I’ve had a bit of a cold for a week now. The worst of it was last weekend, when I was running a fever and coughing a lot, plus the usual stuffy head. It’s been abating since then, although the cough hasn’t finished with me yet.
So sometime around Monday, my chest muscles were getting really sore. Intellectually, I knew I needed to keep coughing to clear my lungs. But a couple of times I just didn’t want to because it hurt to cough. I briefly thought that this must be a little glimpse of what it feels like for someone ready to give up. Let me assure you that I’m not ready to give up yet. I fought through that pain (which, in the big picture wasn’t that bad), and am doing much better today even with the cough and stuffy nose.
But that did get me thinking. The ability to cough effectively is vital to life. If you can’t cough well, relatively simple illnesses (like a cold) can become life threatening.
It would not hurt any of us to work to strengthen the muscles needed for a good cough. I’ve never thought about that before, and I don’t recall hearing it talked about as part of an exercise regimen. Take a look at working out your intercostal muscles and your diaphragm. And the older you are, the more important the strength of these “forgotten” muscles can be.
Diaphragmatic breathing is what you want to practise. There are actually quite a few internet sites with exercises designed to train this skill…vital for singers, wind instrument players and endurance athletes.
As with a good many other compromises that appear to come with aging, disuse atrophy plays a big part in this apparent weakness. Sedentary lifestyle being the culprit. There aren’t many folk around who routinely exercise at an intensity that causes an increase in the rate and depth of respiration …which is one obvious way of applying a challenge to these muscles. It’s not the sort of thing you notice or bother to think about until you’re faced with a situation where the lack of spare capacity is a serious compromise to health.
After my husband’s open heart surgery, he needed to do forced expiration exercises to keep his lungs clear. Every hour I would have to get him to use a small spirometer device to measure/encourage long forced exhaling. As tough as it was with the post op pain etc, it would’ve been darn near impossible if he was a non exerciser with minimal experience of creating and meeting more than a minimal oxygen demand.
Exercise future proofs the body in all manner of ways that aren’t always obvious until they’re gone.
I started playing clarinet and saxophone at about 10 and added singing in high school. Mostly dropped the instruments after college, but have kept up with the singing until the last couple of years.
Even with that background I still got very sore intercostal muscles from the coughing.
Well, a couple of possibilities here. First, coughing…if it’s bad enough…might just be a sort of activity that pushes the muscle to the extreme (apart from, say, blowing up hot water bottles) that soreness afterwards is almost inevitable. Normal, in fact. A bit like vomiting and your abs.
Or, if singing etc is an activity that did keep the muscles in good shape, the time you’ve taken off is plenty to allow a decline in strength to take place. Just like any muscle group…use it or lose it. Happens more rapidly the older we get. If I take something like a 2 week break from a given exercise and come back to it using the same weights as I did before, guaranteed I’ll wake up next day with a definite case of delayed onset muscle soreness.
I’ve had a very humbling example of this myself. Just over 2 years ago I had lapiplasty on my right foot. Knowing that this would involve close to 6 weeks off my feet and having 3 months advance notice of the surgery (backlog from Covid) I used that time to do a bit of “supercompensation” and put even more effort than usual into building muscle…especially fast twitch/strength and power fibers, as I knew that these tend to be lost more rapidly in the Chronologically Enriched.
Long story short…when I was finally fit and pain-free enough to test what I could do in comparison from the week before the surgery, I wasn’t even fit enough to attempt to test myself!! From being able to do a 12" box jump, I couldn’t even launch myself to jump onto a 3" step without risers. Heaps more examples of what I couldn’t…and still can’t…hack! A humbling experience…but to be expected. It’s physiology in action.
Have my appointment with the orthopod on Monday to plan for the other foot in January. Going to be some hard work going on this holiday season.
Edit:…was wondering if I should skip the weights today (I always wonder that) and then this drifted across my radar screen. I guess the answer is no. I’ma thinking some DOMS is on the docket for the next couple of days
I use expectorant pretty early on in a respiratory issue. Really helps bring things up without excessive force. Drink lots of water too.
As far as health issues, I seem to be having a Covid Hangover, (my term.) Covid was at the beginning of September and while I have been improving, my endurance is shot, periodically. Some days great, other days racing heart and dizziness. Got put on a heart monitor yesterday. Got to admit this is less than happiness. It’s my second experience with Covid. The first was much easier. Stay conservative with possible exposure to Covid. You never know how it will impact you!
@ptheland I’m sorry to hear that you are ill. I hope you feel better soon.
I have had serious torso surgeries, including splenectomy, hysterectomy and bilateral mastectomy (plus a subsequent reconstruction surgery). So my experience of recovery is somewhat more relevant than @VeeEnn’s foot surgery. (Which was doubtless painful and debilitating; I don’t mean to minimize it.)
I agree with all above that breathing is key to recovery. In fact, the hospital gives each surgical patient a spirometer to practice breathing. This device measures both the speed of expiration and the volume. In order to meet the challenge, one must be able to finely control the diapragm and intercostal muscles in addition to completely filling the lungs down to the bottom.
