Exercising with Endometriosis
By Brittany, The Pilates Project
Endometriosis. It’s a chronic health condition affecting one in eight women worldwide, yet unfortunately there is little information available around how exercise can help manage and improve the painful symptoms associated with an Endo diagnosis.
Exercise may be the last thing you feel like doing, and there are some inappropriate exercises that may worsen your current symptoms, but returning to exercise post diagnosis can be important for both your physical and mental health! It is always best to seek the guidance of an Accredited Exercise Physiologist to help return you to the exercise that you love to do – and help you to manage your symptoms going forward!
What is Endometriosis?
Endometriosis is a gynecological condition where endometrial-like tissue grows outside the uterine cavity. We say endometrial-like, as this tissue is not identical to the cells found within the uterine cavity, however it has a lot of similar properties.
Endometriosis is fuelled by the hormone oestrogen, however we are still learning and discovering exactly what causes this tissue growth! This tissue can attach itself anywhere within the pelvic and abdominal cavity, with reports of endometriosis even found on the diaphragm (though this is very rare)! Unfortunately the human body is not equipped to remove these tissue growths, and they continue to act as endometrial-like cells, so with every menstrual cycle, scar tissue and adhesions can form through the release of oestrogen. This can cause a wide range of symptoms, including inflammation, bloating, pelvic pain and cramping.
Best exercises to start with post Endo diagnosis:
Looking to start moving again at home or in the gym?
Regular physical exercise can have protective effects against diseases (like Endo!) that involve inflammatory processes since it causes an increase of the anti-inflammatory and antioxidant markers within the body, and also acts by reducing oestrogen levels, making it a great idea to incorporate exercise into your recovery and disease management.
The pain and discomfort associated with Endometriosis can cause a guarding mechanism within the body – where the body braces to protect itself from pain. This bracing can affect the pelvic floor, abdominal wall and hip flexors – the anterior side of the body. So firstly, when resuming exercise, it is important to first focus on the lengthening and strengthening of these muscle groups. You can’t strengthen a tight muscle! Exercises based around the principles of Pilates and Yoga can be fantastic to help these muscles release or stretches such as seated glute stretch, seated hip flexor stretch and a wall side bend stretch can really help to release those muscle groups.
It is great to then progress to reconnect with your core and the muscles around the pelvis – the pelvic floor and glutes! Gentle progression into resistance-based exercises to start activating the glutes include exercises such as:
Clams or side lying leg raises
Sit to stands
Glute bridging with theraband
These muscles help to support the lumbo-pelvic region of the body, so gradually adding in strengthening exercises can help manage your symptoms by balancing out that bracing and tightness through your anterior core muscles.
Some exercises to avoid following an Endo diagnosis:
Sit-ups and crunches
High-impact exercises eg. Running/burpees
That’s not to say you can never return to high-impact exercise, however your body will require some rest and recovery to allow itself to heal while reducing these guarding postures. It is always best to start slowly after surgery and to work with a professional like an Accredited Exercise Physiologist to help you get there safely and successfully.
Bonocher, C., et al, (2014). Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology 12, 4.
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