How to move: with endometriosis

METERMore than 830,000, or around one in nine, Australian women suffer from endometriosis, a condition that can cause debilitating pain during the menstrual cycle, as well as during ovulation, intercourse, urination, and bowel movements. Other symptoms include inflammation, swelling, heavy bleeding, and fatigue, and can affect fertility.

Pain and discomfort can lead women to restrict exercise, but this can create other chronic health problems, says Dr. Angela Spence, a credentialed exercise physiologist at Curtin University. Physical activity can also have countless benefits.

“Regular exercise is associated with a reduced risk of developing endometriosis,” she explains, and may also directly help reduce inflammation associated with the condition. Other potential benefits include pain control, improved mental health, and mitigation of side effects of commonly prescribed medications.

Spence notes that more research is needed to conclusively support the role of exercise in endometriosis control. But considering the benefits, experts have several general recommendations, with some caveats.

“Women should be encouraged to be active and maintain routine activity,” says Spence, “but this should progress gradually as tolerance improves, ideally under the guidance of an exercise specialist.”

The move: the Jacobsen method

A progressive muscle relaxation technique called the Jacobsen method has been found to improve quality of life and reduce anxiety and depression in women with endometriosis, reports Emma Wise, a pelvic health physical therapist.

“This involves contracting and relaxing the main muscles of the body, one by one, as a form of mental and physical relaxation,” he explains. “It can be easily done at home in 30 to 40 minutes.”

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Begin by relaxing and contracting your right hand, forearm, upper arm, and then your left side, in that order. Move to the face, neck, chest, shoulder, and upper back, then to the stomach, right thigh, calf, and foot, followed by the left thigh, calf, and foot.

A specific focus on pelvic floor muscle training can improve the range and relaxation of those muscles and help with the pain associated with endometriosis, says Wise, adding that a specialized physical therapist can help with this. “It is common for people with pelvic pain, including endometriosis, to have decreased tone of the pelvic floor muscles,” she explains. “This can further contribute to pelvic pain and other symptoms such as bladder and bowel problems. [and] pain with sex.”

To strengthen your pelvic floor and glutes, accredited exercise physiologist Brittany Cogger recommends clams or lying leg raises, sitting to standing, and glute bridge with resistance band.

The class: pilates or yoga

Pilates or yoga classes can help relax muscles that are tight with pain, writes Cogger. In fact, Wise points out that women with endometriosis who participated in a study exploring the Hatha yoga style found better quality of life and pain relief. This involved movements focused on relaxation, breathing and posture exercises performed twice a week for eight weeks.

The activity: stretch

Exercises based on Pilates and yoga principles can help release tight muscles, according to Cogger, as well as stretches that include a seated glute stretch, a seated hip flexor stretch and a wall side bend stretch. She explains that lengthening and strengthening your pelvic floor, abdominal wall, and hip flexor muscles are important to relax before starting the exercise.

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In this sense, Spence recommends walking or any other type of low-impact aerobic exercise that you enjoy, such as swimming or cycling.

The hard pass: high impact exercises

Vigorous activity can worsen symptoms and result in buds for some women and exacerbate cramps and fatigue, advises Wise. Specifically, it might be wise to avoid high-impact exercises like running and burpees, according to Cogger, as well as sit-ups and sit-ups.

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