Exercises to Avoid, Other Tips for Running with Endometriosis

Running with endometriosis is possible. In fact, exercise may help alleviate symptoms. Read on to learn what exercises to avoid with endometriosis flares, and how to manage your pelvic pain so you can keep doing what you love.

woman holding stomach
You can run with endometriosis–but listening to your body is key.

One of my athletes suffers from endometriosis, a painful condition that causes pelvic pain. When she is in pain, we have to adjust her running schedule until she is feeling well again. For this reason, I wanted to learn and write about endometriosis, including tips and exercises to avoid with endometriosis.

Endometriosis is when the inner lining of the uterus grows outside the uterus, including on the fallopian tubes, ovaries and tissue lining the pelvis (and sometimes in other organs). This tissue thickens, breaks down and bleeds with each menstrual cycle. However, unlike with a traditional period, it has nowhere else to go. This can lead to ovarian cysts, scar tissue, and adhesions that cause pelvic tissues and organs to stick together.

This can cause pain especially during menstrual periods. Along with pain, endometriosis can cause fertility problems. 

I spoke with OBN GYN Dr. Jaclyn van Nes and Dr. Carrie Pagliano, pelvic floor physical therapist, about the condition including tips to run with endometriosis and what if, any, exercises to avoid with endometriosis.

Now, let’s go!

Related: Can You Run a Race on Your Period

running with endometriosis pin
Running with endometriosis takes extra precaution. Pin the exercises to avoid with endometriosis, plus what to do if it flares up after running.

Consult Your Healthcare Provider

First and foremost, if you think you may have endometriosis, talk to your doctor. I am a running coach, not a healthcare professional, so medical advice should come from them.

Symptoms of endometriosis flare up include painful periods, bleeding in between periods, chronic pelvic pain, painful intercourse, painful bowel movements, bloating, and heavy periods.

Your gynecologist may suspect endometriosis based on your symptoms and a pelvic exam. However, the only way to diagnose endometriosis is through laparoscopic surgery that uses general anesthesia.

There’s no cure for endometriosis but hormonal interventions, pelvic floor physical therapy, and surgery can improve symptoms.

  • Estrogen causes growth, inflammation, and pain related to “endo belly”
  • Pelvic floor physical therapy can help relax pelvic floor muscles that may be too tight, contributing to pelvic pain, and
  • Surgery can remove scar tissue, adhesions, and cysts

Related: How Running Helps Anxiety & Stress

Does Exercise Help Endometriosis?

A woman’s symptoms with endometriosis can vary from person to person so widely, that there is no definitive evidence that exercise helps endometriosis for everyone. One study found inconclusive evidence that exercise helps endometriosis, while another study found that exercise may worsen endometriosis symptoms.

“For patients with pelvic pain which is often associated with endometriosis, exercise has been shown to improve pain, quality of life, mood and sleep,” says Dr. van Nes.

Indeed, there are many benefits of exercise that can help a woman with endometriosis overall feel better including:

Related: Can Exercise Help with Postpartum Depression?

High-impact Exercises to Avoid

However, in some cases, high-impact exercise may worsen endometriosis symptoms especially during a woman’s menstrual period. High-impact exercise can increase the release of prostaglandins in the circulation, which can trigger painful uterine contractions—exacerbating endometriosis symptoms.

You may not be able to run with certain medical conditions that may accompany endometriosis such as a large endometrioma (a type of ovarian cyst), says Dr. van Ness. These cysts are typically removed surgically.

It was once believed that high intensity exercise could worsen symptoms by tightening an already tight pelvic floor muscles—but this has been found untrue, says Dr. Pagliano. She adds that related issues could arise if you are running with endometriosis such as abdominal pain, hip pain, and urgency frequency.

Related: Solutions for a Tight Pelvic Floor

If you are think you have been experiencing an endometriosis flare up after running, avoid high-impact exercises such as the below:

  • Running
  • Hiking
  • Strength training
  • Jumping
  • HIIT workouts or plyometrics
  • Sports like soccer, basketball, tennis, or gymnastics

Related: When Should I See a Pelvic Floor Physical Therapist?

endometriosis and exercise pin
Running with endometriosis takes extra precaution. Pin the exercises to avoid with endometriosis, plus what to do if it flares up after running.

What To Do Instead

If doing high-impact exercises aggravate your endometriosis symptoms, consider low-impact movement. Endometriosis workout examples include:

All these exercises can be beneficial to your running and your endometriosis symptoms.

Yoga, barre, and Pilates can strengthen your core and pelvic floor which is beneficial to your running and for reducing your pelvic pain.

Cycling, walking, and swimming will strengthen your aerobic system which will help your running. It will also help reduce your estrogen levels, which can lessen your endometriosis symptoms.

On days you don’t feel up for running, choose whatever of the above exercises sounds—and feels!—good to you. When you feel up to running again, I recommend halving your normal daily mileage on your first run to see how it feels. Walk as needed. 

Related: The Best Cross-training Exercises for Runners

endometriosis IG post
Running with endometriosis is possible if women stay flexible and let their body be their guide.

5 Tips for Running with Endometriosis

1. Talk to your doctor about treatment.

Always, always, always, talk to your doctor about your endometriosis symptoms and ask about “how to fix endo belly”. It is possible your doctor can prescribe hormonal medications, or perform surgery to help alleviate your symptoms.

2. Seek help of a pelvic floor physical therapist.

Endometriosis affects the function of your pelvic floor muscles. Dr. Pagliano suggests women with pelvic pain from endometriosis connect with a pelvic floor physical therapist trained in treating endometriosis and runners. She can then prescribe exercises for endometriosis and endometriosis stretches such as happy baby or child’s pose to help you feel better.

3. Keep track of your symptoms.

Keep a journal and note when you experience an endometriosis flare up. Note, does endometriosis flare during ovulation? For some women because of the increased estrogen, it can. What about during your period? How long does a endometriosis flare up last? For you, it may be just during ovulation and your period. For other women, it may last weeks due to increased inflammation in the body.

Note what makes it worse and what makes it better. For some women, running may help alleviate symptoms—while for others, running with endometriosis may make it worse. Or, it may make it feel worse during but better after.

For my athlete, a heat pad helps her endo belly. Others get relief from pain relievers like Advil.

Related: Does Ibuprofen Help Injuries Heal Faster?

4. Adjust your running to align with your symptoms.

Once you know when you will likely have an endo flare, and what may cause it, adjust your running. For many of my athletes, we time a “down week” which is a reduction in training volume by 30 percent, during their periods when they have cramps and feel yucky. (Down weeks are good for all runners!). 

A similar tactic can be useful for women with endometriosis who don’t feel up for running. During flares, scale back your running and focus on supplemental cross-training activities that make you feel good such as yoga or barre.

Working with a running coach (like me!) can help you adapt your running so you can stay on track!

5. Reach for the antioxidants.

Eating foods rich in antioxidants that fight inflammation such as berries, nuts, seeds, fatty fish, and avocados may help alleviate endometriosis symptoms. Also, steer clear of foods that may cause inflammation such as simple carbohydrates and processed foods which may help you feel better, research finds.

Related: 7 Science-backed Reasons Running Makes You a Better Mom

The Bottom Line

Running with endometriosis is possible. The key to exercise with endometriosis is to listen to your body and have a back-up plan for when running exacerbates symptoms, or you just do feel up for it.

It can be so hard to be flexible as a runner, but using days you can’t run to supplement your training with other beneficial exercises will keep you moving forward.  

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