Physiotherapy Care in Endometriosis- Advanced Level

Dates: 18-19-20 of September
25-hour in-person course, Oporto, Portugal
Recommended prerequisite: foundational skills in pelvic ultrasound.

1. Pathophysiological Foundations of Endometriosis

• Current theories: retrograde menstruation, metaplasia, stem cell theory, neuroangiogenesis

• Hormonal, inflammatory and immune mechanisms

• Deep infiltrating vs peritoneal vs ovarian endometriosis: biological differences

• How lesions behave: fibrosis, adhesions, cross-sensitization

• Impact on pelvic organs and movement dynamics

2. Pain Neurophysiology in Endometriosis

• Types of pain: nociceptive, inflammatory, neuropathic, nociplastic

• Peripheral sensitization: neurogenic inflammation, neurotrophins, sprouting

• Central sensitization: cortical reorganization, descending modulation

• Visceral–somatic convergence and pelvic cross-talk

• The role of the autonomic nervous system

• Predictors of chronicity

3. Pain Phenotypes in Endometriosis

• Identifying pain drivers: nociceptive, nociplastic, visceral vs. somatic, myofascial, neuropathic, other pain phenomena;

• The “Endo Trifecta”: lesion-related pain, cross-sensitization pain, sensitization

• Overactive pelvic floor & neurovascular & neuromuscular adaptations

• Ultrasound (RUSI Method) + clinical reasoning → intervention

• Phenotype-based profiles for decision-making

4. Clinical Intervention in Endometriosis: The 360º Framework

• Deep dive into a multidisciplinary model

• Medical + surgical approaches: what physios must understand

• Biopsicossocial approach: nutrition, sleep, stress, gut–pelvis axis, mental health.

• Exercise, movement literacy and load management

• When to refer, how to co-manage

• Building long-term care plans

5 . Intervention: Assessment & Treatment

• Advanced subjective assessment of endo patients

• Mapping pain & questionnaires

• Ultrasound assessment findings & clinical reasoning

• Tool box for overactive pelvic floor

• Visceral mobility, neuropelveology insights

• Abdominal-lumbar-pelvic function (CALP) in Endometriosis

• Physio Tool box: intervention techniques in Endometriosis

6 . Principles of Therapeutic Exercise in Endometriosis

• Mobility vs stability vs load progression

• Breathing-based strategies

• Strength training for endo patients

• Abdominal-lumbar-pelvic function (CALP)

• Exercise during flares

• Building a sustainable program

7 . Clinical Reasoning Applied to Endometriosis

8 . Case Studies & Hands-On Integration