A.P was a 22 year old female diagnosed with endometriosis and a few years of debilitating abdominal and pelvic pain, even after having surgery. She was referred by her gynecologist as they wanted her to exhaust conservative treatments before thinking about another surgery.
Initial Examination
Her evaluation findings showed a lot of adhesions between her abdominal wall uterus, bladder and rectum. Meetings with her referring doctor confirmed treating these adhesions as the priority, and together we developed her plan of care
Treatment
Being sensitive to her expressed level of anxiety around pelvic floor work, our treatment approach for her sessions 1x/wk started with lots of guided meditation, breath and self care education. This added with gentle manual therapy externally only helped to establish trust and reinforced the control she had in her plan of care.
After observing a trend of stress being a key trigger of her pain, we collaborated closely with a Cognitive Behavioral Therapist (CBT), who helped her develop stress management techniques as we progressed with her PT.
Outcome
After 16 visits, she reported a reduction in her pain by 75%, enjoyed physical intimacy a few times with very minimal pain and was doing daily self care work. Her symptoms were still present during her periods, but they were no longer to the point where she couldn’t leave her home.
