Reducing Pain and Strain with Better ErgonomicsEveryday activities, such as sitting, standing, walking, lifting, bending and reaching, can contribute to the pain pattern of IC. It's not unusual for the IC patient to experience pain, muscle spasms and stiffness in different areas of her or his body. Pain may travel and stay in one shoulder, knee or hip for several months, and then move to another area. Although massage, gentle exercise and medication are helpful, these therapies are often short lived if the IC patient doesn't practice good ergonomics (modifying one's environment to suit one's needs), use adequate support for her or his body, and avoid unconscious repetitive movements and habits that cause tiny tears in the muscle cells.
When sitting, your pelvis and lower back become the natural base of support for your upper body. If your base of support is weakened by an inflammatory process, you usually will overuse other muscle groups such as your abdominal and hip flexor muscles (front of hips) to comfortably maintain a sitting position (refer to my last column, Positive Moves For The New Year). This compensation increases when you add upper body movements such as typing and deskwork. Therefore, it's very important to sit in a supportive chair and/or use a back cushion to support both your lower and upper back.
You should also consider your desk or table height. Because IC patients need extra support when sitting, some patients find it helps to cross their legs. Although this practice is not encouraged by doctors and therapists, patients should allow plenty of leg room under desks and tables so they can stretch their legs out in front of them, move their legs out to the side, use a footstool and cross their legs comfortably. IC patients should also be mindful of their tasks and arrange desks and tabletops to suit their needs. Twisting and reaching should be avoided.
Work and chairs need to be lined up. Right-handed patients should place phones on their right side (the reverse goes for left-handed patients). Ideally, patients should use headsets or speakerphones to avoid stressing their shoulders, necks and arms. Patients also need to avoid lifting one of their hips off their seat while performing tasks. Sitting, in general, increases pressure on the lumber discs in the lower back and can lead to back problems.
People who sit at their jobs are encouraged to take breaks every thirty minutes. IC patients who fall into this category should ideally stand up and do intermittent stretching every twenty to thirty minutes, as well as practice back strengthening exercises at least 3 times a week (see Strengthening Your Back in my last column, Positive Moves For The New Year). Patients also need to pay attention to posture, movements and environmental surroundings to avoid tension and injuries.
STANDING AND WALKINGWhen you are standing your feet become your base of support. If your hip flexor and hamstring muscles (the large muscles in the backs of your legs) are short, tight and weak, your body's weight will have a tendency to rest back into your heels. In this posture, walking can cause a jarring impact to your pelvic floor, and forward movement, such as walking and climbing stairs, becomes dependent on already tightened hip flexors.
For appropriate body support while standing you should position your feet under your hip joints, "hip width" apart. Your feet should be angled out to assist balance and increase range of motion.
For comparison, try this position. Then turn your feet so they face forward instead of being angled out. Notice what happens in your knees, hips and posture above (you may feel a collapse in your rib cage). Even if you cannot detect a difference, try the suggested position for a few days, then resume your old stance. You may become aware of the advantage.
Proper support for standing and walking also includes good shoe support, which is almost a whole column in itself. However, IC patients can begin by wearing soft-soled shoes with slanted heels. Patients should avoid wearing shoes with a negative heel (a heel that is lower than the toe of a shoe, which is the case in some popular sandals), or a high cut over the insteps. Patients who spend a lot of time at home should pay attention to the shoes or slippers they wear around the house. Slippers generally do not offer much support for standing or walking, so it is necessary to add foam inserts for extra padding.
BENDING, REACHING AND LIFTING
Most people know to use their knees when they bend down, especially when they are lifting something. Even so, many IC patients experience pain when they bend down, and find lifting a challenge. One reason is that lifting involves the hamstring muscles, as well as the gluteus (buttocks) muscles, which help to stabilize the hips. Because these muscles can become tight and weak with the symptoms of IC, patients may find it helpful to bring their legs together when bending and lifting. Stretching the hamstring muscles and strengthening the gluteus muscles can also be very beneficial. Lifting, of course, involves the upper body. But, due to weakness in the lower body, IC patients may tend to overuse their shoulders to lift. Therefore, it's important that IC patients rearrange and organize their environments to minimize bending and lifting.Stores that specialize in storage products carry pot racks, small wire tables and other helpful items. Carrying objects can also be a challenge. Patients should lift and carry objects close to their bodies with both arms, otherwise lifting may cause tiny tears in the muscle cells. Objects should never be heavy or carried for too long. Patients may want to limit the time they walk when they carry packages, and practice upper body strengthening to avoid pain and injury.
LYING DOWNYour whole body is supported when you are lying down. Unfortunately, night can be the most uncomfortable time for the patient with urinary frequency. Not only is it tiring getting in and out of bed to use the bathroom, but it is also difficult to let your body relax when you have a constant awareness of your bladder and other muscles in that area. You can benefit from sleeping in a bed that is not too hard, so muscles can rest comfortably and "let go." However, it's also important to avoid a bed that is too soft and/or uneven, so your muscles won't have to work to find the right support needed for relaxation. If you plan to buy a new mattress, you may want to try one with a cotton top layer or individually pocketed coils, which reduce movement and encourage deep sleep. If you sleep with a pillow between your knees, try a small baby pillow instead of a standard size, which can put pressure on your hips. Sleeping is repair time and it is important to get as much quality sleep as needed.