Experiencing Urinary Leakage Caused by Coughing, Sneezing, Laughing or Exertion? Try the "Knack" Method
By: Allea Francis, PT, DPT
Using the “Knack” to Tackle Stress Urinary Incontinence
Stress incontinence is defines as urinary leakage caused by coughing, sneezing, laughing or exertion. Urinary incontinence affects four out of every ten women, one out of every ten men, and 17 percent of children under the age of 15. Additionally, 28 percent of male and female athletes between 18 to 21 years old experience stress incontinence.
Click on this image to watch a demonstration of the exercises listed in this post.
The knack is a technique designed to optimize a pelvic floor muscle contraction during the loaded phase of an activity. These activities include, coughing, laughing, sneezing, jogging, and jumping.
As we know, there are three layers to the pelvic floor. The first layer acts for urinary and sexual function. The second layer functions with assisting in urinary and bowel function. And the third layer assists with lumbo-pelvic stability and supports the pelvic organs.
The coordination and activation of the first two muscle groups (first and second layer) followed by the third muscle group, then creates optimal force closure of the urethra.
And not to forget, is the abdominal wall and multifidus. Your transverse abdominis and multifidus act as co-contractors with the pelvic floor and provide support and should be activated during the knack as well.
How the Perform the Knack:
In a seated position, inhale and as you exhale pull your pelvic floor up and in. Drawing belly button into your spine. You should feel your pelvic floor slightly lift off your seated surface.
Place your hands underneath a table and slightly press up. This part of the knack is activating the multifidus and fully engaging the transverse abdominis.
Fake cough
Repeat 10x
For an Added Challenge:
Perform in standing
Perform with a full bladder
For More Support:
Place a ball in between your legs and squeeze while coughing
Instead of a cough, start with "clearing your throat" action
We want to encourage you to get evaluated by one of our outstanding physical therapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain—you name it—these conditions do not have to control your life. There is hope. Call us today to book an appointment for 1 of our 3 Southern California locations, or inquire about a virtual, online treatment session.
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