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Pelvic Floor Physical Therapy for Interstitial Cystitis

Interstitial cystitis is a chronic pain condition characterized by both pelvic pain and urinary symptoms.  It’s diagnosed by unexplained pain or pressure that is perceived to be related to the bladder, and affects more than 12 million Americans.  It’s often described as the sensation of a urinary tract infection, but without any bacterial infection.  Many patients report severe pain, often more intense than that associated with bladder cancer, and up to 85% of patients have accompanying pelvic floor dysfunction.

Pelvic floor physical therapy is the most proven treatment for interstitial cystitis.  It’s recommended by the American Urological Association (AUA) as a first-line medical treatment in their IC Guidelines, and is the only treatment given an evidence grade of ‘A’.  Furthermore, it’s the sole intervention that provides sustained relief; bladder treatments and oral medications must be continued indefinitely to provide benefit, if they work at all.


Research has demonstrated that at least 85% of patients with interstitial cystitis also have pelvic floor dysfunction.  In fact, many of the symptoms of IC can only be explained by the pelvic floor.  The majority of patients report painful intercourse, low back pain, hip pain, or constipation accompanying the condition; symptoms that have nothing to do with the bladder.

“More than 20 years of research supported by the National Institutes of Health and industry have failed to show that bladder-directed therapy is superior to placebo [for IC].  This fact suggests that the bladder may be an innocent bystander in a larger pelvic process.  As clinicians, we must be willing to look beyond the bladder and examine for pelvic floor issues and other causes of patient’s symptoms and not be too quick to begin bladder-focused treatments.” – Dr. Kenneth PetersPatients discover that Pelvic PT is an option

Despite this, many patients don’t learn about pelvic floor physical therapy for years after their diagnosis.  Many have to discover pelvic PT for themselves, or their doctor only mentions physical therapy as a last resort.  At PelvicSanity, we just published a study of our interstitial cystitis patients in the International Pelvic Pain Society (IPPS) meeting, reporting on both patient outcomes and their experience with the medical system following their IC diagnosis.


In following the results for thirteen consecutive patients with an interstitial cystitis diagnosis, patients reported more than a 60% improvement in pain, symptom bother, and how much symptoms limited their daily activities.  On average, their pain level was at a 7.6 out of 10 upon initial evaluation, which fell to 2.6 after treatment.

ICimpPatients saw a relatively rapid improvement in their symptoms with treatment.  Over half (54%) reported an improvement in symptoms within their first three visits; 31% saw their first improvement in visits 4-6 and 15% required ten or more visits for subjective improvement.  Importantly, all patients in the study reported a better understanding of their condition and feeling more hopeful for recovery after their initial evaluation.


More than half of these patients reported seeing five or more medical doctors for their condition prior to beginning pelvic floor physical therapy, and had been prescribed multiple medications and undergone bladder treatments without success.  However, only a single respondent (7.7%) believed they had been referred to pelvic PT by their doctor at the appropriate time.  Nearly half (46%) had to find out about pelvic floor physical therapy for interstitial cystitis themselves, while the remainder felt they had been referred by their doctor far too late, as a last resort.

With more than 12 million women and men suffering with this condition in the United States alone, increasing education – for both doctors and patients – is vital.  In our upcoming course for physical therapists in treating interstitial cystitis (April 28-29, 2018 in San Diego), we’ll focus on the most important physical therapy techniques for IC, home stretching and self-care programs, and information to guide patients in creating a holistic treatment plan

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Upcoming Continuing Education Courses

Male Pelvic Floor - San Diego, CA (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: FunctionSmart Physical Therapy

Chronic Pelvic Pain - Medford, OR (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: Asante Rogue Valley Medical Center

Pediatric Functional Gastrointestinal Disorders - Ann Arbor, MI (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: Michigan Medicine

Sacral Nerve Manual Assessment and Treatment - Madison, WI (NOW REMOTE)

Dec 4, 2020 - Dec 6, 2020
Location: SSM Health

Yoga for Pelvic Pain - Phoenix, AZ (Postponed)

Dec 5, 2020 - Dec 6, 2020
Location: St. Joseph's Hospital - Phoenix

Yoga for Pelvic Pain - Remote Course (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Male Pelvic Floor - Satellite Lab Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Male Pelvic Floor - San Diego, CA Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: FunctionSmart Physical Therapy

Male Pelvic Floor - Washington, DC Satellite Location

Dec 5, 2020 - Dec 6, 2020
Location: Georgetown University Hospital

Pelvic Floor Level 1 - Satellite Lab Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Little Rock, AR Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Core Pelvic Physical Therapy

Pelvic Floor Level 1 - Burlington, WA Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Northwest Physical Therapy

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 1 - Canton, OH Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Mercy Hospital

Male Pelvic Floor - Minneapolis, MN Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Fairview Institute of Athletic Medicine

Pelvic Floor Level 1 - Medford, OR Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Asante Rogue Valley Medical Center

Male Pelvic Floor - Self Hosted

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 2A - New Orleans, LA Satellite Location

Dec 5, 2020 - Dec 6, 2020
Location: Ochsner Therapy and Wellness/Ochsner Health System

Pelvic Floor Level 2A - Self-Hosted

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 2A - New Orleans, LA (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Ochsner Health System

Pediatric Functional Gastrointestinal Disorders - Remote Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Pelvic Floor Series Capstone - Washington, DC (POSTPONED)

Dec 12, 2020 - Dec 13, 2020
Location: The George Washington University

Pelvic Floor Level 1 - Tallahassee, FL (Postponed)

Dec 12, 2020 - Dec 13, 2020
Location: Tallahassee Memorial HealthCare

Breathing and the Diaphragm - Remote Course

Dec 12, 2020 - Dec 13, 2020
Location: Replacement Remote Course

Manual Therapy for the Abdominal Wall - Remote Course (SOLD OUT)

Dec 12, 2020
Location: Short Form Remote Course

Pelvic Floor Capstone - Washington, DC Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Georgetown University Hospital

Pelvic Floor Capstone - East Norriton, PA Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Core 3 Physical Therapy

Pelvic Floor Capstone - Salt Lake City, UT Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Pagnani Physical Therapy

Pelvic Floor Capstone - Self-Hosted

Dec 12, 2020 - Dec 13, 2020
Location: Self-Hosted Course

Pelvic Floor Capstone - Greenville, SC Satellite Location (Postponed)

Dec 12, 2020 - Dec 13, 2020
Location: Restore Pelvic Health and Wellness