The Knack
Incontinence

The Knack: A Clever Bladder Leak Hack

Ladies, I want to let you in on a little secret that just might help you the next time you get that “gotta-go” feeling. This trick doesn’t require any surgery or special equipment. It just requires your full attention and willingness to learn. So keep reading to learn more about this pelvic floor power-up called ‘The Knack’. It just might help you say goodbye to leaks for good. 

What Is “The Knack”?

Have you ever heard someone say “I’m getting the knack of it?” It’s a phrase used when someone is talking about gaining a skill to perform a specific task. In the bladder world though, ‘The Knack’ means something a little different.

The Knack, as we know it, is a well-timed and strong contraction of the pelvic floor muscles. You could also think of it as a perfectly-timed Kegel exercise. When all goes well, you could potentially stop a leak from happening altogether. 

How Exactly Does “The Knack” Stop Leaks? 

If you have stress incontinence, you’ll appreciate this. You know how pressure on your pelvic floor from things like coughing and sneezing could lead to leaks? Well, while you can’t stop the pressure, you could potentially stop the leaks. Kegels and other pelvic floor programs are often used to increase the strength of your pelvic floor muscles, but The Knack is a little different. 

The Knack doesn’t strengthen your pelvic floor muscles at all. Instead, it manually activates them. When everything is working the way it should, your pelvic floor muscles automatically contract when there’s an increase of pressure on the pelvic floor. So without you even thinking about it, this active contraction increases the stiffness of the supporting muscles and the pressure within the urethra to stop drips and spritz. 

The Knack maneuver allows you to manually activate these muscles and reap those same benefits when you deliberately pull your pelvic floor muscles up and in to prevent leaks. 

The Knack and Our Anatomy

Our pelvic floor has a total of three layers of muscles, with The Knack focusing mostly on the outermost layer. Research has shown that women who contract the outermost layer first before the deepest third layer, experience leaks less. Here’s a little background about each layer

  • The outermost layer, or the pelvic diaphragm, helps to close around all of the tubes at the end of the urinary system.
  • The second layer, also known as the urogenital diaphragm, helps your body stop and hold urine so you don’t leak. 
  • Layer one, also known as the superficial perineal pouch, provides stability to the perineal body (the muscles lying between the vagina and anus). It also closes the anal canal to prevent fecal incontinence. 

By contracting the right layer of muscles at the right time, you’ll be able to keep the urethra shut and prevent a leak. 

When Should I Do It?

The Knack is an intervention that you can use anytime you do an activity that’ll increase downward pressure upon your pelvic floor. If you have stress incontinence, chances are you’ve started noting every time you get that unexpected spritz. If not, try using a bladder diary to see if you notice that certain activities lead to leaks. We suggest trying The Knack with the following activities:

  • Going from standing to sitting
  • Blowing your nose 
  • Coughing
  • Sneezing 
  • Laughing 
  • Lifting
  • Certain exercises 

How Do I Do It?

Now that you’ve learned what The Knack is, we’re sure you’re curious about how to do it. First, we suggest wearing a bladder leak pad to protect your clothing while you’re learning this move. If you don’t have any, stop by Lily Bird’s site to order a package to be discreetly delivered right to your home.

To start, decide if you want to sit or stand. If you sit, sit away from the back of the chair. If you stand, stand tall with your chest lifted and be sure there’s an inward curve in your lower back. After that, do the following for practice:

  1. Lift and squeeze the muscles in and around your vagina, urethra, and anal openings right before you cough or lift
  2. Contract around all three openings at once. It should be a strong inward lift, then squeeze your pelvic floor muscles
  3. Maintain this pelvic floor muscle contraction as you do a small cough
  4. After you’ve coughed, relax your pelvic floor muscles
  5. As you get better at contracting your pelvic floor muscles, try to cough with more force while doing The Knack. 

Once you get the knack of it, you should start to see a decrease in spontaneous leaks if you squeeze before any abdominal pressure hits. One study found that within one week of learning The Knack, women leaked 98.2% less with a medium cough and 73.3% less with a deep cough. The same study also noted that they did not find an increase in pelvic floor strength with this technique, but imagine if you did Kegels and this!

Leak Less With The Knack

Well, ladies, the cat’s out the bag! The Knack is one of those maneuvers that doesn’t get a lot of love even though it provides real results. If stress incontinence is putting a pin in your plans, try The Knack. Combine this technique with daily Kegel exercises and you just might say goodbye to leaks for good.  

Is a leaky bladder something that’s stressing you out? Lily Bird has you covered with pads and underwear delivered right to your door. Start your trial today.

By Jessica Thomas, MPH