How physical therapy for endometriosis can help you
Learn how pelvic floor physical therapy can help relieve endometriosis pain, improve function, and support bladder, bowel, and pelvic health.
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When you think of physical therapy, you might picture treatment for back pain or sports injuries. But it can also play an important role in managing pelvic pain — including pain related to endometriosis.
Pelvic floor physical therapy is a specialized type of care that focuses on the pelvic floor and can help reduce pain, improve function, and support your daily comfort. "A pelvic floor PT can help address a range of muscle issues in the area — from tension and tightness to weakness and coordination — and improve symptoms like pain, bladder function, and bowel function," says Holly Tipp, PT, DPT, a physical therapist with Hinge Health.
While physical therapy (PT) doesn’t treat the underlying causes of endometriosis itself, it can be a valuable part of your care — whether you’re managing symptoms conservatively, preparing for surgery, or recovering from surgery. Ahead, Hinge Health pelvic floor physical therapists explain how pelvic PT can help ease pelvic and abdominal pain, and suggest gentle targeted exercises for endometriosis relief.
Fully Covered Pelvic Care
What is endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, often on the ovaries, bladder, or other pelvic structures. “When this tissue grows outside of your uterus, it can trigger inflammation and pain,” Dr. Tipp says.
In North America, endometriosis affects up to 1 in 10 women of reproductive age and is commonly associated with chronic pelvic pain.
The exact cause isn’t fully understood, and diagnosis can take time. Many people experience symptoms for at least a decade before receiving a diagnosis, which can delay treatment and support.
Symptoms of endometriosis
Symptoms can vary widely. Some people have endometriosis without noticeable symptoms, while others experience significant pain.
The most common symptom is painful periods. “These can be severe enough to interfere with daily activities,” says Dr. Tipp. Pain may begin before your period and last throughout.
Other symptoms may include:
Pain with bowel movements, sometimes along with constipation
Frequent urination or urgency
The connection between endometriosis and pelvic floor dysfunction
Pain from endometriosis can affect how your muscles behave — especially in your pelvic floor.
“When your body senses pain, it often responds by tightening the surrounding muscles to protect the area,” says Dr. Tipp. Over time, this can lead to persistent muscle tension and reduced coordination.
Endometriosis can also place pressure on nearby organs, which may change how your pelvic floor muscles function and contribute to symptoms like bladder or bowel issues.
How physical therapy can help manage endometriosis
Pelvic floor physical therapy focuses on improving how your muscles move, relax, and coordinate.
"It helps address changes in muscle function that develop in response to pain — whether that's tension, weakness, or difficulty coordinating," says Dr. Tipp. Treatment often includes techniques to improve mobility, reduce pain sensitivity, and support better muscle function in your pelvic floor and core.
A physical therapist may help you:
Reduce pelvic muscle tension
Improve coordination between your pelvic floor and core
Manage bladder and bowel symptoms (such as incontinence or difficulty with bladder emptying)
Support your nervous system to reduce pain sensitivity
Pelvic floor PT can be especially helpful if your symptoms are persistent but not currently being treated with surgery, or as part of preparation and recovery if surgery is part of your care plan.
Research suggests that consistent pelvic floor therapy can help reduce pelvic and genital pain and improve overall function.
Physical therapy approaches for endometriosis
Your care plan will be tailored to your needs, but pelvic floor PT often includes a combination of the following:
Pain education. Your PT will help you understand how pain works and give you tools to manage it. "We want patients to know that pain doesn't always mean damage," says Dr. Tipp. "Often, it means your nervous system has become more protective — sending louder signals even when tissues are safe. That's something we can work on together." Techniques like deep breathing and mindfulness can help calm your nervous system and reduce pain intensity.
Exercise and stretching programs. Gentle stretches and movement help reduce muscle tension and improve mobility. Your PT will also help you find the right exercises for where your body is right now. “In some cases, strengthening exercises like Kegels may not be appropriate, especially if your muscles are already tight,” says Dr. Tipp.
