“The Knack” is a technique that uses your Pelvic Floor exercises in a functional way. This is used to prevent Stress Urinary Incontinence (SUI) or leakage during sudden increases in intra-abdominal pressure such as a cough, sneeze, jump or lift.
People who do not suffer from urinary incontinence are able to automatically contract the Pelvic Floor muscles simultaneously with, or just prior to increases in abdominal pressure. In people with SUI, this reflex appears to be absent so we need to train it.
Set-Up & Practice:
Before using “The Knack”, ensure that you are correctly activating the Pelvic Floor muscles and not making the mistake of “bearing down”. This bearing down can create increased intra-abdominal pressure which places greater strain on the Pelvic Floor muscles. To do this:
- Lie on your back on the floor with your knees bent-up and feet flat on the floor
- Continue to breathe normally as you imagine the cues below to activate the pelvic floor
- Feel a lift up and forwards as the pelvic floor contracts
- Be sure to fully relax the pelvic floor at the end to avoid a “tight” or overactive pelvic floor
Imagine the following scenarios and apply the one that works best for you:
- Pelvic floor as a sling/elevator/hammock -> try to lift
- A ripple in a drop of water – do the opposite
- Do the opposite of a parachute opening-up
- Suck a thickshake up through straw with your vagina
- Hold in flatulence
- Stop the flow of urine mid-stream
How to perform “The Knack”:
Voluntarily brace and lift the pelvic floor muscles just prior to and during increases in intra-abdominal pressure.
I.e. Contract -> Cough -> Relax
Contract -> Lift -> Relax
Practice this so that when it comes to times when you need to unexpectedly sneeze, cough, laugh, jump or lift, you are ready to automatically turn the pelvic floor on to avoid leaking.
To ensure you are performing the activation correctly, you can insert a finger into your vagina (perhaps in the shower) and feel for a forwards and upwards lift as you contract.