Ways to Manage Your Endometriosis

Ways to Manage Your Endometriosis

Endometriosis is a debilitating disease that impairs the quality of life in adolescent and adult females. Sorry – not exactly the best news of the day. But March is endometriosis awareness month, and it’s important to discuss a condition that affects females across the lifespan. Endometriosis occurs when the inner lining of the uterus implants outside of the uterus and cervix, causing scarring, adhesions, and pain within the abdominal and/or pelvic cavity. It has been known to affect 10-15% of all women of reproductive age, with the age of 13 being the median age for onset of initial symptoms. Commonly reported symptoms include dysmenorrhea (painful periods), pelvic pain between periods, dyspareunia (painful intercourse), dysuria (painful urination), and GI complaints (including chronic constipation and IBS-type symptoms). These symptoms closely mimic other conditions, making the diagnosis of endometriosis difficult. It is known as an “invisible illness,” as there is currently no minimally-invasive testing to determine the presence of the disease. The only definitive and most accurate assessment available is laparoscopic surgery.

While rehabilitation cannot stop or cure the disease process, rest assured rehabilitation can help patients in managing symptoms in hopes of improving their quality of life. Here a few ways a pelvic health physical therapist can help with conservative management:

1. Embrace a team approach: ensure the patient has the right medical providers on board, including but not limited to a primary care physician, gynecologist, acupuncturist, and especially a reproductive endocrinologist. Hormone and medical management are vital to promote reproductive health and fertility. PTs are happy to connect patients with the right provider.

2. Pain management: soft tissue work done by the therapist can help reduce pain and tension holding patterns within the muscles of the abdomen, low back, and pelvic floor. Teaching home techniques for the patient to use independently is important for long term benefits. After all, empowering the patient is the gift that keeps on giving.

3. Down training pelvic floor muscles: often with endometriosis the pelvic floor muscles (PFM) tighten up, which facilitates pain patterns. The PFM rarely go off duty when there’s pain. Pelvic health PTs help patients with being able to more successfully lengthen and relax their tightened, painful PFM. It’s almost like helping the pelvis breathe again.

4. Exercise: get the body moving! Keeping the abdomen gliding, moving, and grooving via various stretches and deep breathing techniques can help maintain mobility and reduce pain. Also, encouraging the patient to be successful in basic exercise is helpful, especially when pain is a limiting factor. As the saying goes, “motion is lotion” and all parts of the body require healthy movement.

5. Patient education: the pain and fatigue associated with endometriosis combined with the high demands of current lifestyles can cause further stress. Providing ways for the patient to be consistent with self-care and energy conservation techniques is important for regulating healing for the body. In addition, educating the patient about the disease process is helpful in order to maintain realistic outcomes and goals. Understanding the disease process helps the patient become an active participant in their medical management. As a wise man once said, knowledge is power!



1. ACOG fact sheet: https://www.acog.org/about_acog/news_room/~/media/newsroom/millionwomanmarchendometriosisfactsheet.pdf
2. Endometriosis: epidemiology, diagnosis, and clinical management. Parasar P., Ozcan P., Terry K. (2017) Curr Obstet Gynecol Rep. March; 6(1): 34–41.

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Covid-19 Notice

3/27/2020 Covid-19 Notice:

On March 19th, we made the difficult, yet important decision to close both clinics, in order to do our part to flatten the curve. We will reopen the clinics part time on Monday, April 6th, with an emphasis on telemedicine. This will allow us to comply as much as possible with the governor's Stay Home Stay Healthy order if it is extended, while also meeting our obligation as essential infrastructure workers. According to Dr. Matos, an expert in biological surety and the management of select agent programs at federal facilities: "Physical therapists are essential in flattening the curve of the Covid-19 pandemic. They play a key role in keeping people they can help out of doctors' offices and ER's. This will not only free up the medical teams to treat those impacted by Covid-19, but also limit the exposure of those seeking the care of the physical therapist." To that end, we will focus on telemedicine, but also allow for select, necessary in-office treatments for low risk, healthy individuals. This will be a joint determination between you and your PT. Many, if not all of our patients, have come to appreciate the effectiveness and efficiency of the hands-on manual therapy techniques our physical therapists use to help relieve pain and improve function. So, we recognize that a telemedicine visit may not seem as appealing. At this time, telemedicine is the appropriate and safe way to continue your care without further interruption and your physical therapists are prepared to alter their approach in order to still provide effective care.

During our temporary closure, your physical therapists have been on unemployment and not able to contribute to our communities financially as they normally would like to. Getting back to work, providing your care will allow us to resume caring for you and our community. For every telemedicine visit we provide in April, the clinic will donate $5 to the following organizations:

Kelsea Cannon, PT- Westside Baby
Lauren Esmailka, PT- Treehouse
Elizabeth Rogers, PT- Rainier Valley Food Bank

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. I remain available for urgent (i.e. post-op care, acute injury, treatment needed to decrease/avoid use of NSAIDs and Opiods) in-clinic treatment and telemedicine treatment from now until April 6th. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat class on Wednesdays at 7am and foam roller class on Fridays at 7am. All are welcome to participate in these classes or view them anytime on our Facebook page.

Please contact me directly with any questions or concerns. If you are a current patient, you should have received an email from me with scheduling/rescheduling info. Be in touch with your PT to schedule your telemedicine visit. I am available via clinic phone (206-535-7356) and email (elizabeth@elizabethrogerspt.com). We will update you here and our Facebook page as things change.

We are counting the days until we get to resume our work together both virtually and in the clinic! Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC

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