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Exercises That Are Good for People with Interstitial Cystitis: Why You Shouldn’t Start with Kegel Exercises Right Away
If you’re experiencing discomfort from interstitial cystitis or bladder pain syndrome, you may be cautious about starting an exercise routine. This is because you might worry that moving will further irritate your bladder, and in some cases, pain in your lower abdomen or pelvis may worsen after exercise. However, completely avoiding physical activity isn’t always the best approach. If you repeatedly sit for long periods or lead a lifestyle that causes your body to become overly tense, the muscles around your pelvis can become more tense, making you even more sensitive to pain.
What kind of exercise should people with interstitial cystitis do?
If you have interstitial cystitis, it’s best not to think of exercise as simply a way to “strengthen your pelvic floor.” This is because while some people have weak pelvic floor muscles, others, on the contrary, have pelvic floor muscles that are excessively tense. In particular, if you experience chronic bladder pain or pelvic pain, excessive tension in the pelvic floor muscles can contribute to your symptoms. Therefore, it is important to tailor your exercise routine to your specific condition.
The best way to get started is with a light walk.
Walking is one of the exercises that patients with interstitial cystitis can start with relative ease. Rather than walking quickly for a long time right from the start, try beginning with a 10- to 20-minute walk at a comfortable pace. When walking, it’s important to avoid putting unnecessary strain on your shoulders, lower back, and pelvis, and to breathe naturally.
If you experience bladder pain or a noticeable increase in urinary frequency after exercising, it’s a good idea to reduce the duration or intensity of your workout and monitor how your body responds. It’s not about exercising as much as possible; what’s important is to exercise consistently within the limits your body can handle.
Pelvic floor strengthening exercises aren’t right for everyone.
When people talk about bladder health, many of them think of Kegel exercises first. Kegel exercises involve contracting the pelvic floor muscles to strengthen them, and they can be an appropriate form of exercise for some people who have weakened pelvic floor muscles.
However, Kegel exercises are not suitable for everyone with interstitial cystitis or chronic pelvic pain. This is because, if the pelvic floor muscles are already overly tense, repetitive contractions may interfere with muscle relaxation or worsen discomfort in the pelvic area.
Therefore, rather than taking the approach that “you should do a lot of Kegel exercises because they’re good for the bladder,” it’s important to first assess the current condition of your pelvic floor muscles.
Diaphragmatic breathing and pelvic relaxation exercises can also be forms of exercise.
For people with high tension around the pelvis, it may be better to practice relaxing the muscles rather than tightening them further. Lie down comfortably, place your hands on your abdomen, inhale slowly through your nose, and then exhale slowly through your mouth. As you exhale, try to feel the tension in your shoulders, lower abdomen, and pelvis naturally release.
Abdominal breathing has the advantage of requiring no special equipment and being easy to practice in daily life. However, it is important to maintain comfortable breathing rather than forcing yourself to take deep breaths or tensing your abdomen excessively.
Gently move your lower back and the area around your pelvis.
A sedentary lifestyle can restrict movement in the lower back, buttocks, and pelvic area. One way to address this is to gently move your lower back and gently stretch your buttocks and thighs.
However, the purpose of stretching is not to push through the pain and do it intensely. If bladder pain, perineal pain, or frequent urination noticeably increase after stretching, you should reduce the intensity or duration.
Common Cases Encountered in the Clinic
“I did Kegel exercises every day because I heard they’re good for the bladder.”
Some patients who visit our clinic for interstitial cystitis or chronic pelvic pain share the following experience: After hearing that it was good for bladder health, they began tightly contracting their pelvic floor muscles every day, but at some point, they started experiencing stiffness in the pelvic area, a more frequent urge to urinate, or severe discomfort in the perineum.
In cases like this, exercising harder isn’t necessarily the solution. You need to check whether your pelvic floor muscles are already overly tense and whether there are any other factors that might be causing or exacerbating the pain.
The key to exercises for interstitial cystitis is not “strengthening at all costs.”
Exercise for patients with interstitial cystitis may vary depending on their individual symptoms and the condition of their pelvic floor muscles. If the pelvic floor muscles are excessively tense, it may be appropriate to start with movements that help relieve tension, such as walking, diaphragmatic breathing, and gentle stretching.
Conversely, if your pelvic floor muscles are actually weak, you may undergo an appropriate evaluation and then perform strengthening exercises. The key isnot to “blindly follow exercises said to be good for the bladder,” but to assess your current physical condition and choose exercises that are appropriate for you.
If your bladder symptoms worsen after exercising,
If you experience a noticeable increase in bladder pain after exercising, or if frequent urination or urinary urgency worsens and even leads to perineal pain, it is advisable to reduce the intensity and duration of your workout. In particular, you should avoid pushing through the pain and continuing to exercise.
Since the symptoms and causes of interstitial cystitis can vary from person to person, rather than trying to resolve all symptoms through exercise alone, it is important to first examine the current pattern of your symptoms.
A Word of Advice
Starting an exercise routine for bladder health can be a good habit. However, just because an exercise is said to be good for the bladder doesn’t mean it’s right for everyone.
In particular, if you have interstitial cystitis and pelvic pain at the same time, it’s important to first ask yourself, “Is my pelvis tense right now, or does it need to relax?” rather than thinking, “Harder, more.”
Just because you have an overactive bladder doesn’t mean you should avoid physical activity, nor does it mean you should blindly repeat exercises that are said to be good for your bladder. Pay attention to how your body responds and start slowly with low-impact movements.
