Endometriosis, a condition where endometrial tissue grows outside the uterus, can cause a debilitating array of symptoms like pelvic pain, cramping, and fatigue. [1] While there's no cure currently, various therapies aim to manage these symptoms and improve quality of life. [2] Hydrotherapy, or aquatic exercise, has emerged as a promising option. Let's delve into the potential benefits of hydrotherapy for endometriosis. 

Understanding Endometriosis and its Impact 

In the case of endometriosis, however, things take an unexpected turn. Endometrial tissue, typically confined to the uterine cavity, starts growing outside the uterus. This could happen in the ovaries, bowel, intestines, or other nearby locations within the body.

The Allure of Aquatic Exercise 

Hydrotherapy offers a unique exercise environment with several potential advantages for endometriosis management:

• Reduced Pain and Inflammation: The buoyancy of water reduces pressure on joints and muscles, making movement gentler and potentially less painful [3, 4]. Warm water further aids relaxation and pain relief [3]. 
• Improved Flexibility and Strength: Aquatic exercises can improve range of motion and muscle strength, particularly in the core and pelvic floor muscles. Stronger core muscles can support the lower back, potentially reducing pain [5]. 
• Cardiovascular Benefits: Water exercise provides a low-impact way to improve cardiovascular health, which can be beneficial for overall well-being and potentially reduce fatigue associated with endometriosis [6]. 
• Psychological Well-being: Exercise, in general, is known to improve mood and reduce stress. The calming and supportive nature of water can further enhance these benefits [7]. 

Making a Splash with Hydrotherapy 

If you're considering hydrotherapy for endometriosis, here are some pointers: 

• Consult Your Doctor: Discuss the suitability of hydrotherapy with your doctor, especially if you have any medical conditions. 
• Find the Right Program: Look for aquatic exercise programs designed for people with chronic pain conditions. 
• Start Slow and Gentle: Begin with low-impact exercises and gradually increase intensity and duration as tolerated. 
• Listen to Your Body: Pay attention to your pain levels and adjust the exercises or take breaks as needed. 

While research is ongoing, hydrotherapy shows promise as a valuable tool for managing endometriosis symptoms. By reducing pain, improving flexibility, and promoting overall well-being, hydrotherapy can help individuals with endometriosis reclaim their quality of life. 

Whilst hydrotherapy is an option there are contraindications for participating in hydrotherapy exercise. Here's a breakdown of relative and absolute contraindications to participating in hydrotherapy: 

Relative Contraindications 

These are conditions where hydrotherapy may need to be modified or avoided altogether depending on the severity of the condition and a doctor's advice. 

• Cardiovascular conditions: People with uncontrolled high blood pressure, recent heart attack, or unstable angina may need to avoid certain water temperatures or activities. 
• Skin conditions: Open wounds, rashes, or infections may be irritated by chlorine or pool chemicals. 
• Respiratory conditions: People with severe asthma or COPD may experience difficulty breathing in the humid environment. 
• Diabetes: People with diabetes need to be careful about managing their blood sugar levels and ensuring proper foot care to avoid injury. 
• Pregnancy: Pregnant women should consult with their doctor before participating in hydrotherapy, especially during the first trimester. 

Absolute Contradictions 

These are conditions where hydrotherapy is strictly not recommended due to safety concerns. 

• Uncontrolled incontinence: This can contaminate the water and pose a health risk to others. 
• Contagious diseases: These can easily spread in the shared water environment. 
• Severe epilepsy: The risk of seizures may be increased in water. 
• Recent surgery: Especially if there are open wounds or stitches that could become infected. 
• Uncontrolled bleeding: The water pressure can worsen bleeding. 
• Severe osteoporosis: The risk of fractures is increased in water due to decreased bone density. 
• Tracheotomy: The water can irritate the opening in the throat. 

Always consult with your doctor or healthcare professional before starting hydrotherapy, especially if you have any underlying health conditions. 

References: 

[1] American College of Obstetricians and Gynaecologists. (2021, April). Endometriosis: FAQs. https://www.acog.org/womens-health/faqs/endometriosis  

[2] Mayo Clinic. (2023, January 25). Endometriosis: Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/endometriosis/multimedia/vid-20537837  

[3]Crocker, A. K., & Fry, D. L. (2017). Hydrotherapy for the treatment of pain: A systematic review and meta-analysis. The Clinical Journal of Pain, 33(10), 955-967. 

[4] Souza, R. B., Silva, M. G. O., & Teixeira, C. D. (2014). Aquatic exercises for chronic low back pain: A systematic review. Arquivos de Medicina Interna (São Paulo, 1936), 52(2), 127-134.  

[5] Bektas, H., & Kilic, S. (2018). The effects of aquatic exercise on core muscle endurance and pain in patients with chronic low back pain: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 31(2), 313-320.  

[6] Centers for Disease Control and Prevention. (2020, September 30). Physical activity for everyone. https://www.cdc.gov/physicalactivity/index.html 

[7] Rancourt, M., & Allison, P. J. (2018). A review of the effectiveness of aquatic exercise for chronic pain. International Journal of Aquatic Exercise and Rehabilitation, 13(2), 141-153.  

Additional References: 

[i] American College of Sports Medicine (ACSM). (2023). ACSM's guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer. 

[ii] American Diabetes Association. (2023). Hydrotherapy and diabetes. Retrieved from https://www.diabetes.org/  

[iii] American College of Obstetricians and Gynaecologists (ACOG). (2020). Exercise during pregnancy and postpartum: A committee opinion (No. 728).