I had never heard of pelvic physical therapy when my doctor suggested it. I was both wary of what pelvic physical therapy would entail and how much it might help. Pain from endometriosis, especially pain that has gone on for years, can contribute to myofascial issues (Aredo et al., 2017; dos Bispo et al., 2016). Most people with endometriosis have other conditions that can contribute to chronic pelvic pain as well. Pelvic physical therapy can be a great part of a treatment plan for chronic pelvic pain (Weiss, Rich, & Swisher, 2012). It did help me tremendously- especially after I had my endometriosis lesions excised.
There is specialized training to do pelvic physical therapy. For instance, my pelvic PT held a certification in pelvic health physical therapy (CAPP) and knew that kegels weren’t a blanket treatment for pelvic conditions in women (see “Everyone should do kegels” and other pelvic floor myths).
When I went for my initial consultation with the pelvic physical therapist, she went through my history and did both an external and internal exam. She assessed what might be contributing to my problems. She used external electromyographic biofeedback where I could see the screen and see how tight my pelvic floor muscles were (off the chart so tight).
My PT then created a plan to address my specific issues to help restore balance to my body and retrain my pelvic floor muscles to release. She utilized biofeedback, neuromuscular electrical stimulation, yoga therapy, myofascial release techniques, manual joint mobilization and therapeutic exercises. She also adapted my plan based on my feedback. Having a knowledgeable pelvic physical therapist is so important- because everyone is different and will need a unique treatment plan.
I did 3 months of physical therapy before surgery and then 3 more months after. I noted some improvement before surgery, but it wasn’t until after my surgery to remove my endometriosis that I really noticed a big difference. It did take that amount of time to heal after surgery and continue the physical therapy work in order to get to a point that I felt I was where I wanted to be. It wasn’t easy, but it was worth it.
If you are considering pelvic physical therapy, then check out our Treatment page and look under Physical Therapy.
Here are some good places to start to learn more about pelvic physical therapy and how it might help you:
- Preparing for Pelvic Floor Therapy
- Pelvic Floor Spasm: The missing link in chronic pelvic pain
- Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction
- 10 Expert Physio Techniques that Relieve Pelvic Floor Muscle Tension and Pelvic Pain Fast
- Video: Endometriosis, Your Pelvic Floor, and You
- Video: Painful Sex and the Endo Pelvis
References
- Aredo, J. V., Heyrana, K. J., Karp, B. I., Shah, J. P., & Stratton, P. (2017, January). Relating chronic pelvic pain and endometriosis to signs of sensitization and myofascial pain and dysfunction. In Seminars in reproductive medicine (Vol. 35, No. 1, p. 88). NIH Public Access. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585080/
- dos Bispo, A. P. S., Ploger, C., Loureiro, A. F., Sato, H., Kolpeman, A., Girão, M. J. B. C., & Schor, E. (2016). Assessment of pelvic floor muscles in women with deep endometriosis. Archives of gynecology and obstetrics, 294(3), 519-523. Retrieved from https://link.springer.com/article/10.1007/s00404-016-4025-x
- Weiss, P. M., Rich, J., & Swisher, E. (2012). Pelvic floor spasm: the missing link in chronic pelvic pain. Contemporary OB/GYN. Retrieved from dos Bispo, A. P. S., Ploger, C., Loureiro, A. F., Sato, H., Kolpeman, A., Girão, M. J. B. C., & Schor, E. (2016). Assessment of pelvic floor muscles in women with deep endometriosis. Archives of gynecology and obstetrics, 294(3), 519-523. Retrieved from https://link.springer.com/article/10.1007/s00404-016-4025-x