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Endometriosis & Physio – The Low Down on Down Low!

In my first blog on endometriosis I explained how the implants of endometrial tissue can deposit themselves outside of the uterus (womb) and cause inflammation, pain and scar tissue formation.

A lot of women and girls with endometriosis experience very painful periods (dysmenorrhea) which often results in days every month in bed or sofa curled up with a hot water bottle. This can have an impact on musculoskeletal structures such as the hips and back too. Partly because of its effects on your strength and posture but also because the muscles of the pelvic floor, hip, abdomen and back can develop myofascial trigger points (MTrP). A myofascial MTrP is a hype- irritable locus within a taut band of skeletal muscle, located within muscle or fascia. These trigger points can refer pain away from their source. How many times have you experienced thigh pain when you are on your period?

So, what can physiotherapy do to help?

  1. Help pelvic floor dysfunction

Your pelvic floor muscles are the muscles that join all the bones of the base of your pelvis thereby forming a ‘floor’. They also have connections to your hips, back and abdomen and thighs with either muscle of fascial links.

The pelvic floor has multiple roles:

It supports your pelvic organs.

It works to allow proper bladder and bowel function.

Through its links with other areas of the body it helps to support the back and hips.

It aids sexual ability, both it its ability to expand to allow penetrative sexual intercourse and to contract during orgasm.

If the pelvic floor muscles develop MTrP it can sometimes lead to pain referred from the pelvic floor into the thighs, bladder frequency and urgency, constipation or pain when emptying the bowel, painful sex, back pain and hip pain.

A women’s health physiotherapist can assess whether MTrP are present within the pelvic floor muscles and treat you in the following ways:

Gently treat the trigger points of your hips, back, abdomen, thighs and pelvic floor. This is done through a variety of release techniques to the various muscles effected. This can be done using a type of massage, and by giving you stretching exercises and advise of posture. In addition, acupuncture can be used to treat your abdomen, hips and back.

  1. Give you advice on bladder and bowel care if these have been affected by your endometriosis.

  1. Treat ‘endobelly’ or excessive bloating. This can be caused either by inflammation due to the inflammatory response of endometriosis, problems such as irritable bowel syndrome or increased muscle activity in some muscles of the hips, pelvis or upper abdominals. Some physiotherapists use a type of treatment called visceral manipulation. This can gently create a slide and glide to return between the organs in the pelvis and abdomen that have been affected by adhesions either caused by the endometrial implants or by surgery. This allows movement patterns to regain between the organs and can improve lymphatic and venous drainage.

So, if you suffer from endometriosis (or know someone else who does) and want to do something to help feel better and get some excellent care please call us on 01548 852355 and make an appointment with Wendy or email We shall look forward to hearing from you!