 I was prompted to share this post because I've had a really nasty bout of coccyx pain recently. However - I've utilised some of these strategies and it's now resolved!
1. Offloading the tailbone is important during sitting. You can buy lots of different ring cushions on amazon but I find the blow up travel neck pillows have worked a treat for me! 2. The pelvic floor can often aggravate or contribute to tailbone pain so pelvic floor stretches can be very helpful in relieving symptoms. 3. Manual therapy doesn't work for everyone but when it does it's great! I then give patients a way of self treating at home. 4. You can try heat or ice, whichever gives relief. I definitely prefer warmth but see what works for you. 5. The coccyx is part of the spine so low back problems can also contribute to tailbone pain. Therefore it is important the spine as a whole is moving freely. Incorporate some spinal mobility exercises into your daily exercise programme. 6. Make sure you are not sitting in a slouched position because this loads the coccyx and can irritate it further. Make sure you're are sitting on your sitting bones (the bony bits in your bottom), not your tailbone!
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If your pelvic floor rehab doesn't include some kind of glute strengthening, now is the time to get started! Strong glutes allow your pelvic floor to focus on what it's best at - supporting your pelvic organs and keeping you continent!
 I was delighted to produce this infographic for the POGP journal to support Christien Bird's presentation at the POGP conference last year.
The presentation by Christien covered many different aspects of menopause management but the three key elements that all women need are good sleep, good diet and regular exercise. There is lots of confusing information out there, especially about diet in menopause. But the take home from the presentation was this: Manage your blood sugar levels. The easiest way to do this is through eating a combination of protein and complex carbohydrates. There is a tendency for women to "go to the mat" in the peri/post menopausal years. Whilst there are lots of benefits to doing lower impact mat based exercise, the benefits or doing a mixture of exercise types (including resistance and higher impact) are incredibly important for optimising muscle mass and bone density. Variety is key!  The boat in the dock theory (Delancey et al) is a way of illustrating the relationship between the pelvic organs (the boat) pelvic floor (sea), ligaments (ropes) and prolapse.
A weak pelvic floor doesn't cause a prolapse. But over time not having that support puts more strain on the other support systems, which in turn can cause more stretching or damage to the support system. The best approach is to always maintain a strong pelvic floor. If you then stretch or injure any of the connective tissue supports (eg through pregnancy or childbirth), you've still got some solid muscular support. If you've already gott a prolapse and haven't had any pelvic floor strengthening, hopefully you can see from this image why it's so important!  There is little conclusive evidence on the best method of rehabilitating a diastasis. The aim of this infographic was to provide a bite size reference for best practice approach, based on the evidence that is available for managing the condition. It also aims to raise awareness ofthose less familiar with treating diastasis, to give them an overall view on management. The take home message is that there is no one size fits all method and that each patient will
need an individualised approach. The poster highlights the need to focus on tension of the linea alba, rather than gap size. This is supported by literature evidence that inter recti distance can actually increase with TVA contraction (Lee and Hodges, 2015 and Theodorsen et al, 2019). The basis of rehab is therefore focussed on tension rather than whether the gap physically decreases during the exercise. Assessing functional response to exercise on an individual basis can potentially give them more freedom to return to the things they love. The functional ability will vary person to person, even if the diastasis presents similarly to another in size or tension.The focus should be on whether clients can create tension across the linea alba during the task, rather than relying on gap size. When functional activities are not yet appropriate, rehabilitation can be goal specific and modifications set. Further research is needed to identify which rehab protocol of strengthening provides the best results, in order that we can confidently offer our patients the best possible treatment outcome that is evidence based. |
AuthorClaire is a women's health and sports Physiotherapist. She is the owner of Spring Physio and is based in East Sussex. Archives
October 2024
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