IC/PBS: A Whole-Body Approach

Understanding Interstitial Cystitis / Painful Bladder Syndrome (IC/PBS)

If you experience bladder pressure, pelvic pain, urgency, frequency, or the feeling of “always needing to pee” even when tests come back normal, you may fall somewhere on the IC/PBS spectrum — also called Bladder Pain Syndrome (BPS).

IC/PBS is a symptom pattern, not a single condition.

It can be rooted in:

• bladder hypersensitivity

• pelvic floor tension

• fascial restrictions around the bladder or urethra

• psoas or abdominal tightness

• stress and nervous system overload

• hormonal fluctuations

• dietary irritants

• or (in a small percentage of cases) bladder inflammation such as Hun

  ner lesions

  

  Hunner Lesion

  
  

Most people do not have Hunner lesions — meaning their symptoms often stem from tension and sensitivity, not bladder tissue damage.

This is why antibiotics don’t always help, and why many people feel confused or dismissed when their urine tests come back “normal.”

This is also where a whole-body, integrative approach can make a meaningful difference.

How Manual Therapy Can Support IC/PBS

Many people with IC/PBS symptoms have tension patterns that create or amplify bladder discomfort. Through gentle, external, hands-on techniques, we can support the structures around the bladder so it can move, expand, and calm more comfortably.

Manual therapy approaches that may help include:

• Abdominal and pelvic fascial work

  • Supporting mobility around the bladder, urethra, pelvic floor, and lower abdomen.

• Visceral mobility-style techniques

  • Improving glide and reducing sensitivity in the bladder region (non-invasive, external only).

• Psoas, iliacus, and hip mobility work

  • Tight hip flexors and deep core muscles often contribute to pelvic tension, urgency, or pressure.

• External pelvic floor release and relaxation techniques

  • Reducing overactivity that can mimic UTI symptoms.

• Diaphragm and rib mobility work

  • Improving breath mechanics to reduce downward pressure on the bladder and pelvic floor.

These approaches can reduce the tension patterns that “irritate” the bladder and create symptoms even when a urine test is completely normal.

Many clients notice improvements in:

✔ urgency

✔ frequency

✔ suprapubic pressure

✔ urethral or pelvic discomfort

✔ hip or low-back tightness related to bladder tension

Nutrition & Bladder Irritants

IC/PBS is highly individual, but certain foods and drinks are known to irritate the bladder in sensitive individuals.

Within my scope, I support clients with:

• education on common bladder irritants

• identification of personal triggers

• gradual, non-restrictive approaches

• bladder-friendly substitutions

  
  

Common bladder irritants include:

• caffeine

• carbonated beverages

• alcohol

• citrus

• spicy foods

• artificial sweeteners

• tomato-based foods

• chocolate

  
  

Instead of strict long-term elimination, I help clients find a balanced, low-stress approach with gentle changes that support a calmer bladder.

Pelvic Floor Rehab & Bladder Habits (Within My Scope)

While I do not diagnose or treat pelvic floor disorders, I support clients with:

• external pelvic floor relaxation techniques

• coached breathwork for pelvic floor coordination

• posture + movement strategies

• hip and core alignment to reduce pressure

• bladder habit education

• nervous system calming techniques

• general strengthening or mobility suggestions for hips, core, and low back

  
  

IC/PBS symptoms often worsen when the pelvic floor is:

• gripping

• overactive

• responding to stress

• out of sync with the diaphragm

  
  

We work together to restore:

✔ pelvic floor ease

✔ breath-led relaxation

✔ balanced pressure management

✔ improved bladder habits

✔ supportive hip/core mechanics

These changes can help calm urgency, frequency, and pelvic or bladder discomfort over time.

The Nervous System Connection

One of the biggest drivers of IC/PBS symptoms is a nervous system stuck in “fight-or-flight.”

When stress rises:

• the pelvic floor tightens

• breathing becomes shallow

• the bladder becomes more reactive

  
  

I incorporate:

• grounding techniques

• gentle breathwork

• slow manual therapy

• calm-paced movement

• awareness-based strategies

  
  

Many clients notice that as their nervous system softens, their bladder symptoms also ease — sometimes even during the session itself.

A Whole-Body Approach to IC/PBS

If you’ve been told your tests are normal…

If antibiotics don’t help…

If the symptoms keep coming back…

If you feel confused or dismissed…

You’re not imagining it — and you’re not alone.

IC/PBS symptoms can improve when the whole system is supported:

the bladder, the fascia, the pelvic floor, the hips, and the nervous system.

If you’re curious or have questions, I’m here for you.

Allegan + Holland sessions now available.

Free 30-minute consultations for new clients.

Written by Chelsea Robles, LPTA, LMT, LSVT, CPT, CNC

Pelvic Health & Movement Specialist

Empower Her Pelvic Health & Bodywork — Allegan & Holland, MI