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Role of Exercise

Program: Interstitial Cystitis: Self-Help for Painful Bladder Syndrome
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Andrew Schorr:

Let me go over a couple of other things and then we’ll go back in greater detail. So we talked about diet. Where does exercise come in helping in what a sufferer can do for themselves for the good?

Dr. Moldwin:

Oh that’s a great question. Boy you have good questions today. I’m a very big advocate if exercise. If you look across the board, not just for interstitial cystitis, but some of what we call comorbid conditions, whether it be chronic fatigue, fibromyalgia, etc.; aerobic activity is an awesome thing to do. It is very, very helpful on multiple levels. Also, unfortunately, some of the medications we may use with interstitial cystitis patients can enhance a weight gain. So it is so important from multiple angles that exercise be done as best possible.

Now how can you mess up, alright? Well you can mess up by perhaps over-exercising. That’s sort of like myself. I know myself. If I do something I go maybe sometimes a little too crazy with it. You have to start off slowly. You have to start off doing maybe the elliptical machines or very light weights or maybe yoga. Nothing really heavy, and do if for very short intervals, and build your body up. Don’t go for the gold ring or the brass ring right off the bat. You have to tread the waters slowly.

The other thing that I believe that people do, and it is unfortunate, is that they don’t breathe properly when they do their exercises. So for example, let’s say one wants to do a crunch. That’s a popular exercise. You see in on the TV things all the time. You want to do a crunch, and you lift the upper part of your body off the floor, and a lot of people what they do is they hold their breath, and they bear down and, they involuntarily actually tighten up their pelvic floor. They actually tighten up their behind muscles and the muscles that are used to control urination. They don’t even know they are doing it, but they are. Usually they are doing it because they are not controlling their breathing properly. They are not exhaling as they are coming up. So you say how does a crunch make my pelvic pain worse? It is often because of the things that we do during the exercises, sometimes even unconsciously, but we are still doing that, and breathing control and working with someone who knows about these types of issues is important.

Even, for example, a bench press. You just want to lift something about your head, a weight. What does that have to do with my bladder? Well it does if again if you are not breathing properly. So aerobics is a great thing. Yoga is an awesome thing just the stretching and so forth that’s involved and even the meditative work with it. So any type of aerobic activity is always to the patient’s benefit if possible.

Andrew Schorr:

I never thought about that. I did some sit-ups today. I never thought about was I was breathing right, and did it affect my bladder? Well, I know that many people along the way, this journey related to interstitial cystitis and painful bladder situations do consult often with a nurse or a physical therapist specialized in urology. So that’s a discussion that people can have, aerobic exercise to help.

Dr. Moldwin:

That’s a very good point you make, the physical therapist. Many of my patients of course, and all clinicians who see IC patients, I’m not just saying IC but also seeing it in tandem with pelvic floor spasms, and the physical therapists have been just incredible partners in the care for these patients, an expanding group of people, and they also can give really, really beneficial advice, especially regarding certain exercises that can be done and stretching techniques that can be done for the patients.

Andrew Schorr:

Okay, Dr. Moldwin, ready for a controversial subject?

Dr. Moldwin:

Oh, yes, that's me.

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