How To Manage Pelvic Floor Symptoms While Dealing With A Respiratory Virus
Coughing stresses your pelvic floor and that’s OK. I’ve fielded so many emails from patients these past few weeks who are really worried that their cough fueled by a cold, the flu, RSV or COVID is going to worsen their pelvic floor condition. Here’s the thing - a respiratory virus will stress your pelvic floor, and that’s OK. It’s common for folks to notice a worsening of symptoms like urinary incontinence and heaviness in the pelvis during a respiratory virus, but that doesn’t mean that whatever existing impairment is getting worse. Once you recover, your pelvic floor should as well.
What we want to make sure we do is support our bodies the best we can during these periods of increased stress to manage symptoms in the short terms while strengthening our bodies in between bouts of illness to improve resiliency in the long term. This blog post will cover why coughing often worsens symptoms, what kinds of tips and tricks we can use in the short term to manage symptoms, options available for improving support to your pelvic floor while sick and what the long term solution for a strong and healthy pelvic floor looks like.
Why does coughing often worsen pelvic floor symptoms?
Coughing creates an increase in intra-abdominal pressure. Intra-abdominal pressure is the pressure in your abdomen that exerts force on your pelvic floor. As you cough, particularly involuntarily, your body experiences a “coordinated contraction of the thoracic, abdominal and pelvic muscles, which increases intra-abdominal pressure (IAP).”
Ideally we’d want to see a coordinated pelvic floor contraction strong enough to support your body through the cough. But for some who’ve experienced pelvic floor injury (like birth), that coordinated contraction doesn’t always reach the pelvic floor. For others, the coordinated contraction occurs but the strength of the cough overpowers the strength of the contraction.
What’s the short term solution?
Just because the stress from a respiratory virus is normal doesn’t mean there aren’t things we can do to lessen the impact on your symptoms! If you’re struggling with leakage, heaviness in your pelvis or other symptoms while dealing with a cough, there are lots of things you can do.
There are two main categories of tips that we can implement when navigating a respiratory virus. These two categories for managing pelvic floor symptoms throughout illness include:
Reducing pressure on the pelvic floor.
Increased pressure is typically the driving force behind aggravated symptoms during respiratory viruses. If we can reduce the intensity or frequency of that pressure, we give your pelvic floor a break.
Increasing support for the pelvic floor.
It’s not always possible to reduce pressure, and in that case increasing support for your pelvic floor can make a huge difference. We can’t make your muscles stronger overnight, but we can certainly give them some help. Pairing these two together is even more effective!
Read on for details in both categories.
Here’s how to reduce pressure on your pelvic floor:
Reducing pressure on the pelvic floor during a respiratory virus typically centers around cough suppression. Depending on whether you’re lactating or not, different options may be more or less appropriate for you to suppress your cough. If considering medications to help reduce pressure on your pelvic floor, be sure to talk to your medical provider for personalized advice.
Options for cough suppression, thus pressure reduction, can include:
Cough suppressants
Decongestants
Inhalers
Cough drops with or without numbing agents
Gargling salt water
Tea with honey
Drinking warm fluids
Depending on the cause of your cough and other symptoms you’re experiencing, one method of cough suppression may be more effective than others.
Here’s how to increase support for your pelvic floor:
Pressure reduction isn’t always possible. Sometimes a respiratory virus has you coughing up a lung for weeks at a time no matter what you do. In that case, it may be helpful to increase support for your pelvic floor.
Options for pelvic floor support include:
Wearing your pessary: A pessary is an insertable device that you can wear vaginally to help support your internal organs and pelvic floor. Pessaries come in all shapes and sizes and need to be sized for your body. Urogynecologists, obgyns and urologists can fit you for a pessary.
Using a pelvic support garment: While pessaries provide internal support, external support garments are a little easier to come by as they don’t need to be fit by your medical provider. Check out HEM Support Wear or the V2 Support by It’s You Babe for examples of external support garments.
Increase glute and core exercises to provide extra support from surrounding muscles: Your pelvic floor doesn’t work in isolation. Surrounding muscles like glutes, adductors, and abdominals play a big part in supporting your pelvic floor. When your pelvic floor is fatigued from navigating all the coughing, doing some extra glute and core work can take a load off your pelvic floor. Strong coordinated muscles are also a great long term solution to prevent these symptoms from returning with every sick spell!
Spend time in gravity assisted positions like hips on a wedge or legs up the wall: Resting with your legs up a wall or hips on a wedge can help take stress off your pelvic floor and give your muscles a break.
But more than anything, remember that this illness is temporary and the symptoms will improve as the illness does.
What’s the long term solution?
Will a coughing spell always be a stressor for your pelvic floor? Absolutely. But will you always have symptoms when this happens? Not necessarily!
Cough suppression and pelvic floor support will always be helpful, but a long term goal for many is to reduce the onset of symptoms, not just manage them, even during times of stress.
So what’s the long term solution so this doesn’t continue happening every time you’re sick?
Get stronger! Having strong, flexible and coordinated muscles will help your body be resilient to the stress of illness. If it’s possible for you, working with a pelvic floor PT can help you gain the strength, coordination and techniques you need to manage symptoms even in times of stress. Every body is different and every individual needs a slightly different approach.
Have questions about pelvic floor PT?
Give us a call at 512-766-2649 or send us a message here to chat with our office and learn more about how we can help you!
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.