Can Covid-19 really affect your pelvic floor?
Can coughing really affect your pelvic floor?
We are starting to see more and more people in the clinic who have recovered from the acute symptoms of covid - 19, but some people are left with unusual symptoms. One of the more common, although slightly upsetting, symptoms is accidental leakage of urine when they cough or sneeze.
Why would my pelvic floor be impacted by coughing?
We're glad you asked..
Did you know that when you cough or sneeze, you put more pressure on your pelvic floor than running, or jumping or lifting and carrying 18kg. We rely on our pelvic floor contracting at the right time in order to support our organs and keep us dry. This is especially important when you cough or sneeze.
If you already have a mild pelvic floor dysfunction, coughing, such as with covid-19 or other illness may result in issues including light bladder leakage or worsening of pelvic organ prolapse symptoms. There are a range of reasons the pelvic floor can be affected by coughing, but two of the most common are:
1. Muscle (Neurological) timing problems
2. Tired Muscles (pelvic floor fatigue)
1. Muscle (Neurological) timing of the pelvic floor
To do its job properly, the pelvic floor not only needs to be strong, but also needs to contract at the right time. Our pelvic floor needs to squeeze prior to a cough or a sneeze to help support our organs and keep us dry. If your timing is off, it doesn’t matter how strong your pelvic floor is you could have some leakage. Especially when your muscles are tired. More more information, see the video below.
Click the video to learn more about Timing and the pelvic floor:
How do you test or correct this timing?
You can perform ‘the knack’. ‘The knack’ is a well timed strong contraction of the pelvic floor usually just prior to a cough or sneeze. But it can be used prior to any increases in intra-abdominal pressure. We've put together a video describing ‘The Knack’.
Click the video to learn how to retrain your pelvic floor using ‘The Knack’:
2. When the pelvic floor is tired (pelvic floor fatigue)
When muscles are tired, such after lots of coughing or sneezing, they get tight and tight muscles don’t work as well. How does this affect your pelvic floor?
Your pelvic floor moves in sync with your breath. Under normal circumstances, as you breathe in your diaphragm (the big muscle under your ribs) descends and your pelvic floor lengthens and drops down. As you breathe out, your diaphragm moves up and your pelvic floor contracts and lifts back to its resting state.
When we start to work harder with our breath, such as when we cough, sneeze or struggle to breathe when our nose is blocked, our pelvic floor also needs to work harder. This can lead to the muscles in the pelvic floor becoming tight and tired, which can prevent them doing their job to support your organs and keep you dry when you cough or sneeze.
How can you relax your pelvic floor muscles? Laying flat on your back with your shins resting on a chair and practicing some relaxed diaphragmatic breaths. This will help your pelvic floor lengthen. It can also have the added benefit of reducing stress in your body. Many people hold stress in their shoulders, but a surprising number grip their pelvic floor in response to stress. Reducing tension in your pelvic floor will allow it to function better.
Click the video to learn how to perform two simple pelvic floor relaxation exercises:
Please note that these exercises can be generally helpful if your pelvic floor has been affected by coughing etc. However, if you are experiencing symptoms that aren’t improving, you can see Dr Liz Johns or a pelvic health physiotherapist for an in-depth assessment of your pelvic floor.
The pelvic floor doesn’t work in isolation:
Lastly, coughing, sneezing and the changed breathing patterns that can accompany covid-19 and other illnesses affect far more than the pelvic floor. They can also put a lot of strain on your ribs and upper back. This may include increased muscle tension and reduced mobility through your ribs and upper back and altered breathing patterns due to both the disease process and possibly the immobility of bed rest. The impact on your musculoskeletal system can affect your pelvic floor by restricting the function of your diaphragm, which may then cause tension through your pelvic floor muscles.
With Covid-19, washing our hands, practicing social distancing and staying home if we are unwell have become second nature. It may also be time to add a ‘knack’ prior to coughing, sneezing and lifting. And who wouldn’t benefit from five minutes of pelvic floor relaxation in our daily routine?
By doing so we can strengthen, lengthen and teach our pelvic floor muscles about the appropriate timing of contraction. These suggestions may help reduce the impact a cough or sniffle has on this essential group of muscles during this tricky time.
We hope you’ve found this information helpful.
If you have any questions, our team at Pivot Osteo is here to help.
Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no practitioner/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.