The knack refers to the timing of a kegel or pelvic floor muscle contraction. Not only is it important to have strong pelvic floor muscles (PFMs), but also good control, coordination, and timing of them. Let’s examine stress urinary incontinence for a minute. When a woman sneezes and leaks urine, the force from above (in the form of intra-abdominal pressure) is greater than the force provided by the muscles and soft tissue keeping the urethra closed, with urinary leakage resulting. If that woman strengthens her PFMs, they will have a better chance of being able to counteract the pressure from above when she sneezes. However, even if she has strong pelvic floor muscles, if they do not contract at the appropriate time, urinary leakage could still result. This is where the knack comes into play. This woman will need to train her PFMs to contract just a second before the sudden burst of intra-abdominal pressure, in this case, a sneeze, occurs. Learning timing and coordination- the knack- ensures that the PFMs are working when most needed.
If you leak urine with activities such as sneezing, coughing, running, laughing, etc, give us a call for an initial pelvic health consultation. We can assess if you need to strengthen your muscles, work on timing, or learn to relax your muscles so they can contract for you when you need them most.
The information in this blog is provided as an information resource only and should not be used as a substitute for seeking personalized direction from your overseeing physician. Please consult your healthcare team before making any decisions about your pessary treatment plan, which is unique to you and your overall health. Toronto Pessary Clinic expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this blog.