Endometriosis can cause problems with the surrounding muscles and soft tissues. Pelvic floor spasms, tight muscles, other myofascial changes, and more will often contribute to symptoms (such as pain with defecation or pain with sex). These muscular and soft tissue changes can benefit from pelvic physical therapy. However, appropriate therapy for endometriosis associated problems requires a specific skill set by your physical therapist (Amundsen & Kawasaki, 2011). Here are some resources to help you know what to expect and what to look for with physical therapy:
Links:
- 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
- Sallie Sarrel: Q&A About What to Expect During Pelvic Floor Therapy for Endometriosis
- Five things that pelvic health physical therapy can do to improve your endometriosis-related pain
- EXPERT VIDEO SERIES: How do I know if I have pelvic floor dysfunction?
Studies:
- 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
“Women with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.”
- 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/
“Treatment for pelvic pain associated with endometriosis warrants identification and therapy directed to the pathological findings that generate and sustain pain symptoms. Since a myofascial source may contribute to endometriosis-associated CPP even after hormonal and surgical treatment has been undertaken, a growing number of practitioners are exploring pain management methods that directly address myofascial pain.”
- Amundsen, A. & Kawasaki, A. (2011). Update on pelvic floor dysfunction. OBG Manag. 2011 October;23(10):17-28. Retrieved from https://www.mdedge.com/obgyn/article/64496/pelvic-floor-dysfunction/update-pelvic-floor-dysfunction
“Levator myalgia, myofascial pelvic pain syndrome, and pelvic floor spasm are all terms that describe a condition that may affect as many as 78% of women who are given a diagnosis of chronic pelvic pain.1 This syndrome may be represented by an array of symptoms, including pelvic pressure, dyspareunia, rectal discomfort, and irritative urinary symptoms such as spasms, frequency, and urgency. It is characterized by the presence of tight, band-like pelvic muscles that reproduce the patient’s pain when palpated….Physical therapy of the pelvic floor—otherwise known as pelvic myofascial therapy—requires a therapist who is highly trained and specialized in this technique. It is more invasive than other forms of rehabilitative therapy because of the need to perform transvaginal maneuvers.”