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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

Oncology of the Pelvic Floor Level 1 - Remote Course

Sep 12, 2020 - Sep 20, 2020
Location: Replacement Remote Course

Boundaries, Self-Care, and Meditation - Remote Course

Sep 12, 2020 - Oct 11, 2020
Location: Replacement Remote Course

Male Pelvic Floor - Arlington, VA (Postponed)

Sep 18, 2020 - Sep 20, 2020
Location: Virginia Hospital Center

Mobilization of Visceral Fascia: The Urinary System - Self-Hosted

Sep 18, 2020 - Sep 20, 2020
Location: Self-Hosted Course

Mobilization of Visceral Fascia: The Urinary System - Atlanta GA Satellite Location

Sep 18, 2020 - Sep 20, 2020
Location: JMM Health Solutions LLC

Mobilization of Visceral Fascia: The Urinary System - Crown Point, IN (Postponed)

Sep 18, 2020 - Sep 20, 2020
Location: Franciscan Health System

Mobilization of Visceral Fascia: The Urinary System - Kokomo, IN Satellite Location

Sep 18, 2020 - Sep 20, 2020
Location: You're In Control

Mobilization of Visceral Fascia: The Urinary System - Medford, OR Satellite Location

Sep 18, 2020 - Sep 20, 2020
Location: Asante Rogue Valley Medical Center

Athletes & Pelvic Rehabilitation - Minneapolis, MN (Postponed)

Sep 19, 2020 - Sep 20, 2020
Location: Viverant

Bowel Pathology and Function - Ann Arbor, MI (Postponed)

Sep 19, 2020 - Sep 20, 2020
Location: St. Joseph Mercy Ann Arbor

Pelvic Floor Level 1- Minneapolis, MN (SOLD OUT)

Sep 19, 2020 - Sep 20, 2020
Location: Allina Hospitals and Clinics

Osteoporosis Management - Remote Course

Sep 19, 2020 - Sep 20, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2A - Boston, MA (Postponed)

Sep 19, 2020 - Sep 20, 2020
Location: Marathon Physical Therapy

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Sep 19, 2020 - Sep 20, 2020
Location: Replacement Remote Course

Athletes & Pelvic Rehabilitation - Remote Course (Sold Out)

Sep 19, 2020 - Sep 20, 2020
Location: Replacement Remote Course

Bowel Pathology and Function - Remote Course

Sep 19, 2020 - Sep 20, 2020
Location: Replacement Remote Course

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

Sep 19, 2020 - Sep 20, 2020
Location: Self-Hosted Course

Pudendal Neuralgia and Nerve Entrapment - Remote Course

Sep 19, 2020 - Sep 20, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Coon Rapids, MN Satellite Course (SOLD OUT)

Sep 19, 2020 - Sep 20, 2020
Location: Mercy Hospital

Pelvic Floor Level 1 - East Norriton, PA Satellite Course

Sep 19, 2020 - Sep 20, 2020
Location: Core 3 Physical Therapy

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

Sep 19, 2020 - Sep 20, 2020
Location: University of Arkansas for Medical Sciences

Pregnancy Rehabilitation - Garden City, NY (Postponed)

Sep 19, 2020 - Sep 20, 2020
Location: Metro Physical & Aquatic Therapy

Pelvic Floor Level 1 - Satellite Lab Course

Sep 19, 2020 - Sep 20, 2020

Pelvic Floor Level 1 - Fairlawn, NJ Satellite Location

Sep 19, 2020 - Sep 20, 2020
Location: Bella Physical Therapy

Pelvic Floor Level 2A - Atlanta, GA (Postponed)

Sep 25, 2020 - Sep 27, 2020
Location: Emory Healthcare

Nutrition Perspectives for the Pelvic Rehab Therapist - Winfield, IL (Postponed)

Sep 25, 2020 - Sep 27, 2020
Location: Northwestern Medicine

Low Pressure Fitness for Pelvic Floor Care - Houston, TX (Postponed)

Sep 25, 2020 - Sep 27, 2020
Location: Texas Children’s Hospital

Sacral Nerve Manual Assessment and Treatment - Vancouver, WA (Postponed)

Sep 25, 2020 - Sep 27, 2020
Location: PeaceHealth Southwest Medical Center

Pelvic Floor Level 1 - Mequon, WI Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Health In Balance Physical Therapy