For IC patients, getting off of the couch can sometimes be difficult. Leaving the house may be impossible. Exercising seems a laughable idea during the worst of times. But according to urologist Robert Evans at Wake Forest University Baptist Medical Center in North Carolina, exercising can really be just what the doctor ordered.
“We encourage everybody to every day or every other day do something to get that endorphin release and get a little pain relief,” he said, explaining that endorphins help alleviate pain.
However, Evans was also quick to point out that IC patients need to be careful when exercising to ensure they don’t aggravate the bladder further. While each patient is different in many ways, some forms of exercise seem to fit across the board for ICers. Typically low-impact exercises tend to be the most bladder friendly ones.
How exercise helps IC symptoms
Back in 2004, Evans encouraged Dr. William Karper, associate professor in the Department of Kinesiology at the University of North Carolina in Greensboro, to include IC patients in his research. Karper, who had been working with fibromyalgia patients on how exercise affected their pain, decided to include IC patients, though he had his doubts.
“I did not think it would work,” Karper said. “I did not think it would help them that much. [Evans] strongly believed that these women needed an exercise program. It would also affect their self concept and how they felt about their ability to do things. That seemed to be the case.”
Karper’s study was small and started with only six IC patients. Of those six patients, only two were able to complete the low impact exercise regime. What struck Karper most was that no negative effects were observed from the exercise. Instead, the women reported a lessening of some IC symptoms.(1)
“I think the right kind of mild exercise for many people with IC could really be helpful in their activities of daily living,” Karper said. “[IC patients] are just so miserable that they cannot imagine that a little bit of physical activity can help. The fact is that seems to be the opposite.”
Evans concurred: “If they can do enough, it will help with the pain. It just has to be done reasonably.”
For Karper’s study, he had patients work out for 35 to 40 minutes, three days a week for six months. Each session included walking, light upper body strength training with 3- to 4-pound dumbbells, range of motion exercises, balance exercises and core strengthening exercises.
“It’s just a matter of going slow and not doing things that aggravate the condition,” Karper said. “The whole idea is to improve quality of life.”
Yoga
The first type of exercise that Evans recommended was yoga, because many of his patients have had luck with it.
“We’ve had patients time after time come in and say [yoga] made a difference,” he said.
Yoga can actually help alleviate IC pain caused from tight pelvic floor muscles. The vast majority of IC patients have some level of pelvic floor dysfunction. You can attend a yoga class or do a quick search online for yoga for pelvic pain can come up with a variety of yoga exercises and videos designed to help relax the pelvic floor. Be cautious that you aren’t doing pelvic floor strengthening exercises, which can make your pelvic floor tighter.
Along with that, you can also look for beginner yoga or yoga for senior adults. Both are usually lower impact and easier poses. Listen to your body and don’t push yourself too hard, especially as you are just starting.
Yoga offers a variety of health benefits. It can improve your strength, balance and flexibility, reduce back pain and help you manage stress.(2)
Water exercise
Another good low-impact exercise option is water sports. Evans said swimming or water aerobics have worked well for some of his patients, but they come with some caveats.
For ICers who have trouble with increased symptoms from chlorine, Evans recommended looking for a salt pool or a pool not treated with large amounts of chlorine. He also said patients should immediately change out of their wet bathing suits and shower right away, especially after being in a chlorinated pool.
Making sure the pool is extra warm as well is important for IC patients who are generally sensitive to extreme temperatures. Consider checking with your local physical therapists to see if their facility offer a physical therapy pool. Some locations offer classes for water workouts or have free times for swimming. Most of them have warm water pools.
Water exercise improves your balance and coordination as well as improves your cardiovascular strength and muscle tone, burns calories and increases your flexibility.(3)
Belly dance
Belly dance may not be a traditional type of exercise, per se, but it is a low-impact activity that works the body while still being gentle for the bladder. Belly dancing can work muscles throughout your body and build your core muscles while giving you a low-impact, cardio workout. Plus it has the added bonus of feeling more like fun than like exercise! Just like with yoga, lots of belly dancing instructional videos can be found online or you can check in your area for a belly dancing class.
Because it is a weight bearing exercise, belly dancing can help build bone density. It can also reduce stress, alleviate back and joint pain, boost self esteem and help with loosing weight.(4)
Walking
Another great low-impact exercise for many IC patients is walking. Even if you start with walking slowly, walking is still moving your body. Walking is also pretty flexible. You can walk around your house, around your neighborhood, on a treadmill, in a shopping mall, in a park or pretty much wherever. You can make it social and walk with family or friends. Or you can even involve your beloved pooch.
If you are looking for an exercises you can do solely at home to stay near the bathroom, check online for walking videos designed to have your walk a mile in your house.
Walking offers a variety of health benefits. It can help you lose weight, strengthen your heart, lower your blood pressure and reduce joint pain.(5)
Exercise machines
Besides walking on treadmills, other exercise machines offer low-impact workout options that often work well for IC patients. Whether you invest in an exercise machine for your house or use them at the gym, look for one that isn’t very jarring. The more jarring an exercise is, the more likely it will negatively impact IC symptoms.
Consider the elliptical machine. It keeps the hips more even than a StairMaster does, so it is more ideal for IC patients. A rowing machine is another great choice because it exercises your limbs while isolating the pelvis.(6)
And a recumbent bike is a great option because its seat is more like a chair and less likely to put additional pressure on your pelvic floor.
Modified workouts
Having IC doesn’t mean patients can only do certain workouts. Many workouts are able to be modified to work with a patient’s body instead of against it. You can take a workout you did previous to IC and modify so that it is lower impact and won’t irritate your bladder. For example, if the workout includes 30-second sets of jumping jacks, walk or march in place instead.
Keep at it
Staying motivated to continue exercising can be a challenge in general. However, that challenge is even greater when your body gives you built-in excuses, aka flares, to skip workouts. Some determination, flexibility and grace, though, can help you be successful in continuing an exercise plan even with IC.
Start with setting some realistic goals. For example, in Karper’s study, he had patients exercise 35 to 40 minutes three days a week. If you haven’t been working out before, this sort of goal is a good starting point, but you might need to make it even less — and that’s OK. Maybe instead aim for 20 minutes three days a week.
Find ways to make your workouts fun.(7) If you find yourself getting bored with the workout you’re doing, try adding something new. Maybe your routine is doing a yoga video for half an hour three days a week. Try switching to belly dancing for one of those days or going for a walk.
Another great way to stay motivated is to involve others if you can.(7) Recruit family members or friends to join you. You’ll get time together and also help keep one another accountable. Plus, it can make the workout more fun as an added bonus!
Finally, give yourself a break when you aren’t feeling well.(7) If you’re dealing with a horrendous flare or UTI, take a day or week off. Or modify your workout to be much more minimal. Just do what you can, when you can. Don’t beat yourself up for needing some breaks and listening to your body!
References
- Karper WB. Exercise effects on interstitial cystitis: two case reports. Urol. Nursing. June 2004 Volume 24, No. 3.
- John Hopkins Medicine. 9 Benefits of Yoga.
- Cambridge Fitness Wilmington. Top 10 Health Benefits of Water Aerobics.
- Lo Iacono V. Health Benefits of Belly Dance. World Belly Dance.
- Chertoff J. What are the Benefits of Walking? Healthline. Nov. 8, 2018.
- Osborne J. Exercise and Fitness for IC and Chronic Pelvic Pain. IC Network. Aug. 5, 2013.
- Mayo Clinic Staff. Fitness: Tips for Staying Motivated. Mayo Clinic. Oct. 6, 2018.
