Most Certainly.
As many of my blog posts are, this one was sparked by my own experience of my pelvic floor’s reaction to two weeks’ worth of coughing. I was the lucky recipient of a chest cold that was shared over Christmas. I only leaked a couple of times during the worst of it, but my most noticeable reaction was my muscles jumping back into their overactive state. This caused me to feel like I had difficulty urinating again and created that hot sensation that is common with an overactive floor. I haven’t felt these symptoms for some time, so I thought it was worth talking about.
Why Does Coughing Affect Our Pelvic Floor?
Within our core canister (our torso from the throat down to the pelvic floor and the surrounding muscles including the transverse abdominus and some back muscles) we have what is called the intraabdominal pressure system. This system is responsible for providing stability to the spine and supporting us during movement and activities.
When we cough, it can increase pressure in the abdominal and pelvic areas. When coughing is ongoing, as with a respiratory infection, that ongoing increased pressure may aggravate whatever we’ve got going on with our pelvic floors, including making muscles weaker, prolapse worse, and overactive/hypertonic overly contract.
Weak vs Overactive
In the case of weak/lax/overstretched muscles, the pressure from coughing might cause us to leak or full-on pee ourselves. This is often due to the muscles not being strong enough to provide support when called upon during a cough, sneeze, etc. and the extra pressure, if ongoing, can weaken them more.
If we suffer prolapse (a condition often going along with weak, lax muscles), ongoing pelvic floor pressure can worsen the condition.
When our muscles are already in or have a history of being in a switched-on overactive response, coughing can cause the muscles of the pelvic floor to contract against the increased pressure, which can kick them back into chronically contracting or make existing chronic contraction worse.
Overactive (hypertonic) pelvic floor muscles are held in a continually contracted state. This can be due to many reasons, ranging from constant gripping to try to stop urine leakage, to stress and anxiety causing us to grip and hold our abdominals and pelvic floor, to the pelvic floor muscles trying to provide support to our pelvic structure if we lack tone in the lower body. Pain conditions can cause gripping and tension, and gripping and tension can cause pain conditions. It’s a puzzle down there.
Overactive/Hypertonic/Tight Rarely Means Strong
It is important to remember that overactive/hypertonic does not mean strong. Usually quite the opposite. In cases of overtraining – athletes for example – muscles could be very strong and overactive. However, for most of us, this isn’t the case.
Weak muscles, for reasons mentioned above but not limited to, can kick into a chronically contracted/overactive state. If the muscles in your pelvic floor remain in a state of constant tension, they may grow weaker and less effective when you require their support, such as during coughing, sneezing, or lifting. This is due to their already being active and fatigued and unable to adequately contract and assist you when you need it.
If coughing causes aggravation of your overactive tendencies, practice your relaxation and release techniques regularly and directly after a coughing fit.
Once you are recovered, make releasing and strengthening your pelvic floor muscles a priority. Keep in mind that overactive/hypertonic muscles must first be relaxed and released before they can be properly strengthened.
For both weak muscles and prolapse where coughing causes a lot of leaking and/or pressure…
You should make strengthening your muscles a priority. Strengthening can improve your symptoms greatly and possibly prevent prolapse from worsening.
In the meantime, try these steps to provide some stability while you cough:
Tips for Managing the Effects of Coughing
For Leaking:
Before you cough or sneeze:
1. Take in a full breath before.
2. Engage your pelvic floor muscles. *
Doing this two-step technique can provide some stability and help prevent leaking.
For Overactive Response:
1. Take in several diaphragmatic breaths (feeling the expansion of breath begin at the base of the ribs, expand through the abdomen, and down between the sit bones. Your sit bones are the two bones you sit upon at the base of your pelvis.) laying down to this can be helpful, as lying back take some pressure off the pelvic floor and allows us to feel the movement of breath more easily.
2. Soften your whole body with each exhale.
* If you aren’t sure how to engage your floor, one way to do it is to feel like you are contracting your vaginal walls around a tampon. This might take some time to develop.
If you aren’t sure if you have, or what to do with, weak muscles, a prolapse, or overactive muscles and your symptoms are interfering with your daily life, talk to your doctor or a pelvic wellness professional.
