“In some people, certain exercises can exacerbate or worsen the pain,” he adds. “This can occur, for example, when scar tissue has developed from endometriosis, and activities that cause pulling, stretching, or pulling on these areas can make the pain worse.”
Then what do you do? Dr. Roskin and other experts recommend the following tips to make your workout as healthy and enjoyable as possible.
4 Best Practices When Exercising With Endometriosis
1. Stick to shorter workouts
Instead of one long workout, incorporate multiple mini workouts, also known as “do exercise,” it’s key.
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“With endometriosis, it’s common for an elevated heart rate over a long period of time to cause a flare-up of painful symptoms,” explains Aly Giampolo, certified fitness instructor, professional dancer, and co-founder of the ness, a gym known for its mini-trampoline workouts. Exercise is a stress on the body, and the greater the intensity or duration of the exercise, the greater the stress, causing the muscles to tense and contract and increases inflammation and pain sensation overtime.
“Breaking your exercise up into shorter bursts and sprinkling it in here and there is a great way to get some movement in and reduce the risk of increased soreness.” An “exercise snack” might look like five minutes of morning yoga, a short walk after dinner, half a video dance class, or any other move that makes you feel good and fun.
Here’s a five-minute barbell workout to add to your rotation:
2. Know which exercises cause you the most (and least) pain
You know your body best, of course, but some types of exercise tend to be painful for most people with endometriosis. “You should avoid higher-intensity workouts, particularly those that target your core, pelvis, and lower back,” recommends Mariel Witmond, yoga teacher and founder of conscious probe. “That can include things like running, due to the impact on our spine and hips, and sit-ups, due to the stress on our abdomen and back.”
Other exercises you may want to avoid are those that involve bending over. “Any exercise that requires you to push down (squats, weightlifting) can put extra pressure on your pelvis, increasing pain in the affected areas,” adds Somi Javaid, MD, founder and medical director of hermd.
Whitmond suggests low to moderate impact yoga and stretching. Flexibility and mobility training, including Pilates, may also be beneficial. “Many people with endometriosis tend to do better when they do an exercise program that involves more lengthening and stretching of the muscles rather than resistance and weight-bearing exercises, which may not be as comfortable,” he says. Laurence Orbuch, MD, OB/GYN, endometriosis surgeon, and director of GYN Laparoscopic/Robotic Associates LA. “That said, each individual should tailor his training to a regiment that suits his personal needs.”
3. Listen to your body and don’t push through the pain
One of the most important things you can do for your overall health is trust your body signals. “Don’t be a hero,” says Giampolo. “If you start a workout and your pain level goes up, just stop. This is your body saying, ‘I’m not here for this today.’ There’s no need to push yourself when your body is going through so much.”
But what is the difference between the pain and the “normal” discomfort that can arise with a workout? “Discomfort can be managed, whereas pain is a warning signal from our body that something is wrong,” explains Dr. Javaid. “With endometriosis, the pain you may experience with exercise will often depend on where you are in your menstrual cycle. You should monitor your symptoms throughout your cycle and remember not to push yourself if you have a ‘bad’ symptom day or experience increased pain with exercise.”
Dr. Roskin emphasizes starting slow and paying attention to your pain. “Sharp or worsening pains are a warning to dial again,” she says.
4. Take care of yourself before, during and after exercise
The clothes you wear and the way you treat your body can also affect how you feel.
“have put compression leggings or shorts, which can help minimize swelling and discomfort,” says Dr. Javaid. “Apply heat or ice packs to the swollen area after exercising to help relieve any discomfort.” He also suggests stretching, taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, before you exercise, and drinking plenty of water throughout your exercise. This “will promote optimal performance, prevent dehydration, and stop the onset of muscle cramps,” he explains.
Ultimately, how much and how much exercise you choose is up to you and how you feel. There is no shame in any way. “If you feel pain before you exercise, exercise may help,” says Witmond. “If you feel pain during or afterward, you may want to reconsider what you’re doing and whether it’s helping or worsening how you feel.”
