Many women with endometriosis also have tight painful pelvic muscles. Sometimes pain from spasm in these muscles is worse than the pain from their endometriosis. It can be confusing, too, because painful muscles don't show at a laparoscopy or on an ultrasound scan. They are a good example of a pain you can't see.
When the muscles around the opening of the vagina are tight, sex becomes painful. It may also be painful using a tampon, or having a cervical smear test.
When the muscles on the side of the pelvis become tight, there may be sudden sharp pains on one side. The pain can come at any time, can make it difficult to walk, may also be felt down the leg on that side and is often better with a heat-bag or hot bath.
If you have this type of pain, it is helpful to:
- Avoid 'core-strength' exercises such as pilates. Your muscles are already tight and strong. Gentle regular exercise, such as walking is a better choice.
- Do stretches like those shown below twice daily, before exercise and if you have pain
- Consult a specialist pelvic physiotherapist who knows how to treat painful tight pelvic muscles. You do not need to have these muscles strengthened. They need to learn to work normally.
- Use a pelvic muscle relaxation CD to help your muscles re-learn new habits
- Read about this problem in our 'Endometriosis and Pelvic Pain' book
- Think about how you hold your body, and learn to allow your whole body to be less tense
- Specialist pelvic physiotherapists, Dr Patricia Neumann and Ms Sonia Sharfbillig have prepared a muscle relaxation CD that you can use each day at home.
Dr Patricia Neumann has a PhD in physiotherapy from the University of South Australia. She is a specialist Pelvic Floor Physiotherapist with a special interest in Pelvic Pain.
Mrs Sonia Sharfbillig has a Bachelor of Physiotherapy (Hons UniSA), a master of Musculoskeletal and Sports Physiotherapy (UniSA) and a Bachelor of Science (Flinders University). She has a special interest in pelvic floor dysfunction, including chronic pelvic floor pain.
Both Patricia and Sonia see patients at:
32 Kensington Road, Rose Park, Adelaide, SA. Phone: +61 8 8331 8131
For most women with pelvic pain, an understanding of the pelvic floor muscles and how to relax them is an important part of managing their pain.
Both authors use a multi-disciplinary holistic approach to help women with endometriosis live well, despite their disease.
Helpful stretches for patients with pelvic pain
Buttock Stretch 1
Place your right ankle in front of your left knee.
Grasp your left thigh with both hands and gently pull it towards you.
The stretch is felt in the shaded area on the diagram (buttock and back of thigh).
Hold for at least 30 seconds.
Repeat on the other side.
Buttock Stretch 2
Draw your left knee towards your right shoulder.
Hold for at least 30 seconds.
Repeat on the other side.
Do the above stretches at least once per day or as directed by your physiotherapist.
Consult your physiotherapist if they exacerbate your pain.
