The Knack is a very useful technique for women with pelvic floor problems.
The Knack is an exercise that helps women:
- Control bladder leaks
- Protect prolapse and after prolapse surgery
- Protect after hysterectomy
- Withstand downward pressure on the pelvic floor
‘The Knack’ exercise is a well timed contraction of the pelvic floor muscles before and during events that increase pressure on the pelvic floor such as cough and sneeze. Your pelvic floor muscles should automatically contract to help close shut your urine tube (urethra), control bladder leaks and support your insides.
This short Physiotherapist video teaches you ‘The Knack’ exercise that will quickly help you control bladder leaks and protect your pelvic floor (prolapse) when you cough, sneeze or lift.
Video Duration: 3 minutes
What is ‘The Knack’?
‘The Knack’ is a strong and well timed contraction of the pelvic floor muscles. It involves the pelvic floor muscles contracting immediately before and during any increase in downward pressure on the pelvic floor. ‘The Knack’ exercise is actually a strong well-timed Kegel or pelvic floor exercise.
How Does ‘The Knack’ Help Control Bladder Leaks?
Bladder leaks can be controlled using this exercise which helps to close the urine tube more effectively. When the pelvic floor muscles are working as they should, they contract automatically before and during any increase in pressure from within the abdomen, such as during a cough, sneeze of lift.
Women often lose the ability to automatically contract their pelvic floor muscles; with pregnancy and childbirth, after some types of pelvic floor surgery or pelvic radiation therapy or with repeated straining to empty the bowels. By actively contracting their pelvic floor muscles, women can often overcome the bladder leakage that occurs with lost automatic activity.
Can ‘The Knack’ Help Prolapse Support?
‘The Knack’ involves lifting and firming the pelvic floor muscles to withstand downward pressure from within the abdomen. A strong well-timed pelvic floor muscle contraction may help to reduce downward movement of the pelvic floor (and prolapse) helping to decrease prolapse symptoms during events or activities that increase pelvic floor pressure. If you have a prolapse or previous prolapse surgery, this technique is definitely worth knowing for long-term pelvic floor support and protection.
When to do ‘The Knack’?
‘The Knack’ can be used with events or activities that increase downward pressure upon your pelvic floor such as:
- Blowing your nose
- Rising into standing from sitting
- Stepping down heavily.
How to do ‘The Knack’ Exercise?
You can practice ‘The Knack’ exercise to control bladder leaks and support your pelvic floor, here’s how…
1. Sit away from the back of the chair or stand tall with your chest lifted and the normal inward curve in your low back
2. Lift and squeeze the muscles in and around all three pelvic openings (urethra, vagina and anus) immediately before you cough, sneeze or lift
3. Contract around all three pelvic openings at once, with a strong inward lift and squeeze of your pelvic floor muscles
4. Maintain this pelvic floor muscle contraction as you do a small cough
5. After you cough, relax your pelvic floor muscles back to normal resting level.
6. Progress this exercise with more forceful cough, or repeating a couple of coughs in a row maintaining your pelvic floor contraction throughout as you do so.
The Knack is an quick and simple exercise technique that can very quickly improve bladder control during episodes of increased pressure on the pelvic floor. It is also a very useful technique to help women protect their prolapse and reduce prolapse symptoms. Simply remember to lift and squeeze with every cough, lift or sneeze.
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support, along with Dr Judith Goh Urogynaecologist. The Inside Out exercise DVD and book show women how to strengthen the pelvic floor and exercise effectively with pelvic floor safe exercises.