Endometriosis
A whole-system approach to endometriosis management
Do you plan on surgery for endometriosis, or have you already had surgery? Pain patterns can continue with or without surgery. This often happens because of underlying fascial holding, muscular tension patterns, nervous system sensitivity, and how your brain has learned to interpret pain signals over time.
Pelvic physical therapy for endometriosis works with all of your systems—nervous, endocrine, immune, myofascial, and fluid—to integrate your care, change your pain experience, and retrain movement patterns that your body can sustain. This approach supports people with mild endometriosis, persistent pelvic pain, endometriosis and back pain, and pelvic floor dysfunction.
Endometriosis Physical Therapy
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Touch therapy for endometriosis and pelvic pain
Do you respond well to touch? A pelvic physical therapist uses skilled manual work and touch therapy to help change fascial holding patterns and guide breathing and movement in ways that feel safe and supportive.
You may benefit from visceral and myofascial mobilization to support movement of the abdominal wall and the tissues of the pelvis. These techniques can help interrupt the pain loop by changing how sensations are interpreted by your nervous system. Over time, this may reduce pelvic pain, deep tension, and protective guarding that can contribute to vaginismus and pain with penetration.
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Individualized exercise and pelvic floor therapy
When you are able to attend inwardly to sensory information—breath, pressure, effort, and ease—you are often ready to train more sustainable movement patterns. A typical journey begins with awareness, then activation and coordination.
This process supports the body–mind connection and helps different systems work together for daily movement. As endurance improves, your body becomes better able to sustain supportive patterns, reducing the likelihood that painful compensations return when you are tired or stressed. This is especially important for people navigating endometriosis and pelvic floor dysfunction.
How to explain endometriosis pain
Endometriosis pain is rarely caused by a single factor and it is exacerbated by endometrial lesions. Persistent inflammation, restricted tissues in the abdominal wall and visceral fascia, and reduced blood flow to nerves can all increase sensitivity. When certain areas—especially the abdomen and pelvis—move less, nerve pathways may become more reactive.
This heightened sensitivity is a protective response, signaling that something needs to change. Sometimes the request for change is gentle, such as diaphragmatic breathing that massages the organs from the inside and restores fluid movement.
If your pain has been present or recurring for more than three months, your body may have adapted in ways that are no longer serving you. Physical therapy supports the brain and body in learning new, non-habitual patterns that feel safer, more efficient, and more empowering.
Pelvic physical therapy for endometriosis and PCOS
Pelvic physical therapy can also support people with overlapping symptoms of endometriosis and PCOS. Gentle, specific myofascial techniques are guided by how your body responds to touch and movement. These skills can help restore tissue mobility and broaden your movement capacity.
Fascia surrounds everything—muscles, organs, nerves, blood vessels, ligaments—and when it moves freely, circulation improves and movement often becomes more pleasurable. This work can help shift habitual tension patterns that contribute to pelvic pain, back pain, and pelvic floor symptoms.
Even after surgery, the nervous system may continue to hold protective tension patterns until they are specifically addressed. Skilled touch therapy and individualized exercise remain valuable tools for long-term endometriosis management.
How exercises help with endometriosis and pelvic pain
Exercises for endometriosis are most effective when they are individualized. When movement fits naturally into your life, it becomes a lifelong, evolving practice rather than something you have to force and rarely practice.
Over time, your pelvic floor gets stronger at supporting posture and core coordination. As total-body strength, power, and endurance improve, compensatory tension patterns become less necessary. These reflexive holding patterns are often what drive pain with endometriosis, pelvic floor dysfunction, and vaginismus.
Exercise can also support hormone regulation, reduce inflammation, lower stress, and strengthen nervous system resilience. Pelvic physical therapists help you return to exercise with confidence, safety, and trust in your body—whether or not surgery is part of your journey.