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Letโs talk honestlyโendometriosis isnโt just a โbad period.โ Itโs a full-body condition that can impact your energy, digestion, mood, and yes, your ability to move and exercise the way you want.
Pelvic pain, abdominal bloating (aka the infamous โendo bellyโ), fatigue, and tension that feels like your muscles are bracing for battle, those symptoms can show up even on whatโs supposed to be a โgoodโ day.
But hereโs the deal: movement matters. And not just in a โfitness influencer on Instagramโ kind of way. Gentle, intentional workouts can actually help reduce pain, boost circulation, improve posture, and support the pelvic floor.
The trick is choosing movements that respect what your bodyโs dealing with, rather than forcing it into routines designed for a totally different context.
So if youโve ever Googled something like โcan I do leg day with endometriosis?โ or โis it safe to work my abs with pelvic pain?โ youโre in the right place.
Table of Contents
ToggleCore Work: Building Strength Without the Strain
When people think โcore,โ they often picture crunches or planks. But for someone with endo, especially if there’s scar tissue or involvement of abdominal organs, those moves can be too much.
We want to engage the deep coreโthe transverse abdominis, pelvic floor, and obliques, in a gentler, smarter way.
Try: Supine Marches (a.k.a. Marching Bridges)

- What it targets: Deep core, pelvic stability, glutes
- Why it works: Youโre lying on your back, so thereโs no compression on the abdomen. Plus, itโs gentle on the spine and hips.
How to do it:
- Lie on your back with knees bent, feet flat on the floor, arms at your sides.
- Engage your core like you’re zipping up tight jeans.
- Slowly lift one knee toward your chest, keeping your pelvis stable.
- Lower and repeat on the other side.
Reps: 8โ10 per leg, 2โ3 rounds
Avoid: Full Sit-ups, V-Ups, and Intense Oblique Twists
Those kinds of moves increase intra-abdominal pressure like nobodyโs business, and they can flare pain or tension in the pelvic region. Not worth it.
Try: Dead Bugs (with a pillow or stability ball)
Dead bugs are one of those deceptively hard moves that are amazing for engaging the deep core without stress.
Youโll start by lying on your back with your arms reaching up toward the ceiling and your knees bent in a tabletop position. For a bit more control and connection, place a small pillow or a squishy ball between your hands and knees.
As you exhale, slowly lower one arm and the opposite leg toward the floor. Keep your lower back gently pressing into the mat, no arching.
Then return to the center and switch sides. Everything should move slowly and deliberately, like youโre doing core Pilates in slow motion.
What makes dead bugs so perfect for endo is that they teach your brain and core to stabilize while moving, without crunching or bracing hard.
They also allow for a ton of customization. If your symptoms are flaring, you can keep the range of motion small. If youโre feeling good, go for a bigger reach and extend fully.
- What it targets: Transverse abdominis, coordination, and spinal stability
- Why it works: Itโs a controlled way to engage the whole core without crunching or bracing too hard.
How to do it:
- Lie on your back with arms pointing to the ceiling and knees bent at 90 degrees.
- Option: Place a small pillow or ball between your knees and hands.
- Slowly lower your right arm and left leg toward the floor, keeping the core tight.
- Return to the start and switch sides.
Reps: 6โ8 each side, 2โ3 rounds
Try: Seated Pelvic Tilts (great for flare days)

Now, letโs talk about pelvic tilts. These are underrated, especially for people dealing with pelvic pain.
Sit on a chair or a stability ball with your feet flat on the ground and spine tall. From here, gently tip your pelvis forward and backward, almost like youโre rocking a bowl of water.
Thereโs no need to exaggerate the movement; keep it small and focused.
This exercise helps unlock tension in the lower back and gently reintroduces movement to the pelvis.
Itโs especially helpful during flare-ups when lying down feels uncomfortable, but you still want to move a bit.
- What it targets: Lower abdominals, pelvic mobility
- Why it works: No strain, no pressureโjust awareness and gentle movement.
How to do it:
- Sit tall on a chair or stability ball.
- Gently rock your pelvis forward and back, as if youโre tipping a bowl of water.
- Keep shoulders relaxed, breathe evenly.
Reps: 10โ15 tilts, slow and controlled
It sounds so simple, but that little movement can reconnect you to your core and relieve tension in the lower back.
Lower Body Strength Without Compression or Tension
The lower body is often where people lose strength, not because the muscles arenโt working, but because pain and fatigue get in the way of consistent training.
Add in poor sleep, inflammation, and tension from guarding the pelvic area, and youโve got a recipe for tight hips and underused glutes.
But when done thoughtfully, lower body exercises can help relieve pelvic tension.
Strong glutes, hamstrings, and hips give your body better alignment and reduce strain on the pelvis and lower back.
Try: Glute Bridges (with or without a band)
This is a staple for a reason. Lie flat on your back with knees bent and feet about hip-width apart.
Press through your heels to lift your hips toward the ceiling, squeezing your glutes at the top. Donโt push your hips so high that you arch your back, instead, focus on driving the movement from your butt, not your lower spine.
You can add a loop band above your knees to get more outer hip activation, or hold a small weight on your pelvis for resistance. Glute bridges are fantastic for activating the posterior chain without standing up or putting pressure on your pelvis.
- What it targets: Glutes, hamstrings, pelvic floor
- Why it works: You’re off your feet, so no pounding or pressure. Plus, activating the glutes helps stabilize the pelvis.
How to do it:
- Lie on your back, knees bent, feet flat.
- Press through your heels to lift your hips.
- Squeeze your glutes at the top, then lower with control.
Reps: 10โ12, 2โ3 rounds
Option: Add a loop band above the knees for extra resistance.
Avoid: Deep Squats and High-Rep Jump Lunges
Some people with endo feel fine doing squats. Others? Not so much. The key is moderation.
Deep squats can create downward pressure in the pelvis, and jump-style moves might trigger inflammation or joint pain.
Try: Modified Wall Sits (Short Hold Time)

