Your Body After COVID-19 Virus or a Chest Infection

Learn How to Manage your Body After a Virus

Your Body After COVID-19 Virus or a Chest Infection 1With the widespread prevalence of COVID-19 in our community it is important for us to know how to manage our bodies during and after COVID. There are also many other viruses which may affect us and are still running rampant in our community, as well as chest infections.

When your COVID-19, virus or chest infection symptoms are at their worst, you are solely focused on the basics: resting, hydrating and monitoring yourself for worsening symptoms.

However as you're on the road to recovery and your symptoms subside, you can be left feeling flat, and possibly with a dry cough or shortness of breath. In fact it's not always just your chest and throat that are affected. There are many secondary symptoms that come with persistent coughs and sneezes, here are a few that your physiotherapist can help with.


Prolonged coughing can put additional pressure through your abdomen and pelvic floor, which can be a problem if you don't have very good strength to start with. If sneezes and coughs are starting to leave you with a little leakage, know that this is very often treatable. Many physiotherapists specialise in pelvic floor control and strengthening. Doing some basic pelvic floor muscle strengthening, even when you're resting lying or sitting, will help to prevent or improve incontinence.  But speak with your physio if you are unsure as to how to do these effectively.  We can also use Real Time Ultrasound to help educate you on how to use and activate these muscles.  Click HERE to read more about this.

Pelvic floor exercises begin with learning to simply activate the pelvic floor muscles. Here's how you do it...

  1. The first step is to find a comfortable position, attempt to relax all muscles, and focus on a steady breathing pattern.
  2. To activate the anterior pelvic floor muscles, replicate the action of stopping the flow of urine mid-stream.
  3. To activate the posterior pelvic floor muscles, replicate the action of stopping passing gas.
  4. To activate both the anterior and posterior pelvic floor muscles, combine the two above actions.

When activating the anterior pelvic floor muscles, it is important to not actually stop the flow of urine mid-stream when using the bathroom, as this may lead to difficulty with fully emptying the bladder.


Coughing and sneezing can raise your ICP (Intracranial Pressure), the pressure of blood on the cranial circulatory system. This can cause a throbbing feeling in your head when feeling unwell. Coughing elevates this pressure, resulting in increased feelings of heaviness and aching. You may also find that coughing and sneezing bring your head into a forward position, putting additional pressure on the muscles at the base of the skull, the most common culprits in causing headaches. Your physio can help you with neck exercises, stretches and postural re-education to help ease these symptoms.


Coughing and sneezing also put pressure on your lower back and ribs. If you already suffer from back pain, this might be obvious to you. Many people experience an episode of acute low back pain during or after a chest infection or virus thanks to a sudden, awkward cough. Sneezes in particular create a sudden force on your body that can lead to strains and sprains of the ligaments and muscles around the spine. Your physio can help you with back exercises, stretches and back care tips to help ease these symptoms.


When your body is in a heightened immune state while fighting an infection, your entire body can feel stiff and achey. Any pre-existing pains can be more painful, particularly neck and thoracic pain. Your physio can help with stretching exercises and advise about return to exercise and sport.


Breathing can be impacted during the acute phases of the virus and beyond.  Learning to use your Diaphragm muscle can be a valueable tool to managing this. By doing some regular slow & controlled diaphragmatic breathing you not only get your breathing under control, but you can keep your chest clear, keep your oxygen intake (saturation) high and take the load off your upper shoulders and neck, which can be overused when you're not breathing effectively.  Overall you also get more relaxation through your body, which is crucial as you are recovering from any illness.

Here's how you do it....

  1. Lie on your back on a flat surface (or in bed) with your knees bent. You can use a pillow under your head and your knees for support if that's more comfortable.
  2. Place one hand on your upper chest and the other on your belly, just below your rib cage.
  3. Breathe in slowly through your nose, letting the air in deeply, towards your lower belly. The hand on your chest should remain still, while the one on your belly should rise.
  4. Tighten your abdominal muscles and let them fall inward as you exhale through pursed lips. The hand on your belly should move down to its original position.

You can also practice this sitting in a chair, with your knees bent and your shoulders, head, and neck relaxed. Practice for five to 10 minutes, several times a day if possible.

A colleague and friend who works on the COVID ward at the Royal Adelaide Hospital also advised that improvements are being seen in patients' oxygen saturation levels by changing position, from lying face up to face down.  Changing your body position in bed is important to change the airflow in the lungs.  If you are short of breath lying down then sit up and practice the above.


The two muscle groups you can work whilst you're resting are your PELVIC FLOOR and DIAPHRAGM muscles as detailed above.  Any other exercise should be commenced GENTLY and GRADUALLY.

When can I start exercising again?

Exercise is an important part of recovering from COVID-19. If your symptoms were mild, you can start exercising again if:

-you’ve had 10 days of rest since symptoms started
-you’ve had at least 7 days with no symptoms, and
-you’re no longer taking any medications such as paracetamol

Start with 15 minutes of light activity like walking or cycling, and see how you feel. Continue to slowly increase the duration and intensity of your exercise, paying careful attention to your heart rate and breathing rate.

Stop exercising immediately and contact your healthcare provider if you have any:
-chest pain or palpitations. If you experience severe central crushing chest pain lasting more than 10 minutes call 000
-unexpected breathlessness
-signs of blood clotting, such as swollen calves.

If you’re recovering from moderate or severe illness, speak with your healthcare provider before returning to exercise.

