Allergy Season Have You Worried About Urine Leakage When You Sneeze?

woman blow blowing nose

Pelvic floor physical therapy can assist in decreasing urine leakage during a sneeze, with the KNACK technique.

What is the KNACK? 

The KNACK is a strong and well timed contraction of the Pelvic Floor Muscles (PFM), also known as the Kegel. It involves the PFM contracting immediately before and during any increase in downward pressure of the pelvic floor, including sneezing or coughing.

When to perform the KNACK? 

The KNACK can be used with activities that increase downward pressure through the pelvic floor, including:

  • Coughing
  • Sneezing
  • Lifting
  • Blowing your nose

How does the KNACK control bladder leakage?

Bladder leaks can be controlled using this exercise by activating the PFM during increased downward pressure, which helps contract the muscles are the urethra. Usually during downward pressure like a sneeze there is minimal PFM activation, and with someone with more weakness, the sneeze causes more leakage. That is why we encourage patients with decreased in PFM strength, to perform this KNACK technique during downward pressure on the PFM.

How to perform the KNACK?

If you already know how to perform a proper kegel, then you are almost set. You will perform the kegel right before the downward force occurs. For example, if you feel a sneeze coming on, perform the kegel then hold the kegel as you sneeze. You have just utilized the KNACK technique!


If you do not know how to perform a proper kegel, you can call your local Aquacare Physical Therapy to discuss being seen by one of our Pelvic Floor Specialists.

Written By Kaitlyn Smith PTA at Injury Center location

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