Endometriosis is an inflammatory condition that affects 1 in 7 women Australia wide. It involves endometrial tissue growing outside of the uterus. This can lead to severe pain and poor quality of life for those affected. Research tells us it can take up to 7-10 years to receive an endometriosis diagnosis. In this time individuals often experience severe pelvic pain as a result.
When our body is exposed to pain signals like that for a prolonged time it can lead to “chronic pain”. Chronic pain is defined as “pain that persists/occurs with a chronic health condition”. Chronic pain has been shown to change the very structure of our neurochemistry, in which it affects multiple components of our central nervous system such as: sensory, emotional, cognitive, and behavioral elements. (Yang, S & Chang , M. 2019.)
Chronic pelvic pain is seen in nearly half of those with endometriosis. To treat an individual with chronic pelvic pain we have to look at the individual holistically. In doing so we have to look at the social, emotional, physical, and environmental factors that may be increasing the symptoms experienced. Awed, E et al 2017 looked at exercise prescriptions in women who have been diagnosed with endometriosis. They looked at the benefits of physical activity and how exercise can lead to anti- inflammatory effects on the body. Additionally physical activity has many as well as the emotional and physical benefits that can help the symptoms of endometriosis.
Women’s health physiotherapists are trained in assessing and treating pelvic floor conditions that are associated with endometriosis. As previously stated, nearly half of uterus bearing individuals will experience chronic pelvic pain as a result of endometriosis. Pelvic floor dysfunction affects the muscles, connective tissue and supporting ligaments of the pelvis. The dysfunction refers to these muscles either being too “weak” or “too tight”/ overactive likely because of prolonged pain signals in our bodies. These dysfunctions are likely contributing factors that lead to chronic pelvic pain. If we as physiotherapists can address the factors leading to these dysfunctions, we may be able to relieve the symptoms of endometriosis.
Physiotherapy techniques have been reported to reduce pain and improve the quality of life in people with endometriosis. (Award, E. et al 2017.) We use a variety of techniques that address pelvic floor dysfunction but also work on the secondary musculoskeletal causes as well. These can include manual therapy work on surrounding structures such as your lower back and hip muscles affecting postural changes. Physical activity has been shown to have an anti-inflammatory effect on our bodies through the release of certain proteins. (Febbraio 1985).
The study conducted by Award, E et al looked at a group of endometriosis sufferers who completed an 8-week exercise program. It consisted of 3x 60-minute session per week of moderate intensity exercise. Exercise was supervised by a physiotherapist in a group class, with exercise consisting of relaxation and stretching exercises. The research found that after 8 weeks of these physiotherapist lead classes there was a significant reduction in pain intensity levels. (Award, E 2017)
Research is still growing in this space to determine which physical activity can best be used to help with the treatment of endometrial symptoms. The article only had a small sample size so conclusions should be taken with caution. However, the results are positive for those who suffer from endometriosis and there is an ever-growing body of evidence supporting physiotherapy in the treatment of endometriosis.
As a women’s health physiotherapist, we would also recommend our clients to reach out to dieticians, psychologists and their regular GP’s to help with the holistic approach to their symptoms. Bump Fitness has developed an endometriosis group session to help women find their community and to educate all on how physical activity can improve their quality of life.
For more information on how we can help you on your endometriosis journey reach out today.
References
Awad E, Ahmed HAH, Yousef A, Abbas R. Efficacy of exercise on pelvic pain and posture associated with endometriosis: within subject design – PubMed (nih.gov)
Yang S, Chang MC. Chronic Pain: Chronic Pain: Structural and Functional Changes in Brain Structures and Associated Negative Affective States – PubMed (nih.gov)