Endometriosis

In typical female anatomy, the lining of the uterus, known as the “endometrium” is shed during menstruation in preparation for a new ovulatory cycle.

This growth and regeneration is a normal part of the uterus’ function.  However, abnormal growth of “endometrial-like tissue” can develop in a women's body leading to Endometriosis.

Endometriosis is defined as a condition where cells similar to the endometrium (different histology), are found outside of the uterus.  The abnormal growth of the endometrial-like tissue can cause irritation or inflammation in surrounding organs or can even produce scar tissue, known as “adhesions,” that can cause organs to attach to each other, ultimately causing an organ to dysfunction.

How can pelvic floor physical therapy benefit someone from suffering from Endometriosis?

Many women who are suffering from Endometriosis often develop musculoskeletal dysfunction secondarily.  Often the muscles in the abdomen, pelvis, and lower extremities will develop trigger point or connective tissue restrictions.  Leading to increased pain levels from Endometriosis.

Currently, excision surgery is the gold standard for diagnosis and treatment of Endometriosis. However pelvic floor physical therapy is a great way to manage symptoms, prepare your body prior to surgery, address scar tissue restrictions post-surgery, and optimize your quality of life throughout your healing journey.

Specific symptoms we address in physical therapy are reducing tension surrounding the pelvis contributed to symptoms such as bloating, constipation, or urinary urgency/frequency, downtraining techniques to reduce central nervous system sensitivity, elongate muscle groups that may be restricted or tight around the pelvis.

With over 176 million women suffering from this condition, Endometriosis is one of the most common causes of pelvic pain and at Sarton Physical Therapy we want to support you in your healing process.  Please contact our front desk for a consultation with one of our award-winning physical therapists to see if pelvic floor physical therapy is a good fit for you.

We hosted a FREE Endometriosis Lecture on Wednesday, March 14th. 

Symptoms

Symptoms of Endometriosis may include:

• Abdominal pain and cramping

• Pain with intercourse or penetration

• Infertility

• Urinary urgency/frequency

• Gastro-intestinal dysfunction (diarrhea, constipation, painful bowel movements, bloating)

• Lower back pain

• Malaise and fatigue

To receive a true diagnosis of Endometriosis, one must consult with their physician and receive a pelvic exam by their gynecologist. Further action would require a laparoscopic exam if Endometriosis is suspected. The laparoscopic exam consists of a small device with a camera on the end. This is inserted into the abdominal cavity, looking for any abnormal tissue growth and scar adhesions. The findings from laparoscopic surgery would then decide if a woman has Endometriosis and at what stage is her condition.

Endometriosis and the Pelvic Floor

Your pelvic floor is a group of muscles that sit inside your pelvic bowl.  These muscles have several functions and can become dysfunctional with Endometriosis.  Your pelvic floor has a variety of purposes such as supporting organs, aiding in sexual function, and providing a role in urine and bowel elimination. For your pelvic floor to perform optimally, these muscles must be able to lengthen to allow blood flow and mobility of your connective and muscle tissue.

A woman who has developed Endometriosis will most likely have scar tissue adhesions throughout her abdominal cavity.  

This results in additional swelling and bloating, commonly known as the “endo belly.” In addition, if you have undergone laparoscopic surgery for removal of Endometriosis, there is additional trauma to the abdominal cavity—perhaps causing further pain. 

The pelvic floor and abdomen have a close relationship anatomically and physiologically, as they share the same attachment points on the pelvis and work together to change intra-abdominal pressure. As a result of increased stress on both bodily structures, one can develop trigger points along the abdominal muscles and throughout the pelvic floor. Trigger points are points along the muscle that have become in a persistent contracted state. This causes pain that may be localized to the pelvis or abdomen, or perhaps can be felt down the leg or in your back. While your body remains in this pain cycle it can facilitate a neurological response with the sympathetic nervous system continuing the endless pain cycle.

It is common to have pain with sex if you have Endometriosis.  

This is because you have inflammation, scar tissue, and adhesions throughout your abdomen and pelvis, as well as secondary pain from trigger points and muscle tension from being in constant pain. To have intercourse, your pelvic floor muscles must be able to lengthen and relax. However, if you are having significant tissue tension this can again cause pain and create difficulty with becoming pregnant.

The Good News

How does Pelvic Floor Physical Therapy Help?

With collaboration with your physical therapist there are many different strategies to relieve pelvic pain caused by Endometriosis.

Interventions from your physical therapist would include a pelvic exam and manual therapy. These techniques would include myofascial release to treat trigger points and allow tissues to become normalized, visceral manipulation to treat organs that have been affected by adhesions, and scar tissue mobilization.  Through skilled interventions, we help provide pain relief and improve overall tissue mobility. Our objective is to empower you as a patient to reach your goals to become a mother or have painless intercourse and periods.

Sarton Physical Therapy is home to the best pelvic health physical therapists in Orange County. The women at Sarton PT have an eclectic perspective in treating Endometriosis with their successful interventions. Let our advance board certified physical therapists help, please contact us with any questions or requests for additional information.