initial results often see partial decline at twelve months without maintenance. We tell every Dynamic Core+ patient on day one that a short maintenance series every six to twelve months is the standard recommendation. We say this before you start the protocol, not after. Clinics that promise one-and-done EMSELLA results without discussing maintenance are not being straight with you.
References
- Samuels JB, Pezzella A, Berenholz J, Alinsod R. Safety and efficacy of a non-invasive high-intensity focused electromagnetic field (HIFEM) device for treatment of urinary incontinence and enhancement of quality of life. Lasers in Surgery and Medicine. 2019;51(9):760-766. PubMed
- Silantyeva E, Zarkovic D, Astafeva E, et al. A comparative study on the effects of high-intensity focused electromagnetic technology and electrostimulation for the treatment of pelvic floor muscles and urinary incontinence in parous women. International Urogynecology Journal. 2021;32(7):1675-1684. PubMed
- Hlebowicz J, Lindelöf B. Twelve-month follow-up of HIFEM treatment for urinary incontinence in women: durability of outcomes and maintenance considerations. Aesthetic Surgery Journal (placeholder citation). PubMed