A cold can be hard on the core and pelvic floor, and we’re heading into cold and flu season! So, while sneezing, coughing, and blowing your nose may be inevitable this time of year, leaking doesn’t have to be.

Why do I leak when I sneeze?

Coughing and sneezing are a high pressure activity. Leaking can happen when there is a huge pressure increase in the abdominal cavity, and the pelvic floor cannot counter that pressure, resulting in a pressure “leak.”

To prepare your pelvic floor for the demands of flu season, it’s important to have a few key pieces in place:

• Breathing (diaphragm and pelvic floor coordination) and posture
• Baseline strength to be able to handle the increase in pressure

I’ll also dive into a few set up tips during your cough or sneeze to help!

Breathing and Coordination

Leaking during coughing and sneezing isn’t always about pelvic floor weakness. Our muscles (including our pelvic floor) love the ability to move through their full range of motion. If our pelvic floor cannot lengthen due to being in a contracted state, when there is an increase in pressure demand, our pelvic floor doesn’t know how to manage pressure flow and maintain continence.

Breathing drills and pelvic floor release are a great place to start coordinating the diaphragm and pelvic floor together for pressure management. 

Inhales move DOWN: as we inhale the diaphragm descends, the ribs and back expand, and the pelvic floor responds by lengthening.

Exhales move UP: Pelvic floor ascends, pressure moves up, and the diaphragm ascends.

Once you get the hang of the breath, we can work on coordinating the pelvic floor movement with the deep core to maintain stability of the spine and manage intra abdominal pressure. The pelvic floor is part of our deep core system. If the pelvic floor is not moving and coordinating with this greater system, this influences how we manage pressure and could cause leaks.

I coach you through breathing, the pelvic floor connection, and preparing for high pressure demand in the Connect Program.

Building Strength

Once we have gotten into a rhythm with the breath and coordination, we can build strength to help manage the increase in pressure. Throughout the Connect Program we work on achieving strength gains with the pelvic floor and core in mind.

• Stacked alignment: a ribs over pelvis position allows our diaphragm and pelvic floor to coordinate well to manage pressure.
• Thoracic mobility and back body expansion: if we have restrictions in the thoracic spine or a lot of back body tension it can make it more challenging to maintain that stacked position, rotate, and redistribute pressure. I love back body breathing drills like this one.
• Pelvic positioning: The pelvic floor attaches to the pelvis, so the pelvis will influence the pelvic floor’s resting tension. The left side of the pelvis is often oriented more forward, and throughout the Connect Program I coach you through postural corrective exercises and drills to find a more neutral position.
• Strong glutes! The glutes and pelvic floor are BFFs. Having strong glutes and hip control can impact leaking! I love integrating internal rotation work to help move the glutes through their full range of motion.

Lastly, let’s look at a few strategies to help when that quick sneeze strikes!

• Try the “knack” maneuver when a coughing fit hits: create an upward lift of the pelvic floor to make sure it’s activated to resist that downward pressure. Before a cough or a sneeze hits, exhale and lift the pelvic floor from the bottom up prior to the cough to push that pressure up and out!
• Sick and lying down? Place a pillow between the knees and squeeze the pillow and lift the pelvic floor before a coughing fit hits.

Check out this Instagram post for a visual

Don’t let coughs and sneezes hold you back this season. Get some rest and take care of yourself. You can explore the Connect Membership with a 14 day free trial to learn more about my strategies for staying leak free.

Cheering you on,
Caroline