Endometriosis & Pelvic Floor Physical Therapy: Before and After Excision Surgery

Endometriosis doesn’t always end with excision surgery. Your pain and symptoms deserve care, too.

Endometriosis can affect much more than the reproductive system. When pain has been present for a long time, the pelvic floor and surrounding muscles can become protective, tense, overactive, and sensitive.

That can contribute to symptoms such as:

• Pelvic pain or pressure
• Pain with intercourse
• Pain with bowel movements or urination
• Difficulty relaxing the pelvic floor
• Hip, low-back, abdominal, or tailbone pain
• Muscle tension and guarding
• Difficulty returning to exercise or normal activities

This is where pelvic floor physical therapy can be an important part of care both before and after excision surgery.

Before surgery

Pelvic floor PT can help you understand what your muscles are doing and work on reducing unnecessary tension, improving mobility and coordination, addressing breathing and pressure management, and building strategies that may make movement and recovery easier.

After excision surgery

Even when the endometriosis has been surgically treated, your body may still be responding to months or years of pain and protection.

We can help address the secondary musculoskeletal effects including muscle guarding, scar and tissue mobility, pelvic floor coordination, strength, movement patterns, and your gradual return to exercise and the activities you love.

We also use technology as part of treatment

SoftWave Therapy has helped some of our patients with pelvic pain reduce pain and tension and improve their ability to move and participate in rehabilitation. We use it as one tool within a larger treatment plan not as a treatment for the endometriosis itself.

We’re also incorporating StimPod neuromuscular stimulation into care for some patients. Depending on the individual’s symptoms and goals, we may use it to help with pain modulation, muscle relaxation, and nervous-system regulation. We can also use abdominal stimulation with a focus on supporting relaxation, bowel function, and calming the nervous system, including vagus-nerve–focused stimulation.

These tools are individualized and are used alongside hands-on therapy, movement, education, and exercise not instead of them.

You don’t have to simply “push through” pelvic pain because you have endometriosis.

Your care may need to address both the underlying condition and what your body has been doing to protect you from it.

If you have endometriosis whether you’re preparing for excision, recovering from surgery, or still dealing with symptoms afterward pelvic floor PT may be one piece of your care team that can help you move forward.

Pelvic floor physical therapy does not treat or remove endometriosis lesions. Treatment should be individualized and coordinated with your medical/surgical team.