“We Are Never Just Our Endo”: A Conversation with Pelvic Physiotherapist Jill Mueller
Shani Boyd,
#chronicpain
#pain
#endometriosis
#sexualhealth
#health
Jill Mueller is a pelvic health physiotherapist with over 20 years of experience. Specialising in endometriosis care, she is the founder of EndoTogether, where she provides one-to-one physiotherapy for residents of Ontario, Canada, alongside online courses designed for both endometriosis patients and healthcare practitioners. She also facilitates a supportive Facebook community dedicated to connection, education, and shared experience.
In addition, Jill is a founding member of the Endometriosis360 team, which delivers an interdisciplinary, collaborative approach to endometriosis treatment. By combining her professional expertise with her lived experience and deep passion for pelvic health, she offers a truly comprehensive and holistic model of care.
We’re thrilled to welcome Jill to Bloomwell and to dive into a meaningful conversation about improving support and outcomes for those living with endometriosis.
When Jill first trained as a physiotherapist, she didn’t plan on specialising in endometriosis. In fact, she didn’t even know she had the condition until she was trying to get pregnant.
“I didn’t even know what endometriosis was,” she tells me. “I definitely had pain, but I was told it was normal. So I didn’t seek treatment because I thought it was normal.”
Like so many women, Jill’s symptoms were minimised. She underwent ablation surgery following an exploratory procedure, but it didn’t improve her pain or fertility. “There wasn’t as much information. I was just focused on trying to get pregnant.”
It wasn’t until later, after completing her fertility journey and moving into pelvic health physiotherapy, that everything shifted.
Integrating Lived Experience
Jill didn’t initially advertise that she had endometriosis herself. But when patients began opening up about their own diagnoses, she would gently mention her experience.
“And they would just cry,” she says. “They would be so relieved that they didn’t have to convince me.”
That moment of not having to justify invisible pain became pivotal for her clients.
“I realised I have a voice here that can be really powerful to help people.”
Now, Jill integrates lived experience with clinical expertise and pain science research to support people navigating endometriosis pain and medical dismissal.
How the Nervous System Influences Endometriosis Pain
A core part of Jill’s work focuses on pain science; particularly central sensitisation and nervous system dysregulation in chronic pelvic pain.
“I’m obsessed with the nervous system and the brain”
She explains that pain is not solely determined by tissue damage.
“Pain is 100% determined by the brain. Physical is one component the brain will consider, but it’s considering many other components.”
For some people with endometriosis, sensitisation, where the nervous system becomes overprotective and hypersensitive, becomes the primary driver of ongoing pain.
“When I used strategies to desensitise an overprotective nervous system, I was able to get out of my pain entirely.”
Importantly, this does not mean pain is psychological or “made up.”
“Pain is always real. It will always express itself in the body. There’s no difference between it being driven by sensitisation or by tissue. The experience is real.”
Research by As-Sanie S, et al. using functional MRI scans has shown measurable differences in brain activation patterns in people with endometriosis and chronic pain compared to those with endometriosis but no pain.
“It allows people to think about the brain and nervous system while also showing we can see [their pain]. It’s validating .”
Is Hormonal Birth Control the Only Treatment for Endometriosis?
Like many clinicians in women’s health, Jill is critical of the automatic prescription of hormonal contraception as a universal solution.
“You know what I call it?” she says. “I call it the shut up pill.”
For many young patients, the pill is offered before their bodies have fully developed, often without discussion of long-term impacts or alternative endometriosis treatment options.
“You’re 13. You don’t have a voice. You’re scared, you’re in pain, and the doctor tells you this is what to do.”
For Jill, the issue isn’t medication itself, it’s the lack of options and the dependency it can create in an already overstretched system.
“It’s so debilitating when you feel like you’re dependent on a medical system that we barely have access to.”
Jill is not anti-medication. Instead, she reframes its purpose within a broader treatment strategy.
“Let’s use it to put out the fires and build a foundation for resiliency, so that when you come off it, your system has something to land on.”
That foundation may include pelvic physiotherapy, nervous system regulation, bowel and bladder support, stress reduction, and lifestyle changes, particularly during long waiting periods for specialist care.
What Does Pelvic Physiotherapy for Endometriosis Involve?
