Self-management during Covid

Endometriosis New Zealand understand that the COVID-19 pandemic is a source of significant worry and uncertainty for everyone. We can only imagine how disappointing it must be to have had appointments, surgery or fertility treatment postponed, especially if you had been waiting a long time for it. We are still here to support you throughout all the alert levels and you can book a free 30-minute Endo Help session here, or phone our ENZ Coordinator on 03 379 7959 if you have any questions or concerns. We’re here to help you!

We would like to offer you some reassurances and suggest the following self-management strategies to get you through the coming weeks as best as possible. 

Pelvic Exercises

Here are a few simple pelvic exercises recommend for women with endometriosis to do at home. If you need further guidance or you feel like they may make things worse, speak to a pelvic physiotherapist.

1. Diaphragmatic Breathing

Deep breathing helps to allow for the ribs to expand, easing tension in the back, right up to the neck, and down into the pelvis. Often women with pain will take shallow breaths into their upper chest so their diaphragm doesn’t really get a stretch. The diaphragmatic breath calms the nervous system, which leads to less pain. You can do deep, wide breathing anywhere. I suggest taking 5–10 deep wide breaths every hour.

2. Pelvic Floor Drops

Very often women with endometriosis and pelvic pain actually have a tight and tense pelvic floor, so I recommend reverse kegels or pelvic floor relaxation exercises. We want to lengthen and relax the pelvic floor, especially with women who have pain with sex. Imagine the way a pebble drops into a pond, and imagine the ripples it makes outwards. Visualise this in your pelvic floor, and feel the way the pelvic floor muscles let go. Another image is visualizing your pelvic floor as an elevator in a 3 story building, then imagining the elevator at the roof coming down to ground floor and the elevator doors opening. You can combine this with your diaphragmatic breath and as you breathe in feel the elevator dropping to ground floor, and to get more relaxation, as you breathe out, feel the elevator coming down to the basement. Again try to do 5–10 breaths combined with pelvic floor drops every hour.

3. Hip & Buttock Stretch

This is a really great simple hip opening stretch that also allows your buttocks and deep hip rotators to stretch. Simply lay back on your mat or on your bed with your knees bent, then take one ankle onto the opposite knee and use your hand to gently press away at the knee. Because a lot of women with endometriosis and pelvic pain often curl up in pain, we really want to open the hips, but in a gentle way. Hold this stretch for 60 seconds or as long as your feel comfortable and repeat daily.

4. Groin Stretch

This is another effective hip opening stretch that also lengthens the pelvic floor and allows the tailbone to soften away from the hips. You can do this laying back on your mat or in bed. Slowly bring both knees up towards your chest, and then when you are comfortable, slowly take the knees apart towards your shoulders. You can rest here for 60 seconds, and focus on your deep breathing and pelvic floor drops.

5. Hip Flexor Stretch

I love this yoga variation of the hip flexor stretch because you get a lot of lengthening of the muscles and connective tissue along the front of the body. The front of the hips, the pelvis, the belly and the chest all get a deep stretch. Start in kneeling on your knees on a mat (you can have a towel or blanket under your knee), then take a step forwards with one foot. Rest here for a moment before starting to bring bot arms up towards the ceiling. Rest here again and start to lunge forwards and lift your belly to the ceiling. Take a slow deep breath as you move from each position, but only go to a place where you are comfortable. Hold this stretch for 60 seconds as your breathe deeply and feel your pelvic floor melting down.

6. Shell Stretch

Finish off with a shell stretch by sitting back on your heels and curling forwards bringing your forehead to the mat. Reach your arms forward on the mat. If you feel comfortable, you can even take your knees out into a child pose stretch. This is a really great restorative pose that allows you to expand into your diaphragm more as your breathe in, and also lengthens the pelvic floor. Spend some time here whilst you breathe and visualize your pelvic floor muscles softening down, as your chest and breastbone also melt to the mat.

Sleep

Try to get 7-9 hours of sleep each night and maintain regular sleeping patterns with good sleep practices. You may want to try mindfulness activities that may help you fall asleep or sleep remedies like chamomile tea or lavender oil on your pillow.

Yoga

Yoga offers several benefits that may help reduce endometriosis symptoms such as stress, tension, and pain. It also encourages relaxation, which helps relieve discomfort and calm your mind.

The following restorative yoga stretches are beneficial. If you are can try some of these poses, spend some time in each of these poses whilst you breathe in deep and wide, and visualize your pelvic floor muscles softening down. You can complete the stretches in the following order. 

1

2

3

4

Education

During Covid 19 there may be an opportunity to learn more about Endometriosis. We recommend having a good read through our website and downloading the free e-book “Pelvic Pain”.

Download pelvic ebook

Diet

Try to eat well-balanced meals, including adequate fibre and drink plenty of water to avoid constipation and avoiding known triggers of bladder symptoms (may include alcohol, acidic fruits etc). We do suggest discussing this with a professional before making major diet changes.

There is also an awesome article called, Endometriosis and Nutrition – Sara Widdowson, it’s full of useful tips and information.

Read full article

Heat

Why not consider trying adhesive heat patches that provide a stable temperature for long durations. The heat will help loosen and smooth muscles, making the cramping pain less intense.

Physical Exercise

Physical activity and exercise are essential to good health and general well-being for everyone. If you have endometriosis, we suggest using previous and current personal experiences to judge what exercise is appropriate and to take a graduated approach to advance this exercise, setting achievable goals. 

Social Activities

Try to maintain social activities, following the rules of the current alert levels. If you live alone, invite friends and family to connect on video or zoom

Social support

Try and keep in touch with people you usually see often or take the opportunity to reconnect with old friends. The Endometriosis New Zealand Facebook group is a great place to connect with others living with endometriosis.

Relaxation and mindfulness

During self-isolation, relaxation, breathing exercises and mindfulness are helpful to people suffering with endometriosis they will help relieve stress and reduce anxiety. First Steps is a great website and app you can use to help.

Information above summarised from the article, “Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic”

Mathew Leonardi, Andrew W Horne, Katy Vincent, Justin Sinclair, Kerry A Sherman, Donna Ciccia, George Condous, Neil P Johnson, Mike Armour.

Strength through support - mā te tautoko, ka whai kaha, ka ora

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