This article is not intended to replace medical advice. Speak to your physiotherapist or medical pracitioner for more information on how physiotherapy care might be able to help you.

Osteitis Pubis ~ Groin Pain

What is Osteitis Pubis?

Groin PainOsteitis Pubis is a medical term used to describe sports-related groin pain. Osteitis means ‘bone inflammation’, while pubis refers to the specific bone that is affected: the pubic bone. Osteitis pubis is usually an overuse injury that can sometimes be triggered by a specific event. It is characterized by pain deep within the front of the pubic bone, caused by inflammation. The area of the pubic bone affected is specifically known as the ‘pubic symphysis.  There are a lot of muscles, tendons, joints and ligaments in this region around the pubic symphysis that interact with each other.  Therefore the causes of osteitis pubis or groin pain can be multi-factorial and have mutliple structure involved.

This type of injury is common in load-bearing athletes such as runners. Other people commonly affected include soccer players and footballers, due to their frequent kicking actions.

Chronic groin pain is an often debilitating condition and one for which the recovery is rarely smooth. One of the biggest challenges when dealing with  (research would suggest this occurs in over 40% of cases) meaning getting a clear answer or diagnosis can sometimes be difficult.

How does it happen?Osteitis Pubis ~ Groin Pain 2

Instability within the pelvic region is the primary cause of Osteitis Pubis, particularly if the instability occurs at the connection between the two sides of the pubic bones at the front of the body. The pelvis carries the weight of the upper body and is responsible for providing stability when walking, running and kicking. This means that the joint can easily become irritated and inflamed.

What are the signs and symptoms?
Osteitis pubis is aggravated by weight-bearing activities, with running and kicking being the two main culprits. Pain is usually experienced on one side, however, both sides can be affected. The pain is usually located at the front of the pelvis and may progress into the hip and groin area as it becomes more severe.
Sufferers of Osteitis Pubis tend to have a history of a previous groin strain, as well as lower back pain. They may also have a history of a sports hernia in the hip area. As with most inflammatory conditions, the pain may be worse when in use, better when resting, and worse overnight into the morning.


Osteitis Pubis ~ Groin Pain 3How can Physio help?
Your physio can help this condition in several ways and will hopefully get you back to your pre-injury sporting level.

During the assessment, your physio will look at many different things to determine the cause of the condition. Muscle length, muscle strength and muscle control will all be assessed. Your posture in standing, walking and running will also be assessed to determine any irregularities.
Your physio will ask you to rest from sports for some time to allow some bony healing to occur. They will then progress you through a rehab program aimed at getting you back to the sport.

This rehab program, based on strengthening the core muscles, will retrain your muscles to stabilize the pelvis when walking, running and kicking. The muscles will also need to have relatively equal flexibility to help stabilize the pelvis. Your physio will give you specific exercises to target the strength and flexibility of these muscles. Finally, your physio will progress you to running or kicking, and allow you to gradually return to sport over a 3-to-6-month period.

The information in this blog is not a replacement for proper medical advice. Always see a medical professional for an assessment of your condition.

Shoulder Injuries

SLAP Tears – Labral Tears of the Shoulder

A SLAP tear is a term used to describe a shoulder condition or injury.  The label of ‘SLAP’, is an abbreviation for superior labrum anterior and posterior, identifying where the injury is in the shoulder.  The most common complaint in patients that present with SLAP lesions is pain. Pain is typically intermittent and often associated with overhead movements.

SLAP Tears - Labral Tears of the Shoulder 4What is a SLAP Labral tear?
The shoulder joint is surrounded by a ring of flexible connective tissue, known as a labrum. This labrum increases the stability of the shoulder while allowing the joint to stay flexible. The biceps muscle has an attachment directly into the labrum and this is often a point where injuries occur. A tear of the labrum can occur in many locations, however the most common is at the point where the biceps tendon attaches to the labrum. Usually, this tear follows a typical pattern and is referred to as a superior labrum tear, anterior to posterior (SLAP tear).

How do they happen?
SLAP tears can be caused by trauma such as a fall onto an outstretched hand, lifting something heavy or can develop over time through repeated stress. Repetitive overhead activities such as throwing or painting can gradually weaken the labrum over time and lead to a tear.

What are the symptoms?
Often if a SLAP tear develops over time, patients can be unaware they have sustained an injury at all and there is no significant impact on their pain or function. Preexisting SLAP tears can, however, place more tension on the long head of the biceps tendon, leading to overuse disorders as a secondary complication.  When the tear occurs through a sudden action or trauma, symptoms can be more noticeable.  Patients often notice pain deep in the shoulder joint with overhead shoulder movements, a feeling of weakness, loss of power and/or accuracy with throwing activities. Some people may feel a popping or clicking sensation and occasionally the shoulder may give way. In severe tears, the shoulder might feel unstable and even be at increased risk of dislocation.

Your physiotherapist can help diagnose a SLAP tear and send you for further imaging if needed. SLAP tears are graded by severity from I to IV as a way to guide treatment.  Physiotherapy is usually recommended as a trial for all tears before considering surgical repair and in many cases can effectively help patients return to their previous activities, symptom-free.   If physiotherapy is unsuccessful, surgical repair with a full rehabilitation program is then recommended. Surgery will either repair the tear or reattach the biceps tendon to the humerus (tenodesis). Following surgery, a period of rest in a sling is required before rehabilitation can begin.

None of the information in this article is a replacement for proper medical advice.
Always see a medical professional for advice on your condition.

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