Physical therapy for Endometriosis

Overview
Endometriosis causes changes to the pelvic cavity that can contribute to pain, swelling, and bloating. Physical therapy focused on improving the condition of the pelvic floor can help improve some endometriosis symptoms.

What does it involve?
The muscles that line the pelvic cavity are collectively known as the pelvic floor. The pelvic floor supports the uterus, fallopian tubes, ovaries, vagina, and rectum and keeps the pelvic joints stable. When they are healthy, the muscles of the pelvic floor contract and relax to accommodate changes in the bladder, the digestive system, and the vagina during sex. In women with endometriosis, pain and inflammation can promote dysfunction in the pelvic floor as muscles shorten and become weaker. Problems with the pelvic floor can contribute to bloating, constipation, diarrhea, joint pain, and pain during sex, urination, defecation, tampon usage, or gynecological exams. Physical therapy can improve the condition and function of the pelvic floor muscles and help relieve these symptoms.

When you look for a physical therapist, ask whether they have special training or experience in treating women with endometriosis. Find out what their success rate is in treating pelvic floor dysfunction, and what techniques they use. Ask whether the physical therapist will evaluate the internal muscles of the pelvic floor as well as the external muscles.

At your first visit with a physical therapist, they will assess your condition and interview you about your endometriosis symptoms. They will evaluate your pelvic muscles, which will include palpating both the external muscles of your abdomen and rear, and the internal muscles, which will be done by inserting fingers into the vagina or rectum. Although you may feel uncomfortable about this procedure, the internal exam is necessary for the therapist to gain an accurate understanding of the condition of your pelvic muscles. After the therapist finishes the evaluation, they will help you prioritize which problems you want to work on during sessions. A good therapist will encourage you to challenge yourself while respecting your comfort levels.

Your physical therapist may employ many different techniques to address your condition. They may perform external massage on your abdominal muscles. They may use TENS or biofeedback, a system that allows you to visualize the activity of your muscles. The therapist will teach you different stretches and exercises to do on your own at home. Which exercises you do with your therapist will depend entirely on your condition and your goals. Exercises may include stretching, strengthening, lengthening, and conditioning movements.

It is important not to become discouraged early on in therapy. Focus on slow, gradual progress toward goals.

Intended Outcomes
Physical therapy can improve the condition of the pelvic floor, reducing pain and discomfort associated with sexual, digestive, and urinary functions.

Results
A 2003 article on the treatment of chronic pelvic pain in adolescent girls indicated that physical therapy could provide benefits in cases where musculoskeletal problems contribute to painful conditions.

Constraints
Most types of insurance will only pay for a limited number of physical therapy appointments.

Depending on where you live, it may be difficult to travel to physical therapy visits.