Strengthening the Core and Endo

I've been hearing it for decades now: "Having a strong core is integral to being healthy". When my low back and hip issues (caused my degenerative and herniated discs and labral damage) began to impact me with daily pain, core strengthening is what was prescribed.

What helps one condition may worsen another

But here's the thing: When you have many different disorders, what might help one condition does not necessarily help the other. In some cases, it can even induce or exacerbate symptoms of something else. Furthermore, I find that there's a really stiff cliff effect where certain regimens or exercises can help in moderation, but the bar is low for overdoing it. What initially helped can quickly start to hurt and make things worse. This is especially true in a body like mine, which is easily susceptible to injury due to my having a connective tissue disorder. This has especially been true with abdominal strengthening exercises, whether it be Kegels or stomach crunches.

Why traditional exercises didn't work for me

Here's one experience I had: when I was in my late-20s and in graduate school, I started having a lot of bladder issues and even some leakage. I went to a uro-gynecologist. I was immediately diagnosed with a "weak pelvic floor" (though there was no internal exam even conducted) and prescribed 50 Kegels a day, which I did dutifully. The problem then quickly became much worse to the point where in one instance, I full out wet my own bed (which I never even did as a child). I sought a second opinion, and this time a pelvic exam was conducted and other diagnostic tests were run.

It was instead deduced I did not in fact have a very weak pelvic floor but a very tight one that was prone to spasm, as well as interstitial cystitis (IC). Instead, I was offered pelvic PT that focused more on calming and stretching techniques to relax my pelvic floor rather than strengthen it. I improved and recovered.

The risks of abdominal strengthening with endo

I later read that too much abdominal strengthening can actually aggravate endo symptoms. This is, perhaps, because we've already got a lot of stuff growing and going on inside our pelvic cavity and perhaps stressing it out or constantly tensing muscles in that region isn't always the best thing for it.

Don't get me wrong: It's important to try to maintain a decently strong and stable core.... but it's probably best to achieve a balance between trying to attain/maintain some strength and not overdo it and overexert a sensitive area where a disease is active.

Finding endo-friendly alternatives

A couple of years ago, I was in a PT program devised especially for those with chronic pain. I mentioned my concern about core exercises and together my PT and I came up with a few low impact core strengthening exercises that I do several mornings a week. They keep my core stable and therefore reduce my low back and hip pain, without bringing on abdominal stress that bothers my endo or other related pelvic conditions (such as IBS and IC). I would recommend anyone struggling with this find their own PT, preferably someone who specializes in pelvic pain, and collaborate with them to tailor a gentle regimen with your specific needs in mind.

Have you found that core strengthening exercises help or hurt? What regimens work for you (if any)? Please answer in the comments below!