If you want a way to build quad and glute endurance without jumping or lunging, wall sits are your friend.
Stand with your back flat against a wall, then slowly slide down until your thighs are at about a 45-degree angleโno need to drop into a full squat unless your body likes that.
Hold for 15โ30 seconds, breathing steadily.
This is an isometric move, which means youโre holding a position and engaging your muscles without moving.
It builds strength without pounding your joints or increasing pressure in the pelvis.
You can also place a small pillow or ball between your knees to gently work your inner thighs, which are part of your pelvic stabilizers, too.
- What it targets: Quads, glutes, core
- Why it works: Controlled isometric strength without bouncing or shifting.
How to do it:
- Stand with your back against a wall, feet hip-width apart and slightly forward.
- Slide down into a mini squat, thighs maybe 45 degrees, not parallel.
- Hold for 15โ30 seconds. Rest. Repeat 2โ3 times.
Option: Place a soft ball or pillow between your knees to gently activate the inner thighs.
Try: Standing Hamstring Curls (no equipment needed)
@sarahhersefitness Maybe you donโt have access to a leg curl machine or youโre just looking to switch up your leg exercises! Here are 8 great alternatives to a traditional hamstring curl machine. #legdayworkout #hamstringexercises #hamstringcurls #legpump #fitness #gym #gymtok โฌ Drop – Connor Price & Zensery
This is a no-equipment-needed move you can do anywhere. Stand tall next to a chair or wall for balance.
Shift your weight onto one leg, then slowly bend your other knee, bringing your heel toward your glutes.
Focus on squeezing the back of your leg, not kicking or swinging. Then lower and repeat.
It seems like a small motion, but standing hamstring curls wake up the back of the legs, build knee stability, and gently challenge your balance, too.
And they donโt compress your belly or aggravate scar tissue, which is a big win.
- What it targets: Hamstrings, glutes, balance
- Why it works: Low impact, keeps blood flowing, and is easy to adjust.
How to do it:
- Stand near a wall or chair for balance.
- Shift weight to one leg.
- Slowly bend the other knee, curling the heel toward your glutes.
- Lower and repeat.
Reps: 12โ15 per leg, 2โ3 rounds
Pelvic Floor: Yes, It Matters (But Maybe Not the Way You Think)
A lot of fitness advice for people with endo skips the pelvic floor, or overemphasizes Kegels. The truth? It depends.
Some people with endo have a tight pelvic floor (not weak), so more Kegels might actually increase pain.
Whatโs better is focusing on relaxation, coordination, and awareness.
Try: Diaphragmatic Breathing with Pelvic Drop

- What it targets: Breath-pelvic floor connection, relaxation
- Why it works: Calms the nervous system, reduces guarding in pelvic muscles.
How to do it:
- Lie on your back with your knees bent.
- Inhale through the nose, allowing your belly and ribs to expand.
- Exhale slowly through the mouth, imagining the pelvic floor gently โdroppingโ like a hammock.
Reps: 6โ8 deep breaths, daily if you can
Sample Weekly Routine (Totally Modifiable)
Day | Focus | Notes |
---|---|---|
Monday | Core + Glutes | Supine marches, glute bridges |
Tuesday | Rest or gentle yoga | Focus on breath & pelvic mobility |
Wednesday | Legs + Core | Wall sits, dead bugs |
Thursday | Breathing + Mobility | Seated pelvic tilts, stretches |
Friday | Core Focus | Dead bugs, bridges, and hamstring curls |
Saturday | Optional light cardio | Walking, cycling, and elliptical |
Sunday | Full rest or restorative movement | Gentle stretching, breathing |
Remember, itโs not about sticking to a rigid routineโitโs about listening to your body and adjusting on the fly.
A Few Things to Keep in Mind

1. Flare-ups happen.
Some weeks, everything feels off. Thatโs okay. Resting, walking, or stretching might be the most effective โworkoutโ you do.
2. Warm up always.
5โ10 minutes of gentle dynamic stretching or even walking in place can make a huge difference in how your body responds.
3. Hydration and inflammation are connected.
Dehydration can increase cramping and stiffness, so keep that water bottle handyโespecially after any kind of exertion.
4. Skip the no-pain-no-gain nonsense.
Youโre working with a condition that can be unpredictable. If a move doesnโt feel right, skip it. Thatโs not weaknessโitโs wisdom.
Final Thoughts
You donโt have to avoid working out just because you have endometriosis, but you do need to make smart choices. The right exercises can help manage pain, strengthen the muscles that support your pelvis, and boost your energy without setting you back.
Itโs not about pushing through pain. Itโs about staying consistent, choosing movement that feels good, and giving your body the support it needs, on good days and not-so-good ones.
If one move doesnโt work, try another. If a day calls for rest, honor that. Progress isnโt a straight line, itโs a collection of small, kind choices.
Got questions about tailoring workouts to your body or need help building a routine? Let me know, happy to help.
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