Endometriosis and Physical Therapy

Endometriosis is the growing of endometrial cells (cells of inner lining of uterus) outside the uterus. It affects 2% – 10% of women in general population in the North America 1, and 71% – 87% of women with chronic menstrual pain2. Women with endometriosis typically experience pain in the abdominal and pelvic region, and the pain can also affect lower back and refer to lower extremities2. While the medical and surgical treatments help with the pain associated with the endometrial implants, women with endometriosis can still suffer from pain associated with adhesions and scarring of the tissues.

Women with endometriosis who suffer from pain over time can also develop pelvic floor dysfunction. The pelvic floor consists of muscles, connective tissues and supporting ligaments. They form a sling from the pubic bone to the coccyx (the tailbone), and function to support the internal organs as well as assist with sphincter and sexual functions. People with pelvic floor dysfunction may have muscles that are too weak, in spasm or too tight. Additionally, women with endometriosis may have adhesions and scar tissues that further impair the pelvic floor muscle and connective tissue functions.3

A co-contraction of pelvic floor muscles and abdominal muscles during functional activities is normally desired, unless there are dysfunctions present in the musculature.  Women with endometriosis generally undergo laparoscopic surgeries, which leave behind painful scars and inflamed muscles on their abdomen. The presence of muscle trigger points and adhesions may be the limiting factors to the normal co-contraction.3

In general, pelvic floor muscle dysfunction is more difficult to diagnose secondary to the internal anatomical position of the muscles. A comprehensive evaluation done by a properly trained physical therapist is essential for women with endometriosis to determine whether they would benefit from the treatments. Therapists in New Dimensions Physical Therapy are trained in evaluating and treating problems relating to pelvic floor muscle dysfunction, as well as other general dysfunctions. Make an appointment today to schedule a physical therapy evaluation with us, and start the process of returning to pain-free lifestyle!

Lila Abbate PT, DPT, OCS, WCS


  1. Endometriosis. Rockville, Md: National Institutesof Health, National Institute of Child Health and Human Development, US Department of Health and Human Services; 2002. NIH Publication 02-2413.
  2. Goodman C, Fuller K. Pathology: Implications for the Physical Therapist. St. Louis, Missouri: Saunders Elsevier; 2009
  3.  Herzig N, Stein A. Physical Therapy and the Treatment of Endometriosis. IPPS. 14(2): 1-2.

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