• Susan Winograd PT

Pelvic Floor Physical Therapy for Endometriosis

Did you know 1 in 10 women have endometriosis and that at least 70% of people with endometriosis also have pelvic floor dysfunction. There are many overlapping conditions that often go along with Endometriosis.

Pelvic floor physical therapy should always be part of a healing plan of care and the first line of defense and conservative treatment.

So how specifically can a pelvic floor physical therapist help you with Endometriosis??

1. Pain - Many women with Endometriosis struggle with low back pain, hip pain, groin pain, and pain in the abdomen that sometimes can persist all month long.


Pelvic floor PT are trained to Help clients with these pain conditions, we have a great orthopedic skills, we work with the fascial or connective tissue system to help release any restrictions of scar tissue and tight muscles and perform visceral mobilization to mobilize the tissues around the organs.

For scars and adhesions we at Pelvicore Rehab LLC use a combination of micropoint stimulation (Dolphin MPS a great modality to release scar tissue, manual techniques such as soft tissue mobilization, connective tissue rolling, myofascial release and visceral mobilizations.

2. Pain with Intercourse - many clients with Endometriosis struggle with painful intercourse.

This is particularly difficult because client begin to anticipate the pain prior to intercourse and then protectively guard their pelvic floor muscles which further increases pain.

  • We can teach clients how to keep the nervous system calm in order to prevent this protective guarding.

  • we use manual therapy techniques

  • breathing strategies

  • stretches

  • self-care strategies for home.

  • Biofeedback can be a great tool to help clients restore the brain body connection. We can use external electrodes, internal probes, or even manual biofeedback.

This acts like a mirror for the patient to see how they are engaging the muscles when they try to either contract or relax the pelvic floor muscles.

  • Electric stimulation either internally or externally is another tool we use to help with pelvic floor muscle pain.

3. Bowel and Bladder - in order to urinate and defecate the pelvic floor muscles need to be completely relaxed.

very often clients with Endometriosis protectively guard or have overactive Pelvic floor muscles which can cause bowel and bladder dysfunction.

  • Symptoms can be urinary urgency or frequency, pain with urination, hesitancy, incomplete voiding, constipation.

As pelvic floor PT , We are trained to perform intra-vaginal and intra-rectal techniques to balance these muscles, teach you self care technique, and lifestyle modifications to help resolve these sx

We can help to relax and lengthen the muscles that are tight and help you to strengthen muscles that are weak.

Remember that usually a tight muscle is a weak muscle and very often has to be lengthened and relaxed before strengthening.

4. Musculoskeletal dysfunction-

  • Our bodies response to pain is muscle guarding, therefore clients struggling with endometriosis can struggle with pain as a result and can often have musculoskeletal imbalances as well.

  • Gripping muscles consciously or subconsciously as a response to pain can lead to trigger points anywhere in the body and are often seen in the abdominal wall, pelvic floor , inner thighs, back muscles. These muscle imbalances can pull the pelvic bones out of alignment and generate pain as well.

AS pelvic floor physical therapists we can find the root of this imbalance and restore balance by using various techniques such as trigger point release, manual techniques( internally and/or externally) , Dry needling , stretching and restore the neutral alignment of the bony pelvis .

These are just a few of so many ways that a trained pelvic floor physical therapist can and should be an integral component of a healing plan of care for women with Endometriosis.


If you are struggling with symptoms of Endometriosis call Pelvicore Rehab LLC now to get you started on the healing process and back to your best life !!