After a nasty cough or chest infection, you’re finally starting to feel human again… and then it starts: heaviness and leaks. Not again! you think. Suddenly, you’re leaking when you cough, laugh or even just walk down the street. Maybe this is the first time it’s happened, or maybe leaks you thought you’d sorted through kegels (or with a bit of help from yours truly!) have suddenly returned. Either way, it can feel worrying, frustrating, and disheartening.
But leaking after an illness does not mean your body is broken, or that the progress you’ve made has been undone. It’s simply a blip in the road. So let’s look at why this happens and what you can do about it.
What Does the Pelvic Floor Do Day to Day?
Inside our stomach there’s a natural force called intra-abdominal pressure. This is constantly at work, pressing on our stomach, back muscles and pelvic floor. It helps stop our internal organs from being squashed so they can carry on doing their jobs properly.
This pressure shifts throughout the day with every move we make. Bending over, lifting something heavy, standing up or jumping all increase it. The pelvic floor and stomach muscles respond by either relaxing (making more space) or contracting (holding things in place). They do this so well, we hardly notice.
Coughing, Pressure and Your Pelvic Floor
Every time we cough, there is a sudden spike in this internal pressure. This sudden increase is usually managed by the pelvic floor, which quickly tenses to prevent movement of our internal organs and prevent the bladder from getting squashed and leaking.
But during a chest infection or flu, repeated coughing or vomiting cmeans you rpelvic floor is working overtime. Imagine doing hundreds of mini-squats every day without rest. Eventually your legs would feel like jelly and you’d rest them. The same happens with the pelvic floor. After days or weeks of coughing, the muscles may tire, which may make it harder to hold in wee and prevent leaks. This is one of the most common reasons women notice stress incontinence (leaking with coughing, sneezing or exertion) after illness.
Why Stress Incontinence Can Appear (or Return) After Illness
There are a few key reasons leaking can show up after a long cough:
- Pelvic floor fatigue
Repeated coughing tires the muscles. Even a strong pelvic floor can feel sluggish when fatigued. - Pelvic floor tension
Sometimes the opposite happens. Constant coughing can make the pelvic floor to tense up and forget how to relax. Then, when pressure spikes, it can’t squeeze any harder and instead can add to the problem. - Increased sensitivity of the bladder
Infections, dehydration, or irritation from illness can make the bladder more sensitive. This can lead to urgency or an increased feeling of needing to wee, which can put more pressure on an already tired (or tense) pelvic floor, leading to leaks.
BUT leaks after a long cough or illness are often temporary, with clinical evidence and experience showing that many women who develop stress incontinence after a period of illness improve once the cough has settled and the pelvic floor is given a chance to rest and recover.
How to Support Pelvic Floor Recovery After Coughing
If you’ve noticed new or returning leaks after an illness, there are some practical steps you can take to support your pelvic health:
- Practice Pelvic Floor Squeezes (kegels)
Just before you cough, or sneeze, think to squeeze your pelvic floor to give it a little helping hand in preventing leaks. If your finding this a struggle, you can add and extra ‘oomph’ to the squeeze by crossing your legs, which will again, help prevent any leaks. You can also practice some pelvic floor squeezes little and often throughout the day. - Relax your pelvic floor
You’ve spent a lot of time curled up during your illness, your muscles may be tense or stiff. Sitting with your legs relaxed and apart or crossed legged, taking deep belly breaths or resting in child pose are all positions that puts the pelvic floor into a relaxed position, encouraging your pelvic floor to relax. - Allow time for recovery
Be kind to yourself. Your body has been through a lot. Give yourself time to recover fully from the cough before expecting your pelvic floor to bounce straight back. If you ran a marathon and your legs felt like jelly afterwards, you would rest and not expect yourself to run another marathon, so offer the same grace to your pelvic floor. - Gradually return to activity
Once you’re feeling better, build back up to your usual exercise routine. It can be tempting to dive straight back into your usual routine, but tired muscles can struggle to keep up, possibly resulting in leaks. Ease back in, listen to your body, and build up steadily. - Keep you bladder happy
Aim to drink around 2 litres of water a day (more in hot weather). Dehydration makes urine more concentrated, which in turn, can irritate the bladder and increases urgency. Limit bladder irritants such as caffeine, alcohol and fizzy drinks if you notice they make things worse. And avoid “just in case” wees, which can train your bladder to be more sensitive. - Seek support if leaks continue
If your leaking hasn’t improved within a couple of months of recovering from illness, or if it’s getting worse, it’s worth seeking support. A pelvic health physiotherapist can help you understand what is gooing on in your body and how best to tackle those leaks once and for all by creating a tailored action plan just for you.
Common, but Not Your New Normal
Leaking after a cough is very common. It doesn’t mean your body is broken, and it doesn’t mean you’ll be stuck with it forever. Think of it as a temporary setback: your pelvic floor has been under pressure and now needs some care and attention. With simple self-care, rest, and professional support if needed, leaks don’t have to become your new normal.
If you would like personalised support with leaks after illness, you can book an appointment with me at Thrive Physiotherapy. Together, we can find the right approach to help you feel strong, confident and leak-free again.
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