Hands on therapy such as women’s health physical therapy or pelvic physiotherapy can go a long way in helping endometriosis sufferers manage their pain. Endometriosis is characterised by pain — period pain, abdominal & pelvic pain, pain with urination and with bowel movements, and pain with sex.
When women and younger girls suffer from endometriosis, they often spend a lot of time curled up in bed during their period, and often outside of period time too. All of those cramps, spasms, inflammation and pain make the tissues in the abdominal, pelvic and back area really tight.
There is also a build up of scar tissue from the endometriosis or from the surgeries to remove endometriosis. This tightness in the muscles and connective tissue (fascia) in the area can then cause further pain. The pain cycle begins, going round and round in a vicious circle of increasing pain, tightness and inflammation.
Most people have heard of a physiotherapist who treats sports injuries or back pain, but not many people have heard of a women’s health physiotherapist. And these amazing therapists are paving the way in the management of pelvic pain and endometriosis.
As a women’s health physiotherapist who also has a long history of pelvic pain and endometriosis (you can read my personal story here: Click here), I am both a patient advocate and a therapist advocate.
I am a huge fan of manual therapy and myofascial massage in the pelvic and abdominal area to release scar tissue, adhesions, spasms, fascial and muscle tightness, and to restore the correct alignment of the bones, soft tissues and the pelvic and abdominal organs.
Sometimes the pelvic bones and joints are not in a neutral or appropriate alignment and this can further affect the muscles and fascia in the lower back, pelvic and hip regions. This can usually happen after surgery as often the endometriosis or scar tissue can be more one-sided within the pelvic organs. When surgery is performed to remove this, one side of the pelvic tissues can scar and tighten up more and pull the joints out of alignment.
At my workplace in the Sydney CBD, I treat pelvic dysfunctions, such as is seen with endometriosis, with myofascial massage, muscle energy techniques and exercise to restore the pelvis, hip and spine joints back to a good neutral alignment. Often women with endometriosis have been told they have sacro-iliac joint dysfunctions in the pelvic joints, so an integrative approach of external and internal physiotherapy techniques is important for optimal results.
Endometriosis severely impacts the pelvic floor, and more often than not, women who suffer from endometriosis also suffer from a hypertonic, overactive or tight pelvic floor. If the pelvic floor muscles and fascia are tight, then they are often also very painful, leading to pain with sex.
Overactive pelvic floor muscles can also make period pain worse because when the uterus contracts to expel blood, the pelvic floor muscle and fascia system will be contracting too (it’s like trying to walk with a sprained ankle). This is why a lot of women with period pain also experience vaginal pain during their periods.
Almost every woman who walks into my private practice with endometriosis often has tightness or trigger points in her pelvic floor muscles, so a lot of the treatment she would have would involve internal vaginal muscle releases.
Within 3 months of treatment internally and externally ( the outer muscles of the hip, buttocks, spine and abdomen), she will report less pelvic and sexual pain, better bladder and bowel control, regular bowel emptying, better digestion, and best of all, less period pain.
Periods can also become shorter, more regular, with less spotting before and after periods. Part of the reason for this is because the uterus is now aligned ‘neutrally’ from all the muscle and fascial release work around it, rather than tipping forwards or sideways. If the uterus isn’t positioned ‘neutral’ or well within the pelvis, blood can stay back in the curves rather than flowing straight down and stay there until the next period, when it comes out as dark spotting.
NB: March is Endometriosis Awareness Month. A really awesome event that I am taking part of is the Worldwide EndoMarch (www.endomarch.org).
You can check it out here:tendo2016 where I have interviewed global experts in endometriosis on all the ways to manage this disease holistically. You will receive 2 interviews everyday for 10 days about endometriosis.