Bend Your Knees When You Cough and Sneeze!

It’s the Time for Coughs and Sneezes!
An osteopath told me that some patients come to her because they have hurt their backs when sneezing and coughing. So, as winter arrives, yet more people may find their way to her door, unless they find a way of avoiding this problem to begin with. One way to help ourselves is through looking after our backs by having Alexander Technique lessons and being more mindful of how we use our bodies during everyday activities – even when coughing and sneezing!
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One of the main reasons that we can hurt our backs when coughing, is that if we habitually hold ourselves in a fixed manner with contracted, tense back muscles, this tightness will be increased by the strong spasms of coughing and sneezing, which will obviously be more exaggerated if you have a long bout of coughing. The lower back in the lumbar region can be particularly vulnerable and the jolting can jar the spine or strain the muscles, sometimes even damaging an intervertebral disc, causing great pain. There can also be a problem for people with hypermobility, as they can sometimes dislocate their joints if their body gets jolted strongly.

Protect Your Back 
If we anticipate these sorts of problem, we can cough and sneeze with some awareness and protect our backs. If we are standing we can unlock our hips, knees and ankles so that they can bend a little and, ideally, allow the back to continue lengthening even whilst we cough. Take care to align your hips, knees and ankles so that your knees move forwards and outwards over your toes without twisting.

If you have had some AT lessons, you can remind yourself to use a small (and moveable) monkey position when coughing. If we are sitting, we can free the hip joints and let our bodies angle slightly forwards from the hips, so that the torso is freer to move around as it needs to.

This allows our muscles to respond more with more elasticity but with direction so that there is a centredness within the coughing and this allows our ribs to expand and contract more easily with the spasms. In this way, the jolts can be softened and ripple through us, rather than straining us. As I have personally found, this way of sneezing and coughing can also be helpful for people after having abdominal surgery, possibly with the addition of holding the abdomen during the sneeze, to give the muscles more support.
Let the Tension Go Again

Importantly, let the tension go again after coughing and allow your chest to uncurl and open up again. If you forget to do this, the tension and inevitable pulling down that takes place when coughing will just go on building up. If you can lie down in semi-supine afterwards that can help enormously but sometimes it is hard to lie down horizontally if you have a bad cough. In which case, make sure your back (and head?) has good support and spend a few minutes encouraging your chest and back to free up again, just as you would if you were practising the lying down procedure.

The more able you are to have a free neck and back, the more resilient your muscles will be and the more efficient the coughs can be too. Even if you have not had Alexander Lessons, you can help protect your back as you allow your legs, with their moveable hips, knees and ankles, to act as shock absorbers when you cough and work your way back to health.

Remember: Bend your knees when you cough and sneeze!

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