87% of IC Patients have Pelvic Floor Dysfunction (1).
I was one of the lucky cases, where the first gynaecologist I saw, referred me to Pelvic Floor Physiotherapy right away after seeing the state I was in. I was in tears, in a flare, sitting on my donut pillow in her office after she assessed me. She told me she believed I had IC/BPS and that only a urologist can confirm that diagnosis. She explained she’s seen improvement of symptoms with pelvic physiotherapy in her IC patients so she pointed me in that direction. And I’m so glad she did.I was reluctant at first because I kept thinking “how can Physiotherapy of muscles help my bladder pain!?” Well I quickly learned that our pelvic floor muscles play a huge role in our pain. They are normally tight (hypertonic) in IC patients because they tighten in response to the pain to try and protect us. Since starting Pelvic Floor Physiotherapy, I have been able to use what I learn in each session, to bring my pain to a more manageable level.
Nicole Cozean, the author of The Interstitial Cystitis Solution explains how Pelvic Floor Physiotherapy is the most proven treatment for IC in a blog post on Pelvicpainrehab.com. Below, she explains the IC and Pelvic Floor connection and the goal of physiotherapy.
“The muscles of the pelvic floor are often tight in patients with IC, causing trigger points to develop in these muscles. When the body experiences pain, inflammation rushes to the site. Since IC is a chronic condition, the inflammation persists and begins to affect the fascia and muscles of the pelvis, inner thighs, and lower abdomen. Trigger points, muscle tightness, and inflammation can combine to irritate the nerves that run through the pelvis, which can cause pain to manifest throughout the pelvis and surrounding areas. The brain can also interpret these signals as the urgent need to go to the bathroom, which creates the urge to go even when you know the bladder is nearly empty.
We often refer to this as the dysfunction-inflammation-pain (DIP) cycle. The goal of physical therapy is to disrupt this feedback loop at every point we can. Releasing the trigger points in tight muscles can lessen pain and restore normal function to the pelvic muscles. Clearing inflammation that is present in the fascia (the thin layer between the skin and muscles underneath) can restore blood flow and reduce tender points. In turn, alleviating dysfunction and inflammation can reduce IC pain.”(2)
-Nicole Cozean PT, DPT, WCS @pelvicsanity
Learning about my Pelvic Floor Dysfunction has given me so many answers to a lot of my pain that I have felt since childhood. If you have been diagnosed or believe you have IC, try physiotherapy to see if it helps with your pain.
1. Han, Ester et. al. “Current Best Practice Management of Interstitial Cystitis/Bladder Pain Syndrome.” Therapeutic Advances in Urology 10.7 (2018): 197-211. PMC