The lungs are pyramidal. Most of the air volume is in the bottom of the lungs. However, most people breathe shallowly, using only the upper lobe. The lower lobes are more difficult to empty and fill.
Peter, you are a very smart guy. You know intellectually that it’s important to exercise the “forgotten” intercostal muscles and diaphragm. However, I have not “forgotten” these muscles. This is how I exercise them. These are hard exercises that take a lot of effort.
Yoga deep breathing. Because this exercise is done lying flat on your back, it looks easy. Don’t kid yourself. It’s very hard. To a count of 8, breathe out at an even pace, starting with the upper lungs and then squeezing all the air out of the lower lungs like a sponge. Then, to a count of 8, evenly breathe in, starting with the upper lungs and being sure to completely fill the very bottom of the lungs. This works the diaphragm. Repeat 30 times.
Lie on a yoga mat. Lift your shoulders off the mat – they will stay up through the whole exercise. Hold a weight in each hand. (I use 5 pounds in each hand.) Slowly pull your arms and lets toward your center. The slowly extend your arms and legs, keeping them a few inches off the floor. Repeat 25 times.
Side crunches. Lie on the mat. Lift your feet off the mat. Cross one knee over the other. Lift a weight in the opposite hand. (I use 5 pounds.) Support your head with the same-side hand. Crunch inward diagonally, touching the weighted elbow to the crossed knee. This strengthens the obliques and intercostal muscles.
Active aerobic exercise. Get a pulse oximeter. Do your favorite aerobic exercise, trying to get your pulse rate over 120 with blood oxygen concentration over 95%. My favorite is Zumba, which I do at least 3 times per week. This works the entire cardiovascular system, as well as the nervous system. https://www.youtube.com/watch?v=MQxuNKqRflc
My experience is that it’s essential to exercise the entire body every day, working around the vulnerable areas (e.g. surgical areas, busted tendons, etc.). Any muscle and joint that is neglected will be sure to ache.
An amazing resource is https://www.bandhayoga.com/ . The best anatomical illustrations I have ever seen, including moving videos showing every muscle.
Here you go @ptheland …this is almost identical to the spirometer my husband used and brought home from the hospital. Available on Amazon and a few other merchant sites. Use the how-to guide for self testing and training.
I read the book. Been doing all cold shower routine after hard workouts for a couple of years now, I definitely buy into it. That is not even close to as hard core as Wim, but it’s been working so far.
I had a kidney removed about 25 years ago, when I was near the peak of my amateur singing. They gave me an incentive spirometer in the hospital. I found it pretty easy to do and not much of a challenge, even with a 9 inch surgical wound in my side.
I am not really convinced that the spirometer or the deep breathing techniques others have listed really work the intercostal muscles. They definitely work the diaphragm and get you thinking about breathing deeply - and that is certainly good. Having given your suggested exercises a brief test, #2 works my abs to failure pretty quickly (need to do more of those!!!) I’m not sure #3 really works the intercostals - lots of obliques, of course. Quite possibly my technique isn’t right.
With my current weightlifting program, the Superman wasn’t that bad. I could hold that position for several seconds. I suspect that weightlifing work is why I don’t have back problems. (see note below for a brief story)
So I’m still think there might be a way to target the intercostals a bit more specifically. At any rate, the experience is giving me a new incentive to get back into a bit better shape.
–Peter
Story time:
In spite of not feeling the best, I went to a previously scheduled day at Disneyland with my son and 3 of his friends. Two are a couple with a 2 month old child taking an afternoon off of parenting duties and turning those over to the grandparents. The third is a an active duty Airman taking a bit of a vacation after his first year of service. And I’m the old fuddy duddy, who at 60-something is a good 20 - 25 years older than any of them. So when it comes to getting my son on and off of various rides we started taking turns. I did the first ride to give them an idea of what was involved. The airman and new father then took a turn each. I didn’t expect the new father to do much, as I knew he had some conditions he’s living with that make too much lifting a bad idea. And the airman has some back problems as well. So by the end of the day, it’s the old guy doing all the lifting. But then again, I do all the lifting every day. So I’m in shape for it and know how to do it so as not to hurt myself. My son and I know how to work together on this particular “dance” and we do it well because of all the practice we’ve gotten over the years.
I am 73, and my husband and almost all of my friends here in mexico are under 65, and most are under 50. But when it comes to hauling and lifting I am the go to guy, with the proud nickname “El Gringo Burro”.
All those years mountaineering are still paying off.
If you’re actually finding no real challenge from somewhat challenging activities such as forced breathing etc, it might well be that my first suggestion in my post upstream …that your sore chest is a normal response to industrial strength coughing…it’s possible that there’s nothing at all wrong with your intercostal muscles. Focusing on them might well be “majoring in the minors”.
However, if all this has indeed provided an incentive to improve your fitness then it’s been a timely episode. Incentive can come from the oddest of places.
I oftentimes think that it’s the foundation I inadvertently laid down in my teens and 20s that’s been paying dividends in my 60s and now 70s…and hopefully beyond. A bit like starting a consistent financial plan early on…it’s the power of compound interest.
