Pelvic Floor & Myofascial Pain After Endometriosis Surgery
Why Do I Still Hurt series article three about pain post-endometriosis surgery. Learn the basics about myofascial pain and treatment options.
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Explore how pelvic floor muscle issues can amplify endometriosis pain. Learn about symptoms, links to bladder, bowel, and sexual dysfunction, and evidence-based treatments—pelvic PT, relaxation, biofeedback, and at-home care.
Overview
Pelvic floor dysfunction is common in women with endometriosis and adenomyosis. Chronic pelvic pain, uterine cramping, and inflammation can cause the pelvic muscles to tighten and guard, creating trigger points and nerve sensitivity. The result may be deep or superficial dyspareunia, burning pelvic pain, tailbone or hip aches, difficulty emptying the bladder or bowels, and pain that lingers after periods or intercourse. These muscle-driven symptoms can mimic disease progression, yet they are treatable and often improve with targeted care.
Evaluation focuses on a skilled PT oriented pelvic exam—usually by a pelvic floor physical therapist—to identify overactivity, tenderness, and coordination issues. Treatment centers on “down‑training” tight muscles with manual therapy, biofeedback, breathing and relaxation, vaginal dilators when appropriate, and gradual return to activity. Care is individualized and complements, but does not replace, treatment for endometriosis or adenomyosis. For related concerns, explore Pelvic Floor PT, urinary topics in Urinary Symptoms and Interstitial Cystitis, and bowel patterns in GI Symptoms and IBS / IBD.
Common Questions
Is it normal to feel broken from endometriosis pain during sex?
Yes, feeling this way is incredibly common, and it doesn’t mean you’re broken. Pain with sex can be a symptom of endometriosis, reinforced by pelvic floor guarding and increased pain sensitivity, and treatment can address these pain drivers while supporting recovery.
Why does endometriosis cause tailbone pain?
Endometriosis can cause tailbone pain when pelvic inflammation and pain keep pelvic floor muscles clenched, referring pain to the coccyx. Nerve sensitization can also develop, so discomfort can persist or flare even when the original trigger seems small.
Why does cyclical leg pain switch sides?
Cyclical leg pain can switch sides because hormonally driven pelvic inflammation, swelling, and pelvic floor muscle tension can irritate the right or left nerve pathways at different times in the month. This pattern does not rule endometriosis in or out.
Why does endometriosis feel like twisting pain?
Endometriosis can feel like twisting when scar-like tissue and adhesions tether organs, making movement or cramping feel like pulling inside. Sensitive nerves and pelvic floor muscles that tighten around chronic pain can add to the gripping feeling.