Prevent leaking while you sneeze with this easy trick!
The “Knack” is a Knack!
Knack /nak/ noun: an acquired or natural skill at performing a task
Do you leak when sneezing, coughing, or laughing?
When we sneeze, laugh and cough there is increased pressure placed down on the pelvic floor from above which can lead to more force on the bladder which may in turn lead to urine leakage in some individuals. We can help to prevent leaking during these periods of increased pressure by doing what is colloquially known as “the knack.”
When we sneeze, laugh and cough there is increased pressure placed down on the pelvic floor from above which can lead to more force on the bladder which may in turn lead to urine leakage in some individuals.Essentially the “Knack” is a counter-bracing technique, or a specifically timed pelvic floor contraction (aka kegal). The muscles of the pelvic floor help to create closure pressure around the urethra to prevent urine leakage during times of increased intra-abdominal pressure.
So, the knack is great for 2 things. Firstly, by helping you stay dry while you enjoy a leak-free laugh, cough or sneeze and even when blowing your nose! And secondly, it improves the automaticity of the contraction and the neuromuscular (or brain-body) connection and timing so that over time it will become more habitual and coordinated.
How to perform the knack:
Start by practicing a pelvic floor contraction. Inhale through your nose and then as you exhale squeeze and lift the pelvic floor (this is called a pelvic floor contraction aka kegal). This should feel like you are stopping the flow of urine or picking up a marble with your vagina.
Then add in a small practice cough, laugh, or blow your nose gently while you maintain the pelvic floor contraction. Afterwards, make sure to relax the pelvic floor back to its resting state.
You can continue to practice and progress this exercise by coughing more forcefully or several coughs in a row. (Maybe practice these at home so that others around you don’t think that you have COVID!)
So when the time comes, and you feel your nose start to tickle and your eyes start to water – you know what to do! Stay calm, strongly perform a pelvic floor lift and squeeze and maintain that while you sneeze.
The Evidence
In a 2008 study by Miller et all, pregnant women and non-pregnant women were asked to perform three hard coughs with and then without the Knack maneuver. Urine loss was measured under both conditions. In both groups (pregnant and non-pregnant women), urine loss decreased when the Knack was performed compared to coughing without it.
If you would like to learn more tips and tricks, or even better – get a personalized rehab plan – to staying dry and leak-free, visit us at Up and Running Physical Therapy in Fort Collins, Colorado.
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