Physical Therapy

Learn about the importance of pelvic floor physical therapy in the treatment of pelvic pain

Specialists agree that complementary treatments may help to reduce the patient's pain from endometriosis and provide additional health benefits. Pelvic floor physical therapy is a specialty of physical therapy that focuses on the pelvis and surrounding affected areas. This includes working on the muscles, bones, ligaments, and fascia in the core, hips, back, legs, and pelvis. Physical therapy to address endometriosis-related pain has shown promise in initial studies. In one study, participants experienced significant improvements in all domains of sexual function, including pain, desire, arousal, lubrication, orgasm, and satisfaction. The specific manual therapy used is thought to deform or cause the failure of adhesive bonds. As a result, pain decreases and mobility appears to improve. Since few studies have been conducted, more research is needed to confirm these findings.

Although future research is needed, this therapy, designed to increase function and reduce pain by restoring soft tissue, visceral and osseous mobility, is a non-pharmaceutical, non-surgical technique that has produced few adverse effects or complications. As such, it offers a promising alternative to physicians, clinicians, and others involved in women’s health.
- Decreasing Dyspareunia and Dysmenorrhea in Women with Endometriosis Via a Manual Physical Therapy: Results from Two Independent Studies

The pelvic floor muscles function as a support for the pelvic organs and make up part of the urethra, rectum, and vagina. These muscles allow for sexual intercourse and the normal functioning of bladder and bowel. When the muscles are too relaxed or too tight, it is called Pelvic Floor Dysfunction, or PFD. PFD is closely associated with endometriosis, Interstitial Cystitis, and Chronic Pelvic Pain.

Chronic Pelvic Pain and Interstitial Cystitis, or painful bladder syndrome, are common comorbidities of endometriosis. Studies on pelvic floor physical therapy for these two conditions have shown promise. Pelvic floor physical therapy addresses musculoskeletal components that are involved in pelvic and genital pain syndromes and sexual dysfunction. Physical therapy treatments include manual therapy, electrical stimulation modalities, self-care education, stress management, and biofeedback.

To Kegel or Not?

While kegel exercises are commonly suggested for strengthening the pelvic floor, they may not be suitable for patients with PFD. During a kegel, the pelvic floor muscles are contracted. In PFD, the pelvic floor muscles may be hypertonic, or too tense, so this would not be appropriate. The most suitable exercises for your particular case are decided after you have been thoroughly evaluated by a physical therapist.

Physical therapy treatment of pelvic pain is an integral component of the multidisciplinary approach to Chronic Pelvic Pain and associated sexual dysfunction.
- The Role of Pelvic Floor Physical Therapy in the Treatment of Pelvic and Genital Pain-related Sexual Dysfunction

Resources

For more resources on physical therapy for endometriosis and how to find a qualified physical therapist, explore the following links:

Find a Pelvic Rehab Practitioner through Pelvic Rehab's provider locator tool.
Pelvic Sanity is a physical therapy clinic located in Southern California that specializes in pelvic pain, sexual dysfunction, and urinary and bowl conditions. They offer remote consultations, patient resources, and an immersive out of town program.
Dr. Sallie Sarrel's Pelvic Physical Therapy has offices in New York and New Jersey and provides excellent information on pelvic pain.
Beyond Basics Physical Therapy is led by Amy Stein, DPT, who is an expert on treating pelvic floor dysfunction, pelvic pain, women’s health, and functional manual therapy for men, women, and children.
Heal Pelvic Pain: The Proven Stretching, Strengthening, and Nutrition Program for Relieving Pain, Incontinence, I.B.S, and Other Symptoms Without Surgery offers a stretching, muscle-strengthening, and massage program, guidelines on foods, suggestions for stress, and pain reducing treatments by Amy Stein, DPT.
Ending Female Pain, A Woman's Manual: The Ultimate Self-Help Guide for Women Suffering From Chronic Pelvic and Sexual Pain is the quintessential self-help book for patients suffering from chronic pelvic and sexual pain. Written by Isa Herrera, MSPT.
The V Hive has weekly episodes from the field’s top practitioners in women's health. Their mission is to make the highest quality information on the most beloved part of your body accessible, understandable, and implementable.
ChoosePT can help you locate a Physical Therapist.

Complementary and Alternative Therapies Series

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