In her clinical work, Jill assesses five key contributors to chronic pelvic pain:
- Local physical and fascial restrictions
- Nervous system sensitisation
- Pain-worry thoughts (often called pain catastrophisation in research)
- Conditioned pain responses
- Sensory-motor disregulation (a disrupted brain map of the pelvis)
She explains how even learned associations can trigger symptoms.
“I had a patient who used a hot pack every period. I asked her to imagine putting the hot pack on. She started cramping just thinking about it.”
This isn’t imagined pain. It’s a conditioned nervous system response.
“It’s like Pavlov’s dog. The brain has linked the cue to the response.”
Similarly, when the brain “disconnects” from the pelvis due to repeated pain or emotional stress, common during invasive exams or fertility treatment, the protective buffer zone can expand. Pain spreads. It mirrors. It persists even after surgery.
“This is why people can have a hysterectomy and still have period pain.”
Treatment becomes about restoring a sense of safety in the body.
“We’re helping to settle the nervous system back into its window of tolerance and then expand it.”
That expansion may look like returning to intimacy without fear, going out socially without cancelling, or learning how to rebuild trust of your body.
Why a Holistic, Interdisciplinary Approach to Endometriosis Care Matters
As a founding member of Endometriosis360, a six-week interdisciplinary programme combining pelvic physiotherapy, psychology, dietetics, and gynaecology to integrate a biopsychosocial approach and evidence-based strategies to help improve people’s quality of life, Jill emphasises the importance of a mixed methods approach: “It’s not just multidisciplinary, it’s integrated,” she explains.
Participants receive collaborative consultations and structured education that connects physical symptoms, mental health, and nervous system patterns.
“Online support groups can become very biased. The people who are progressing are silent or off living their lives. So you’re left reading the hardest stories.”
In contrast, the structured group environment allows people to integrate new knowledge and tools gradually.
“It’s really cool watching people connect the dots; how their thoughts influence their nervous system, which influences digestion, which influences pain.”
Read more about the Endometriosis360 Programme here: endometriosis360.ca
Advice for those at the Beginning of Their Endometriosis Journey
When asked what advice she would give someone at the start of their endometriosis journey, Jill’s answer is simple:
“Openness.”
“The biggest barrier to someone progressing is if they aren’t flexible in their thinking.”
After years of medical dismissal, it can feel safer to place all belief in a purely structural explanation of pain. But research shows surgery alone does not resolve symptoms for everyone.
“What percentage of people get better with surgery? It’s not great. So statistically, that makes no sense if endo is 100% the driver.”
Instead of overwhelming patients with theory, she begins with awareness.
“If I’m doing an internal exam and someone’s lying there rigid, I might say, ‘Just notice what your hands are doing.’ That’s where treatment starts.”
Awareness without judgement.
“If we can give them a lived experience of change, there’s nothing more convincing.”
Reclaiming Control in Endometriosis Treatment
Perhaps the most powerful shift in Jill’s approach is moving people from dependency to agency.
“I can’t get rid of your endo,” she says. “So I’m talking about what you and I can do together.”
In a healthcare system where many feel "handcuffed" by long waits, limited options, and repeated dismissal, that collaboration is transformative.
Endometriosis may be complex. It may involve surgery, medication, and ongoing research. But as Jill reminds us:
“We are not compartmentalised. So when we have endo, we are never just our endo. Never.”
And within that whole-person understanding lies the possibility of relief, resilience, and reclaiming control.
We’re incredibly grateful to Jill for sharing her time, expertise, and lived experience with such openness and generosity. Her work is helping to reshape how we understand endometriosis pain and how we support those living with it. We’re honoured to spotlight her work on bloomwell.
Where to find Jill:
Social (IG)
@endotogether
@endometriosis360
@oakvillephysio
Website:
www.endotogether.com
www.endometriosis360.ca
www.hbpw.ca
References:
UK Support resources:
Wellbeing of Women
Period Symptom Checker
Endometriosis UK
Information, helpline, and peer support
Helpline available 0808 808 2227
Pain being common does not mean it is normal.
Mental Health Support:
If you’re struggling emotionally, you are not alone.
Samaritans (24/7 support)
Helpline: 116 123
Shout (24/7 text support)
Text SHOUT to 85258
The Mix (under 25s)
Text 85258 for urgent mental health support
Childline (under 18s)
Helpline: 0800 1111
You don’t need to be in crisis to ask for help.
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