Problem with the body is that, after a certain age, benefits don’t continue to accrue without input. There’s a common phrase in exercise science…you grow up until your 20s and then you grow old. The manager of one of the gyms I taught at back in Boston phrased it well and would often tell members that, if they wanted to be in their current shape in 5 years time, they needed to work hard. If they wanted to be in better shape, they needed to work really hard. My experience from 10+ years further on is that, if, in your later years…71 for me … you want to maintain what you have, you’re going to need to work even harder than you did to gain it in the first place. That’s a bit of humbling experience.
My husband would say that I should’ve aimed lower in the first place then I wouldn’t have to work so hard. Good job I’ve had 45+ years to practise not listening to his nonsense.
Is this a standard Holter monitor (where the reading is analysed after a period of wear) or a device that gives you feedback in real time?
Arrhythmias suck…whether is a very intermittent Paroxysmal Afib or something more serious. There are folk, apparently, who have “silent” arrhythmias…hence the marketing around the ECG feature on wearables like the Apple watch etc and how wearers were alerted to something like Afib by their watch. Can’t understand it myself as I could tell precisely when I slipped into Afib and back to sinus rhythm. My daughter has had me wear a Holter monitor a couple of times and had me record when I thought these episodes occurred …and, comparing with the Holter analysis, I was spot on every time.
I wish you the best of luck and hope it’s a temporary thing that you can get a handle on. It really messed with my head during the period these were happening. Not a single “paroxysm” since the end if 2018 but I haven’t forgotten how vulnerable I felt in spite of protective medication and whatnot.
It’s 14 day monitor that I have to press to record when I feel an issue. Of course, that means I feel something all the time with power of suggestion, but hold off pressing unless it’s a heart pounder or near faint spell.
That said, I would like a wearable, but don’t have a clue what to buy. I am a person who is comforted by data, or lack thereof in the case of a real time device. DH, who already sports a CGM and insulin pump is less enthusiastic about the idea…understandably!
Already can’t wait to get this thing off. Really gets in the way of my pickleball game, not to mention irritating as heck, but it does force me to document what is going on and gives me a better feel for the issue.
Vee, I appreciate your sharing you AFIB issues. It’s part of what made me pay attention to what was going on, and not just assume dehydration. I asked the guy who put the monitor on if he had seen an increased incident of cardiac issues with Covid. I got a strong yes from him. Once again for me the virus itself was less of an issue than your average cold, though it was weird losing smell and taste, which happened after the fact. Recovery this time is not a simple 3 weeks of feeling as though someone was sitting on my chest, as was the case for both DH and I in 2020. But every vaccine I get comes with worse side effects. Feels as though I am damned if I do, damned if I don’t. Youngest has decided he is not going to get any more shots, as the side effects for him as worse than the virus itself. But take heart…he and I react strangely to meds. YMMV.
@ptheland the intercostals are breathing muscles. Your difficulty coughing is what cued you to their importance. If you focus on deep breathing in coordination with the core exercises (e.g. Exercise #2 which puts a lot of stress on the core) you will be exercising the intercostals.
A key teaching of yoga is breathing in coordination with exercises. This is especially stressed in “flow yoga” classes where the teacher directs movements from one pose to the next. This takes a lot of planning on the teacher’s part since the entire class is moving continuously, using body weight as the resistance. These are intermediate level yoga classes, quite strength-oriented. I can’t do these classes the way I used to 10 years ago but I can do them more slowly at home.
Wendy
I bet it’s recording all the time, but also wants your input regarding what you feel at specific times. This guess is solely from an engineering, not medical, perspective, because storage is cheap, small, and low power nowadays. A family member once wore a Holter for 7 days and it was super annoying! I wonder if they could come up with some sort of patch (like the new blood sugar monitors) or watch (like Apple watch?) thing to monitor this without the intrusiveness of a Holter? My nephew with diabetes has one of those blood sugar monitors and it’s tiny and hardly noticeable (to him or to others). It’s very cool, even comes with an app for the phone!
DH was great with his CGM and pump until they changed the program to treat him like an idiot. He inputs his carb count, and the pump delivers the needed insulin. That used to be fine, but the new program will only deliver up to 50% of what he has historically used in a day. This is problematic in that we carefully very low carb to the tune of about 25 net grams a day, so any extra “splurge” triggers the restriction of insulin. This should allow him to minimize insulin error, but when the pump refuses to give him what he asks it for and doesn’t let him know that it the case, he gets screamingly high sugars. Took about 2 weeks of calling the product rep to figure it out. He has no health reasons not to consume a bit more in carbs from time to time, and plugging in the accurate numbers is not an issue for him, except that his pump doesn’t trust him anymore. The recent “upgrade” opened up a whole can of worms. Cool is in the eye of the beholder. The phone app is certainly better than graphing manually, but this is not a good experience with a manufacturer that he has used for several years. I guess they don’t know what to do with an engineer who can control his eating habits and compensate effectively when he splurges.
