Pelvic Floor Physiotherapy

Pelvic Floor and Stress Incontinence

Try Using the “Knack” to Tackle Stress Urinary Incontinence

Stress incontinence is defined as urinary leakage caused by coughing, sneezing, laughing or exertion. Urinary incontinence affects four out of every ten women, one out of every ten men, and 17 percent of children under the age of 15. Additionally, 28 percent of male and female athletes between 18 to 21 years old experience stress incontinence.

The knack is a technique designed to optimize a pelvic floor muscle contraction during the loaded phase of an activity. These activities include, coughing, laughing, sneezing, jogging, and jumping.

As we know, there are three layers to the pelvic floor. The first layer acts for urinary and sexual function. The second layer functions with assisting in urinary and bowel function. And the third layer assists with lumbo-pelvic stability and supports the pelvic organs.

The coordination and activation of the first two muscle groups (first and second layer) followed by the third muscle group, then creates optimal force closure of the urethra.

And not to forget, is the abdominal wall and multifidus. Your transverse abdominis and multifidus act as co-contractors with the pelvic floor and provide support and should be activated during the knack as well.

How the Perform the Knack:

  1. In a seated position, inhale and as you exhale pull your pelvic floor up and in. Drawing belly button into your spine. You should feel your pelvic floor slightly lift off your seated surface.
  2. Place your hands underneath a table and slightly press up. This part of the knack is activating the multifidus and fully engaging the transverse abdominis.
  3. Fake cough
  4. Repeat 10x


  1. Perform in standing
  2. Perform with a full bladder


  1. Place a ball in between your legs and squeeze while coughing
  2. Instead of a cough, start with "clearing your throat" action

At VanCity Physio, we want to encourage you to get evaluated by one of our outstanding physiotherapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain, issues that can be helped and quite possibly resolved. 

Call us today at 604-398-5584 to book an appointment at one of our two Vancouver locations, or inquire about our virtual, online treatment session.