By: Rachael Reuter, PT, DPT, IDN-C
Managing Interstitial Cystitis (IC) or Bladder Pain Syndrome (BPS) can be challenging, but with the right strategies, you can alleviate symptoms and improve your quality of life. Here are some tips and tricks from a physical therapy perspective to help manage IC/BPS:
1. Pelvic Floor Relaxation Techniques
- Breathing Exercises: Practice diaphragmatic breathing to help relax the pelvic floor muscles. Focus on slow, deep breaths, allowing your abdomen to rise as you inhale and fall as you exhale. This can reduce tension in the pelvic area.
- Progressive Muscle Relaxation: Gradually tense and then relax different muscle groups, starting from your feet and moving up to your pelvic floor. This technique can help you identify and release muscle tension.
2. Bladder Retraining
- Scheduled Voiding: Instead of responding to every urge to urinate, try to gradually extend the time between bathroom visits. Start by delaying urination by 5-10 minutes and slowly increase the time as your bladder adjusts. Typical bladder emptying intervals are 2-4 hours.
- Avoiding “Just in Case” Trips: Try not to empty your bladder “just in case.” This habit can reinforce the urgency and frequency associated with IC/BPS.
3. Manual Therapy
- Myofascial Release: A trained physical therapist can perform manual techniques to release tension in the pelvic floor muscles and surrounding areas, such as the abdomen, lower back, and inner thighs. This can help reduce pain and improve mobility.
- Trigger Point Therapy: Identifying and releasing trigger points (knots in muscles) in the pelvic floor can alleviate referred pain and discomfort.
- A pelvic floor PT can educate you on the use of a pelvic wand to help you work on trigger points or muscle tightness.
4. Lifestyle Modifications
- Dietary Adjustments: Identify and avoid bladder irritants in your diet, such as caffeine, alcohol, acidic foods, and spicy foods. Keeping a food diary can help you track which foods worsen your symptoms.
- Hydration: Stay hydrated, but sip water throughout the day rather than drinking large amounts at once. Dehydration can concentrate urine and irritate the bladder, while excessive fluid intake can increase urgency. Drinking more water during a flare may help reduce your symptoms.
- Movement and Stretching: Incorporate gentle stretching and movement into your daily routine to avoid prolonged periods of sitting or standing, which can increase pelvic tension.
5. Stress Management
- Mindfulness and Meditation: Practice mindfulness techniques or meditation to reduce stress and anxiety, which can exacerbate IC/BPS symptoms.
- Meet with a counselor or talk therapist who specializes in chronic pain to help you manage the symptoms, stress, and grief you may experience related to your diagnosis
- Regular Exercise: Engage in low-impact exercises like walking, swimming, or yoga to reduce stress and improve overall well-being. Engage in weight training and impact training with the guidance of a licensed PT or certified personal trainer. After heavy lifting, it is important to engage in a cool down to reduce muscle tension.
6. Biofeedback
- Pelvic Floor Awareness: Biofeedback can help you become more aware of your pelvic floor muscles and how to control them. This technology provides real-time feedback, helping you learn to relax and coordinate your pelvic floor more effectively. This is done best under the guidance of a trained PT and can be done with verbal feedback or feedback from a machine.
7. Patient Education
- Understanding Your Condition: Educate yourself about IC/BPS and how your pelvic floor muscles contribute to symptoms. Understanding the connection between stress, muscle tension, and bladder pain can empower you to take control of your treatment. It may help to keep a journal of your activities, stress level, food, hydration and symptoms to identify what contributes to a flare up or improvement in symptoms.
8. Consistency and Patience
- Commit to Your Plan: Managing IC/BPS requires time and consistency. Stick to your physical therapy plan, including home exercises and lifestyle changes, to see gradual improvement.
- Be Patient: Healing is a process, and progress might be slow. Celebrate small victories and stay committed to your treatment plan.
By incorporating these tips and tricks into your daily routine, you can take an active role in managing IC/BPS and improve your overall quality of life. If you’re struggling with symptoms, consider seeking the guidance of a pelvic floor physical therapist who can create a personalized plan tailored to your needs!
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