Understanding Pain & Flares while Exercising with Endometriosis
Why You Should See a Women's Health Exercise Physiologist Before Starting Exercise with Endometriosis
Endometriosis is a complex, systemic condition that goes far beyond the reproductive system. For many living with endo, the body operates in a constant state of heightened sensitivity. This often presents as chronic pain, fatigue, digestive issues, and an overstimulated nervous system that is always "on."
When it comes to exercise, this upregulated nervous system plays a major role. Traditional fitness advice often encourages pushing through discomfort or going harder to get stronger. But for those with endometriosis, this mindset can do more harm than good.
The Role of the Nervous System in Endo
Endometriosis is associated with central sensitisation—a state in which the nervous system becomes hypersensitive and overreacts to stimuli that wouldn't normally be perceived as painful. This means that even gentle forms of stress, like certain types of exercise, can trigger a protective response in the body.
One common way the nervous system "protects" is through guarding: the unconscious tightening of muscles around perceived vulnerable areas, especially the pelvis. This protective guarding can result in excessive muscle tone, particularly in the pelvic floor, hips, lower back, and abdominal wall. Over time, this pattern of compensation can increase pain, reduce mobility, and make exercise feel uncomfortable or even threatening.
Understanding Compensations
When we move, especially in the presence of pain or chronic tension, our bodies often develop compensatory movement patterns to get the job done. These compensations may not cause issues immediately, but over time, they can lead to more joint stress, muscle imbalances, and nervous system upregulation.
For example, someone with endo might unknowingly brace their abdominal wall or clench their pelvic floor during exercise. While this might feel like "engaging your core," it can actually perpetuate the cycle of tension, reduce blood flow, and signal to the nervous system that movement is unsafe.
The Role of a Women's Health Exercise Physiologist
This is where working with a Women’s Health Exercise Physiologist (EP) can be game-changing.
A Women's Health EP is trained to:
Assess and correct compensatory movement patterns
Support nervous system downregulation through breathwork, pacing strategies, and controlled movement
Guide you in building strength without exacerbating pain or flares
Teach pelvic floor release techniques and improve awareness of muscle holding patterns
Create a safe, structured approach to movement that builds confidence and resilience.
Showing you how to exercise, and progress in a safe way. You too can exercise, run, lift weights when you approach it in the right way.
Creating Safety Through Movement
A key principle in exercising with endo is creating an internal sense of safety. When your nervous system feels safe, it stops overreacting to movement. This is achieved by:
Learning how and where you're holding tension
Releasing overactive areas (like the pelvic floor or diaphragm)
Moving slowly and intentionally to start to build resilience in proper positions.
Progressing gradually and responding to your body’s cues
Instead of pushing through pain, the goal is to move in partnership with your body’s needs. Over time, this can help reduce flare-ups, improve sleep, and increase your capacity for more dynamic forms of movement.
You Deserve Support
Living with endometriosis means you already navigate complex layers of symptoms and challenges. Exercise should never feel like another source of stress or discomfort. With the right guidance and support, it can become a tool for empowerment, healing, and improved quality of life.
If you're ready to explore movement in a way that honours your body, we’re here to help. Book an assessment with one of our Women’s Health Exercise Physiologists and take the first step toward movement that truly supports you.