Learn to Cough with Confidence
By Lara Desrosiers, MSc. OT Reg. (Ont.)
Lara’s Top 4 Coughing Tips
When you are dealing with leaking, pelvic organ prolapse or both, bouts of illness that involve a lot of coughing are no fun.
One thing that can be helpful to bear in mind is that while your body is giving its attention and resources to fighting off whatever virus is plaguing you, it can feel harder to engage those pelvic floor muscles-you might feel weaker BUT that does not necessarily mean that you are regressing. While your body is working hard to recover, fatigue is inevitable. More than likely, you will see the work that you have put into your pelvic floor health return once you recover.
AND…it still sucks! The repeated spikes of downward pressure can be exhausting. So how do you deal?
Never fear, I’m here to share my top 4 tips and tricks for getting through a cough. Give them a try and let me know if they ease the pressure or help you to feel a bit more supported!
Tip #1: The “Knack”
- A quick pelvic floor muscle contraction (squeeze and lift) in preparation for a cough to give you support through it
- Requires good recruitment of the muscles as well as solid coordination/timing
- A great thing to work on with your pelvic floor therapist to help you through any act that requires a similar quick increase in downward pressure – coughing, sneezing, laughing, puking… all the good stuff!
- Sometimes folx find it helpful to focus on relaxing and lengthening the pelvic floor muscles prior to engaging the knack when they feel that cough coming
- We can often access more power and support when the muscles are starting from a place of length or relaxation
- Can get harder to maintain as illness progresses and the pelvic floor muscles fatigue
Never fear! There is more that we can do!
Tip #2: The “Huff”
- Comes from the world of folx struggling with Chronic Obstructive Pulmonary Disease (COPD)
- Clears the airways efficiently and reduces the need for that exhausting reflexive coughing, particularly if coughs are wet and productive as opposed to more dry, hacking coughs
- Begins with sitting in an upright position and getting into a rhythm of slow and deep breaths
- Using diaphragmatic breaths, we expand the rib cage 360 degrees around the spine on the inhale while allowing the pelvic floor to lengthen and relax
- After your fourth/fifth inhalation, pause, holding your breath for 3 seconds
- Then force your breath up and out while making the sound “haaa” or “who” using pelvic floor/abdominal contractions to help expel the breath and mucus
- This may come with a few reflexive coughs at first, as you are adjusting and getting used to the sensation
- Many find that this method sends the pressure intentionally upwards and out as opposed to downwards on the pelvic floor
- Check out my demo here
Tip #3: Experiment with positioning
- Try working with gravity by changing up your positions
- Bend at the waste or get down on all fours when you feel a coughing fit coming
- See if this reduces some of that downward pressure you might typically feel go to the pelvic floor with coughing
Tip #4: Try giving yourself a little support
- When those pelvic floor muscles are exhausted, they might be able to use a helping hand (or chair)
- Try placing a hand on the perineum to provide some upward counter pressure during a coughing fit
- Sit down on a supportive surface
- A support garment can provide compression and a more supportive feel along the perineum for some
- Talk to your care provider about whether internal supports during periods of illness could be helpful
- If you use a pessary for certain activities, it also might provide some welcome internal support while you are navigating illness
Lara Desrosiers is an Occupational Therapist that supports individuals struggling with pelvic health challenges to get back to living life. She works with individuals from across Ontario, Canada. To learn more about Lara and her work, visit Pelvic Resilience.