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Positive Moves For The New Year

(January 2001) I imagine the number one New Year's resolution for most people is to get into shape. Television is filled with body conscious commercials (i.e., the thin girl eating a special woman running on the beach to build strong bones, and the men and women who have just lost thirty pounds and have more energy than ever). Of course, shaping-up and building strength are healthy goals as long as they are realistic, but far too often the IC patient faces failure and disappointment when she or he tries a new exercise program, or turns to a private trainer or physical therapist for instruction. The problem is that there's simply not enough research or information on exercise and the IC patient. And, exercise prescribed for the fibromyalgia (FMS) patient often leads to problems for the IC patient, because the IC patient with FMS, and/ or muscle and joint pain, is different than the FMS patient without IC. There are very specific muscular limitations in the posture and movement of the IC patient. The wrong type of exercise can lead to pain, inactivity and sometimes an increase in bladder symptoms.

The Pain Pattern of IC

Many IC patients complain that they are out-of-shape and that their bellies have become rounder and larger with IC. Although irritable bowel syndrome (IBS), which many IC patients suffer with, can cause bloating, most experts don't believe this to be a symptom caused by bladder inflammation. However, there are a few perfectly logical reasons that explain why some patients develop a bigger belly.

When pelvic and lower back muscles are weakened by the inflammatory process in the bladder, the abdominal and hip flexor (front of the hips) muscles must work harder to provide postural support. For example, many IC patients find that they must sit with their hips rolled slightly back and under to ease the pressure on the pelvic floor and bladder.

However, in this rather collapsed position the abdominal and hip flexor muscles stay very tense, and in time can shorten, and become thick and weak. Using a supportive chair, and/or a back cushion (that supports both the lower and upper back), as well as elevating the feet on a foot stool, can help the abdominal and hip flexor muscles to rest and stop building-up. The other cause for a build-up of tissue in the belly could come from repetitive straining to empty the bladder.

Spot toning exercise for the stomach muscles may only add more tension, shorten the muscles of the abdominal wall and increase the size of the belly. Ideally, exercise should re-educate the whole body in order to promote length, increase range-of motion and strength, and release the muscular restrictions and posture that often accompany IC.

Muscle re-education is a process, and therefore, should begin thoughtfully and slowly. Although it's not a good idea to exercise or stretch first thing in the morning when muscles are stiff, it is a good idea to practice morning rotations. Later in the day, stretching and strengthening exercises will help to reduce the stress and tension patterns that occur during everyday tasks.

A Daily Stretching Plan

For optimum relief, the following exercises should be practiced daily or at least three times a week. These movements can also be beneficial when practiced before other exercise, such as walking, because they target the specific muscular limitations of IC. Of course, preference and capability for exercise is very individual and a doctor should be consulted before trying any new exercise routine.

If you experience pain while practicing the following routine, stop. Instead, try one exercise a day to determine which movement is causing the problem, then discontinue it. If you experience sore, stiff and tight areas after these exercises, use an ice pack. In time these areas should improve or the exercise causing the problem should be avoided.

The best motivation for movement is the reward of feeling better. Reach your goals realistically and realize that there will be times you will not be able to exercise. Take advantage of the good days to keep up your strength, but also remember to be careful not to overdo!

1. Morning Rotations

Start each day by warming your spinal muscles and disks before getting out of bed. To do so, sit up on the side of the bed before standing. Place your feet comfortably apart on the floor. Bend your elbows and touch your finger tips. Imagine that your forearms are resting on an imaginary shelf. Relax your shoulders and very gently rotate your upper body side to side. Lead the movement with your eyes so that your head turns first. Be careful not to arch your lower back. Begin with three gentle rotations every morning before standing. Work your way up to a comfortable amount.

2. The Full Body Stretch

Lie on your back on a comfortable surface. Extend your opposite arm and leg. Take a full breath, and then slowly exhale as you let your back relax into the floor, bed, etc. Repeat by exchanging your arms and legs.

• Keep your shoulders relaxed and your extended arm comfortably bent.
• Make sure that your chin is not tucked under.

3. Knee/Chest Rock

After you have completed The Full Body Stretch bring your knees toward your chest, one at a time. Lightly hug your knees with your arms, then gently rock your body side to side. Let your eyes lead the movement so that your head turns first.

• Avoid locking your fingers too tightly while hugging your legs.
• Keep your shoulders relaxed.

4. Strengthening Your Back

Roll over onto the easiest side and get up onto your hands and knees. Position yourself on all fours, then lift your opposite arm and leg long enough to find your balance. Release, look down, and repeat this exercise by exchanging your arms and legs.

• Avoid lifting your arms and legs higher than your spine.
• Keep your shoulders down and avoid straightening your lifted arm.