The “knack” is known by lots of other names like the pelvic clutch, bracing, and “squeeze before you sneeze.”  The pelvic clutch may be the most descriptive.  I like the term “knack” because it feels positive to me.  It implies a skill that you can use to prevent leaking.  So, what is the knack?

What is the knack?

The knack is really a well-timed kegel squeeze or pelvic floor contraction.  The pelvic floor should contract reflexively when you cough, sneeze or laugh but sometimes this reflex doesn’t work well.  Deliberately contracting the pelvic floor before you cough and holding the contraction while you cough will minimize or even eliminate the leaking.  You can use this during any Valsalva maneuver that makes you leak like a cough, sneeze, laugh, jump, or even lifting a weight.  And practice makes perfect, this is something that you need to work on.  Stronger pelvic floor muscles will make this technique work better.

How do you do it?

Here is how you do the knack.

• First, exhale.
• Deliberately squeeze your pelvic floor.
• Then do the activity that you want to do (like lift a weight).
• Breathe and relax when you have completed the activity.

If it feels hard, start by doing it when you are lying down.  It may also help if you watch yourself in a mirror.  Of if you are working out with a trainer, tell the trainer so they can watch you.  Need more details on the knack?

Does the knack work?

Does this sound to simple to be true?  I totally understand your skepticism but it works well.  And it has actually been well studied. Researchers from the University of Michigan took the time to measure the amount of leaking in women with and without the knack.  They found that the knack minimizes leaking by more than 6 fold.¹  Learning this technique is definitely worth the effort!  It is also something that I recommend after surgeries as it can protect the repair during and after the healing process.

1.Int Urogyn J Pelvic Floor Dysfunct 2008;19(6):773-82.