PT Management of Endometriosis

Since March is Endometriosis Awareness Month, we thought it would be helpful to explain how physical therapy can play a role in managing this disease. Endo affects 1 in 10 women of reproductive age. It is often difficult to diagnose due to the huge variation of how it presents in individuals. Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus, it typically results in symptoms such as pelvic pain, painful/heavy menses, painful intercourse, bowel & bladder dysfunction, fertility challenges, bloating and fatigue (to name a few). The symptoms are often cyclical (like your menstrual cycle) and vary depending on where the endometrial tissue is located in your body. Endo can affect many systems in the body, so a holistic approach to management is so important!

While physical therapy is not curative for endo, we can play a large role in conservatively managing your symptoms and improving the function of your reproductive, digestive, urinary and musculoskeletal systems. PT can improve your quality of life and help you to function better in your day to day. Let’s outline some key places PT can make a big impact…

Dysmennorhea

Dysmenorrhea is significant pain that occurs during menstruation (we’re talking more than just some mild soreness that lasts 1-2 days). For some women, their pain level is so intense that it interferes with their ability to attend work/school. Sometimes this pain can also be accompanied by dizziness, nausea, vomiting, headaches. Much of this type of pain can be attributed to inflammation. From a PT perspective, we can talk about some strategies that can help to reduce bodily inflammation. This can include certain exercises, education on sleep hygiene, education on nutrition, stress management, manual therapy for visceral and soft tissue mobility, and education on certain modalities that may be used at home (such as a TENS unit, for example). We can also teach your valid and reliable cycle tracking methods, and how to identify your fertile signs. By developing greater cycle awareness, we can work to get ahead of the symptoms and be as proactive as possible!

Abdominal & Pelvic Pain

Abdominopelvic pain is one of the most common symptoms associated with endo. When our bodies are in pain for prolonged periods of time, we can develop what’s called central sensitization. This is where our body's pain response becomes more heightened. Physical therapy can help to manage your pain with techniques for nervous system down-regulation, soft tissue mobilization/massage and gentle exercise.

Tissue Immobility/Adhesions

Endometriosis can cause adhesions and limitations in your myofascial mobility throughout your abdomen and pelvis. PT’s that are trained in visceral mobilization, lymphatic massage and other soft tissue techniques for the abdomen and pelvis can help to address this. By improving tissue mobility, we can help restore blood flow to your systems and decrease inflammation, both of which will help you to function better!

Post Surgical Rehab

Laparoscopic excision is the closest we have to a cure for Endo currently. If you decide to undergo this surgery, Physical Therapy can play a huge role in your post-operative recovery. While the surgery can get rid of the endometriosis, it does not fix the underlying muscle dysfunction and pain sensitivity you may have developed. You also will have inflammation, abdominal scars and adhesions after surgery that PT can help address.

Part of Your Healthcare Team

Your PT can be an advocate for you in your journey. Because we get to work with patients for longer appointment times and see you more frequently than most medical doctors, we can really hear your entire story, ask the right questions and help you connect the dots to what you’re experiencing. We are also able to connect you with other specialists such as endocrinologists, urologists, GI specialists, nutritionists, functional medicine doctors, specialized surgeons and mental health professionals. An interdisciplinary approach is essential when managing this disease!