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The pubococcygeus (PC) muscle, also known as the pelvic floor muscle, is a muscle that stretches from the pubic bone to the bottom of the spine. It can weaken due to several factors, including aging, pregnancy, childbirth, and surgery. Weak PC muscles can cause various issues, such as urinary and fecal incontinence, erectile dysfunction, and premature ejaculation. To locate your PC muscle, pretend you are urinating and then try to stop the flow. The muscle you use to do this is your PC muscle. Once you've located it, you can perform Kegel exercises to strengthen it. Kegel exercises involve contracting and relaxing the PC muscle, helping to improve bladder control and sexual function.
| Characteristics | Values |
|---|---|
| Ageing | The muscles of the pelvic floor naturally weaken with age |
| Pregnancy and childbirth | Pregnancy and childbirth can cause pelvic floor muscles to weaken and stretch |
| Surgery | Surgery in the pelvic area can cause pelvic floor muscles to weaken |
| Obesity | Obesity (BMI > 30) or being overweight (BMI > 25) can cause pelvic floor muscles to weaken |
| Excessive straining | Excessive straining during bowel movements or chronic coughing can weaken pelvic floor muscles |
| Exercises | Certain exercises, especially jumping, running, and lifting heavy weights, can put stress on pelvic floor muscles and cause weakening |
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What You'll Learn
Ageing
Sarcopenia is caused by a combination of biological changes and risk factors. The biological changes include a reduction in nerve cells responsible for sending signals from the brain to the muscles to initiate movement, lower concentrations of hormones such as growth hormone, testosterone, and insulin-like growth factor, and a decreased ability to turn protein into energy.
Risk factors that contribute to sarcopenia include inactivity, a poor diet, and chronic disease. Inactivity is a significant factor, with research suggesting that spending a lot of time sitting or lying down contributes to muscle loss, even if one exercises during other parts of the day. Exercise, particularly resistance training, can help counter the effects of sarcopenia and improve muscle function.
In addition to exercise, maintaining a healthy diet that includes high-quality proteins is important in preventing and managing sarcopenia. Scientists are still determining the most important dietary factors, but low protein intake is suspected to be a contributing factor as the body has increasing difficulty turning protein into energy with age.
While there are currently no FDA-approved medications to treat sarcopenia, researchers at Columbia University Medical Center have identified a drug that may help reverse the process. Their study in mice showed that treating calcium leaks in ryanodine receptor channels, which are involved in age-related muscle loss, enhanced muscle strength without increasing muscle size.
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Pregnancy and childbirth
During pregnancy, hormonal changes and the weight of the baby can weaken the PC muscle. The secretion of the hormone relaxin, for example, helps loosen the pubic joint to allow for stretching during childbirth. Additionally, as the pregnancy progresses, the expanding uterus and abdomen shift the center of gravity forward, increasing pressure on the pelvic floor. This can lead to a range of issues, including bladder leakage and pelvic organ prolapse.
Adolescents are more likely to experience hip adductor weakness during pregnancy and postpartum, which may indicate a need for resistance training and physical therapy. Women with muscular dystrophy are also at greater risk of complications during pregnancy and childbirth due to reduced muscle strength. The added weight of the fetus can further contribute to muscle weakness, and the weakening of abdominal muscles can cause reduced breathing capacity.
Vaginal delivery and forceps delivery can also affect pelvic muscle strength years after childbirth. Maintaining a strong pelvic floor and PC muscle after pregnancy is crucial to preventing problems like stress incontinence, overactive bladder, and pelvic organ prolapse. Exercises like Kegel balls or weights can help strengthen the PC muscle, and devices like the Gynie offer active resistance to improve pelvic floor exercises.
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Surgery
Pelvic floor muscles can weaken as a result of surgery. They can become weakened due to prostate surgery, hysterectomy, or radiotherapy treatment. Pelvic floor dysfunction can lead to problems with bladder and bowel control, as well as sexual dysfunction.
Prostate surgery can cause urinary stress incontinence in men, which is characterised by peeing or dribbling when laughing, coughing, sneezing, or lifting. It can also lead to fecal incontinence, or struggling to control bowel movements, and anal incontinence, which is the inability to control the passing of gas.
Hysterectomy, or surgery involving the uterus, can also lead to pelvic floor dysfunction. This may result in pelvic organ prolapse, where the unsupported pelvic organs such as the uterus, rectum, and bladder bulge into the vagina or cause a protrusion from its opening.
Radiotherapy treatment can also weaken the pelvic floor muscles. This may be due to the stress and trauma associated with the procedure.
It is important to note that surgery is not the only cause of weakened pelvic floor muscles. Other factors include injury, childbirth, pregnancy, trauma, natural ageing, and chronic conditions such as diabetes.
To address weakened pelvic floor muscles, individuals can perform Kegel exercises or seek the help of a trained physical therapist specialising in pelvic floor muscle rehabilitation.
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Obesity
The effects of obesity on muscle function can be exacerbated by ageing, with a synergistic reduction in protein synthesis limiting the muscle's ability to adapt to an elevated body mass. This can result in increased functional impairment compared to ageing alone. Obesity can also increase the risk of sarcopenia, a condition characterised by the gradual loss of muscle mass, strength, and function, which commonly affects the elderly.
Research suggests that obese individuals may have greater absolute maximum muscle strength compared to non-obese individuals due to increased muscle size and strength. However, when normalised to body mass, obese individuals appear to have reduced muscle strength, which may be caused by reduced mobility, neural adaptations, and changes in muscle morphology.
While obesity can impact muscle function and strength, it is important to note that the specific effect on PC muscles is not explicitly mentioned in the sources. However, given the overall detrimental impact of obesity on muscle function and strength, it is reasonable to assume that obesity may also weaken PC muscles.
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Excessive straining during bowel movements
Straining during bowel movements can be a symptom of anismus, or dyssynergic defecation, a functional disorder where the muscles and nerves in the pelvic floor fail to coordinate correctly to have a bowel movement. This can cause or be caused by chronic constipation.
If you are regularly straining during bowel movements, you may be at risk of developing hemorrhoids. Straining can also be a symptom of anismus, which is a type of pelvic floor dysfunction that makes it difficult to defecate. This condition can be treated with biofeedback therapy, which uses electrodes on the skin to sense things like heart rate, breathing, and muscle tension. The therapy then guides the patient through strategies to relax and activate their muscles.
If you are consistently straining during bowel movements, you should consider consulting a doctor. They may recommend Kegel exercises, which can help strengthen the pelvic floor muscles. To perform Kegel exercises, you must locate the correct muscles. To do this, imagine that you are trying to stop yourself from passing gas or urinating. Once you have located the correct muscles, squeeze them for about five seconds, then relax for five seconds. Aim to do this 10 times per session, and try to complete three sessions per day.
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Frequently asked questions
The pubococcygeus (PC) muscle, or pelvic floor muscle, stretches from the pubic bone to the bottom of the spine. It supports organs in the pelvis, like the bladder, bowel, and vagina.
PC muscles can weaken with age or due to things like pregnancy, childbirth, or surgery. Obesity or being overweight can also be a factor.
You can strengthen your PC muscles by doing Kegel exercises. These involve tightening and then releasing the muscles in your pelvic floor.
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