Hands-on techniques. Manual therapy — applied externally or internally with dilators or a pelvic wand (tools made of silicone that are gently inserted into the vagina) — can help release tight muscles and trigger points, improving comfort and mobility.
Exercises for endometriosis
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- Seated back bends
- Reverse Kegels
- Open book
These exercises focus on reducing tension, improving mobility, and helping your pelvic floor muscles relax and coordinate more effectively. Over time, they can support better movement, ease discomfort, and improve daily function.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
Benefits of physical therapy for endometriosis
Here’s a closer look at how physical therapy can help to relieve the symptoms of endometriosis:
Reduces muscle tension and releases trigger points. Endometriosis-related pain often causes pelvic muscles to tighten as a protective response — which can add to symptoms like pain during sex, bowel movements, or daily activities. Deep breathing, stretching, and specific tools such as a pelvic wand can help those muscles relax and ease that cycle of pain and tension.
Improves pelvic mobility. “When you have pain from endometriosis, you may automatically fall into certain postures to feel more comfortable,” says Dr. Tipp. You may lean over more, for example, in response to tightening abdominal and pelvic muscles. “When we work to stretch tight muscles and strengthen weak ones, it allows your pelvis to move more freely and easily.”
Enhances circulation and supports tissue health. Endometriosis involves ongoing inflammation, and your pelvic tissues can become tender and sensitive as a result. Deep breathing and gentle pelvic exercises help increase blood flow to those areas, which can support healing and reduce discomfort over time.
Supports bladder and bowel function. Your pelvic floor PT can help you manage symptoms related to bladder and bowel function, such as constipation, pain with bowel movements, or a frequent or urgent need to urinate.
Decreases pain sensitivity. Your PT will work with you to help reduce sensitivity in your pelvic region. “If a patient has a scar from endometriosis surgery, for example, we’ll teach them how to gently touch and move that scar tissue to help them become more comfortable with touch in that area,” says Dr. Tipp.
Builds confidence. As your pelvic and abdominal muscles become stronger and more flexible, movement often feels more comfortable. “Pelvic floor physical therapy gives patients tools to better manage their pain,” says Dr. Tipp.
Offers emotional support. Endometriosis can take a toll both physically and emotionally. Many people spend years trying to get a diagnosis or feeling dismissed. “It can be incredibly validating to have your pain acknowledged and taken seriously,” says Dr. Tipp. Your pelvic floor PT can also help you explore different treatment options, including whether surgery may be appropriate.
PT tip: Stay active
When you have endometriosis, movement may feel uncomfortable — especially during your period. But gentle exercise can actually help reduce pain by boosting endorphins and calming your nervous system. “Try gentle breathing or stretching, and if you’re able, go for a slow, relaxing walk,” says Dr. Tipp. Research also shows that regular movement can help ease endometriosis-related pain.
How Hinge Health can help you
If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
References
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2. Moradi, Y., Shams-Beyranvand, M., Khateri, S., Gharahjeh, S., Tehrani, S., Varse, F., Tiyuri, A., & Najmi, Z. (2021). A systematic review on the prevalence of endometriosis in women. Indian Journal of Medical Research, 154(3), 446–454. doi:10.4103/ijmr.IJMR_817_18
3. Tsamantioti, E. S., & Mahdy, H. (2023). Endometriosis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK567777/
4. Endometriosis Foundation of America. (2019, May 21). What Is Endometriosis? Causes, Symptoms and Treatments. Endometriosis : Causes - Symptoms - Diagnosis - and Treatment. https://www.endofound.org/endometriosis
5. Endometriosis: Does It Cause Infertility? (2024). Reproductivefacts.org. https://integration.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/endometriosis-does-it-cause-infertility/
6. Gabrielsen, R., Tellum, T., Bø, K., Engh, M. E., Frawley, H., Nedregård Tveito, S., & Tennfjord, M. K. (2025). Supervised exercise and pelvic floor muscle training eases current pelvic and genital pain but not worst pelvic and genital pain in women with endometriosis: a randomised trial. Journal of Physiotherapy, 71(4), 246–253. doi:10.1016/j.jphys.2025.09.012
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