5 Ways Pelvic Physiotherapy Can Help You Manage Your Endometriosis Symptoms

Endometriosis is more than “just bad cramps”... It’s pain with intercourse and fertility challenges. It’s painful peeing, constipation, bloating, and diarrhea. It’s chronic fatigue and pelvic pain. It’s having to miss work or school because of severe period pain. It’s extremely impactful on our physical and mental health, social wellbeing and quality of life.

Endometriosis is when abnormal tissue that is very similar to the tissue that lines the uterus grows outside the uterus. It’s a whole body condition, affecting the nervous system, pelvic floor muscles, bladder, bowel, and emotional health. Unfortunately, there is no cure for endometriosis. Surgical and pharmacological treatment methods don’t provide a lot of relief for endo symptoms and often come with unwanted side effects. So what are we left with? Pelvic physiotherapy is one of the main conservative treatment options available to help manage endo symptoms. Physiotherapists are key players in your endometriosis care team and here’s how they can help you:

1. Release tight muscles

In endometriosis, our pelvic floor muscles can be tight and overactive, contributing to pain with sex, painful periods, bowel issues and bladder problems. Kegels and pelvic floor strengthening exercises are generally not the way to start. Pelvic physiotherapists can assess and evaluate tension in the pelvic floor muscles, release them with gentle manual therapy techniques (and yes, that could mean some vaginal or rectal work!), stretch the hips, and teach relaxation and breathing exercises. For those getting laparoscopy to remove endometriosis tissue, physiotherapists can help prepare tissue for surgery and reduce scar tissue formation post op that could contribute to future pain.

2. Improve bowel and bladder function

Endometriosis is associated with a lot of bowel and bladder dysfunction. Chronic bloating, constipation, painful bowel movements, painful peeing, urinary frequency and more. Pelvic physiotherapists can reduce tight muscles contributing to these issues but also teach you proper toileting techniques like toileting posture, pelvic floor control, and constipation and urinary urgency management tools.

3. Pain management

Pelvic pain is one of the most common symptoms of endometriosis. Severe, painful periods, painful sex and pain that disrupts our daily activities aren’t normal. One of the main drivers of pelvic pain in endometriosis is a hypersensitivity of the nervous system called central sensitization. And haunt chronic pelvic pain can make the nervous system more sensitive. It’s like a vicious pain cycle.  Relaxation based exercises have significant improvements on pelvic pain. Pelvic physiotherapists can use pain education, breathwork, mindfulness techniques, and movement strategies to calm and retrain the nervous system.

4. Return to exercise 

Exercise can often cause pain flares, fatigue and pelvic floor symptoms in women with endometriosis, making us afraid to exercise. However, regular exercise can improve pain in pelvic pain conditions! Endo symptoms can flare when the body can’t tolerate the type of exercise, the intensity, the volume, or the order things are done. Pelvic physiotherapists can help guide safe exercise that reflects what your body can tolerate, incorporates modifications and that’s personalised to you so you can exercise the right way. Over time, exercise will evolve as your body adapts and gets stronger!

5. Listen and bridge the gap in care

As you may have noticed, we don’t get a lot of time to ask specialists questions during appointments. Pelvic physiotherapists often spend the most time with patients and can help bridge gaps in fragmented care. We can listen, validate and guide. In order to better self-manage endo symptoms, individuals must better understand the disease itself. A pelvic physiotherapist can give you the education and ultimately the confidence to empower you to make decisions about your health and understand how to manage your endometriosis symptoms outside of surgery and prescriptions.

So if you haven’t thought about pelvic physiotherapy care but are resonating with some of these symptoms above, we’re here to help!