I have been asked this question by past patients after they were initially referred to me as well as friends. And it’s a GREAT question! Endometriosis is a complex and highly variable condition that as many as 1 in 10 women will suffer from (myself included). While excision surgery is considered the gold standard, there are many other layers to this issue.
Here are just 4 ways that pelvic physical therapists can help...
1) Restoring Pelvic Floor Health
The pelvic floor refers to the muscles at the bottom of the pelvis that support the organs at the base of the pelvis, control the exits (urine and bowel), play a crucial role in the core muscle system, and are involved in sexual function.
Pelvic physical therapists are specialists in the care of this region of the body in ADDITION to the entire body’s muscle and bone system.
In specializing in this area, they not only address the pelvic floor, core and back muscles, they also can hep with bladder issues, bowel issues, sexual function, and guide their patients in diet and nutrition related to improving issues in these areas.
When a person has endometriosis, the pelvic floor muscles are very often affected by the disease. These muscles respond to pain by contracting and tensing. When they do this frequently, they begin to lose the ability to function normally (contract and relax). This overlaps into the muscles of the abdomens and thigh muscles as well.
Symptoms of pelvic floor dysfunction include, but are not limited to:
pain in the back, hips, and sacroiliac joint
difficulty emptying the bladder
urinary frequency, burning or pain
Unwanted leakage of urine
constipation or diarrhea
painful bowel movements and fecal incontinence
inability to tolerate a speculum during a gynecological exam, and
pain with wearing tampons.
2) Resolve Pain With Sex
Pain with sex is NOT NORMAL.
With endometriosis, there is an environment of inflammation, scar tissue, and adhesions within the pelvis and abdomen. This can make sex EXTREMELY painful.
To make sex LESS painful, the muscles of the pelvic floor need to be elongated. NOT shortened. The muscles around the pelvis including the abdominals, hip and thigh muscles need to not be restricted or in spasm as well. Fortunately, a pelvic physical therapist is able to assess ALL of these issues together and address your body as a WHOLE.
Pelvic PTs can also address issues like poor alignment, muscle imbalances and posture habits with daily movement tasks that can aggravate the pelvic floor pain.
In the end, pain with sex is a complex issue and advice like taking pain pills or having a glass of wine are NOT going to be very helpful. We GET IT. You want your life back and we want it back for you too! We have so many resources on this issue to share with our patients and are eager to be of help.
3) Resolve Other Causes of Pain
Not all pelvic pain is caused by endometriosis. If this is the only issue that is addressed, pelvic pain may not fully resolve. In addition to muscle and soft tissue imbalances that can easily cause pelvic pain all on their own, there are other conditions that may be causing pain.
Interstitial cystitis is a bladder pain syndrome that can cause the pelvic floor muscles to be in spasm and vice versa. Pelvic floor muscle spasms can bring on a bladder pain flare as well. Pelvic physical therapy is the only intervention for IC that has significant medical research to show it’s helpfulness in treating this condition.
Other issues can include vulvodynia and pudendal nerve pain.
4) Help Our Patients Feel Empowered Instead of Like the Victim
When a person is diagnosed with endometriosis, they have often been suffering for many years already. The typical medical interventions offered include medications and surgery. This can make us feel helpless.
With pelvic physical therapy, the patient is EMPOWERED with knowledge of how they can help their OWN BODY and be a CENTRAL PLAYER in their wellness journey. Success with physical therapy is a team effort between the patient and the therapist.
In therapy, you will learn how absolutely EVERYTHING in your body is connected. Addressing the muscular components of your pain can be the MISSING PIECE to getting you back to feeling great even AFTER having surgery.
With the right therapist, you can find someone that is literally in your corner. They can listen, help you work through your frustrations, support you on your journey and be a resource for holistic options.
If you feel like you have tried everything and are hesitant to try one more thing, we get it. Many women are surprised at how much they can do themselves at home to help with their flares or symptoms after working with a pelvic PT and really understand how much of a difference addressing their body as a whole can help.
If you do experience issues with pelvic floor pain and/or tension, download the pelvic floor tension exercises HERE.