Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda Physiocare®, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... www.bethesdaphysiocare.com Anne Arundel Physiocare® 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda Physiocare®, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... www.bethesdaphysiocare.com Anne Arundel Physiocare® 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda Physiocare®, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... www.bethesdaphysiocare.com Anne Arundel Physiocare® 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Donut Pillows don't work, because they take the pressure off the perineal area not the coccyx. Coccyx Pillows like this one, http://www.coccyx.org/coping/cushions.htm might work better, since they have a cut out for the coccyx area. Also they might try doubling a pillow or rolling up a towel and putting it under their thighs, floating the coccyx. You might want to try some manual therapy to the coccyx and sacrotuberous ligaments. Take a look (well rather a feel) at the obturator internus and pelvic floor. You might want to consider refering to a women's health trained therapist. I have gone to several of the women's health courses from the APTA and we get specific training there on intrarectal and intravaginal coccyx mobilizations and pelvic floor therapy. Find one at here: http://www.womenshealthapta.org/plp/locator/index.cfm?Section=Search Odilia Egbers, PT > > > > > To the group: I haven't seen one for quite some time and suddenly I have 3 > patients with the same problem. Any ideas what has worked for this type of > patients you have seen in your practice? Donut Pillow etc has been tried > already. Any information would be appreciated. > Hiten Dave' PT > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Donut Pillows don't work, because they take the pressure off the perineal area not the coccyx. Coccyx Pillows like this one, http://www.coccyx.org/coping/cushions.htm might work better, since they have a cut out for the coccyx area. Also they might try doubling a pillow or rolling up a towel and putting it under their thighs, floating the coccyx. You might want to try some manual therapy to the coccyx and sacrotuberous ligaments. Take a look (well rather a feel) at the obturator internus and pelvic floor. You might want to consider refering to a women's health trained therapist. I have gone to several of the women's health courses from the APTA and we get specific training there on intrarectal and intravaginal coccyx mobilizations and pelvic floor therapy. Find one at here: http://www.womenshealthapta.org/plp/locator/index.cfm?Section=Search Odilia Egbers, PT > > > > > To the group: I haven't seen one for quite some time and suddenly I have 3 > patients with the same problem. Any ideas what has worked for this type of > patients you have seen in your practice? Donut Pillow etc has been tried > already. Any information would be appreciated. > Hiten Dave' PT > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Dave, A good resource may be a trained PT in Pelvic Pain. Is the pain related to muscle spasm? What was the mechanism of injury? As therapists I think we sometimes forget about the pelvic floor and the impact on pain and function. Have you tried any manual techniques yet, either lumbar or Thieles massage? Where are you located? Good luck! Priestap, MS, PT Centric Therapy Michigan To: PTManager From: hitendave@... Date: Thu, 20 Jan 2011 00:24:12 +0000 Subject: Coccyx pain To the group: I haven't seen one for quite some time and suddenly I have 3 patients with the same problem. Any ideas what has worked for this type of patients you have seen in your practice? Donut Pillow etc has been tried already. Any information would be appreciated. Hiten Dave' PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Dave, A good resource may be a trained PT in Pelvic Pain. Is the pain related to muscle spasm? What was the mechanism of injury? As therapists I think we sometimes forget about the pelvic floor and the impact on pain and function. Have you tried any manual techniques yet, either lumbar or Thieles massage? Where are you located? Good luck! Priestap, MS, PT Centric Therapy Michigan To: PTManager From: hitendave@... Date: Thu, 20 Jan 2011 00:24:12 +0000 Subject: Coccyx pain To the group: I haven't seen one for quite some time and suddenly I have 3 patients with the same problem. Any ideas what has worked for this type of patients you have seen in your practice? Donut Pillow etc has been tried already. Any information would be appreciated. Hiten Dave' PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2011 Report Share Posted January 20, 2011 Mr. Dave' you can try the following: 1. Decompress the Pelvic Diaphragm manually using Upledger's Craniosacral Technique. 2. Purchase a " SacroWedgy " that the patient can lie supine on.(google it) 3. Have the patient do Dynamic Squatting moving in the Transverse Plane of motion Hope this helps, Coccyx pain To the group: I haven't seen one for quite some time and suddenly I have 3 patients with the same problem. Any ideas what has worked for this type of patients you have seen in your practice? Donut Pillow etc has been tried already. Any information would be appreciated. Hiten Dave' PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2011 Report Share Posted January 21, 2011 I agree. If you don't have a pelvic trained PT in your clinic you may want to refer the patient to one. The women's health APTA website has a consumer section to search for a women's health PT anywhere in the US: www.womenshealthapta.org I hope this helps. Jill Piazza, PT, DPT Florida Hospital DeLand > > Dave, > A good resource may be a trained PT in Pelvic Pain. Is the pain related to muscle spasm? What was the mechanism of injury? As therapists I think we sometimes forget about the pelvic floor and the impact on pain and function. Have you tried any manual techniques yet, either lumbar or Thieles massage? Where are you located? Good luck! > > Priestap, MS, PT > Centric Therapy > Michigan > > To: PTManager > From: hitendave@... > Date: Thu, 20 Jan 2011 00:24:12 +0000 > Subject: Coccyx pain > > To the group: I haven't seen one for quite some time and suddenly I have 3 patients with the same problem. Any ideas what has worked for this type of patients you have seen in your practice? Donut Pillow etc has been tried already. Any information would be appreciated. > > Hiten Dave' PT > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2011 Report Share Posted January 22, 2011 Most of the manual techniques for pelvis are beyond an email approach, but remember that upper lumbar restrictions often refer to coccyx (per Maitland) and some P-A mobilizations there, if indicated, may be of help. If not, I concur with an appropriate referral. Anne PT > Coccyx pain > > To the group: I haven't seen one for quite some time and suddenly I > have 3 patients with the same problem. Any ideas what has worked for > this type of patients you have seen in your practice? Donut Pillow etc > has been tried already. Any information would be appreciated. > Hiten Dave' PT > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2011 Report Share Posted January 24, 2011 Speaking from recent experience, (fx of coccyx) I did very well with a v-cushion instead of a doughnut. The cushion was like a regular wheelchair cushion with a v cut in the back allowing the ischial tuberosities to share the brunt of the force versus the doughnut which requires the subject to recline if they are to take the pressure off the coccyx. Best of luck! Jill Sedmak, PT, MSPT, ATC Shelby Twp, MI Subject: Re: Coccyx pain To: PTManager Date: Wednesday, January 19, 2011, 7:40 PM  Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda Physiocare®, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... www.bethesdaphysiocare.com Anne Arundel Physiocare® 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2011 Report Share Posted January 24, 2011 Bed Bath and Beyond sells a v cut cushion (Seat Solution) but if the patient needs more support the Seat Solution Ultra is only available on their website. They are never in a logical place in the store, ask at the desk for the black angled cushion with the u cut out in the back in the blue box as seen on TV. Sandi Pomeroy, PT Pomeroy Therapeutics Dayton, Ohio _____ From: PTManager [mailto:PTManager ] On Behalf Of AOD Physical Therapy Sent: Monday, January 24, 2011 8:48 AM To: PTManager Subject: Re: Coccyx pain Speaking from recent experience, (fx of coccyx) I did very well with a v-cushion instead of a doughnut. The cushion was like a regular wheelchair cushion with a v cut in the back allowing the ischial tuberosities to share the brunt of the force versus the doughnut which requires the subject to recline if they are to take the pressure off the coccyx. Best of luck! Jill Sedmak, PT, MSPT, ATC Shelby Twp, MI From: Dr. Jan Dommerholt <dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> > Subject: Re: Coccyx pain To: PTManager <mailto:PTManager%40yahoogroups.com> Date: Wednesday, January 19, 2011, 7:40 PM Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda PhysiocareR, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> www.bethesdaphysiocare.com Anne Arundel PhysiocareR 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... <mailto:dommerholt%40myopainseminars.com> http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 I have also done some internal work for soft tissue, manual trigger point release, and joint mobility of the coccyx. This works as well as does the intramuscular manual therapy to the muscles stated by Jan Dommerholt in an earlier reply. Ruchin, PT, DPT Atlanta Rehabilitation and Performance Center, Inc. bruchin@... www.atlantarehab.com <http://www.atlantarehab.com/> ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Sandi Pomeroy Sent: Monday, January 24, 2011 9:56 PM To: PTManager Subject: RE: Coccyx pain Bed Bath and Beyond sells a v cut cushion (Seat Solution) but if the patient needs more support the Seat Solution Ultra is only available on their website. They are never in a logical place in the store, ask at the desk for the black angled cushion with the u cut out in the back in the blue box as seen on TV. Sandi Pomeroy, PT Pomeroy Therapeutics Dayton, Ohio _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of AOD Physical Therapy Sent: Monday, January 24, 2011 8:48 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Re: Coccyx pain Speaking from recent experience, (fx of coccyx) I did very well with a v-cushion instead of a doughnut. The cushion was like a regular wheelchair cushion with a v cut in the back allowing the ischial tuberosities to share the brunt of the force versus the doughnut which requires the subject to recline if they are to take the pressure off the coccyx. Best of luck! Jill Sedmak, PT, MSPT, ATC Shelby Twp, MI From: Dr. Jan Dommerholt <dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> > Subject: Re: Coccyx pain To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Date: Wednesday, January 19, 2011, 7:40 PM Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda PhysiocareR, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> www.bethesdaphysiocare.com Anne Arundel PhysiocareR 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... <mailto:dommerholt%40myopainseminars.com> <mailto:dommerholt%40myopainseminars.com> http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 I have also done some internal work for soft tissue, manual trigger point release, and joint mobility of the coccyx. This works as well as does the intramuscular manual therapy to the muscles stated by Jan Dommerholt in an earlier reply. Ruchin, PT, DPT Atlanta Rehabilitation and Performance Center, Inc. bruchin@... www.atlantarehab.com <http://www.atlantarehab.com/> ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Sandi Pomeroy Sent: Monday, January 24, 2011 9:56 PM To: PTManager Subject: RE: Coccyx pain Bed Bath and Beyond sells a v cut cushion (Seat Solution) but if the patient needs more support the Seat Solution Ultra is only available on their website. They are never in a logical place in the store, ask at the desk for the black angled cushion with the u cut out in the back in the blue box as seen on TV. Sandi Pomeroy, PT Pomeroy Therapeutics Dayton, Ohio _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of AOD Physical Therapy Sent: Monday, January 24, 2011 8:48 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Re: Coccyx pain Speaking from recent experience, (fx of coccyx) I did very well with a v-cushion instead of a doughnut. The cushion was like a regular wheelchair cushion with a v cut in the back allowing the ischial tuberosities to share the brunt of the force versus the doughnut which requires the subject to recline if they are to take the pressure off the coccyx. Best of luck! Jill Sedmak, PT, MSPT, ATC Shelby Twp, MI From: Dr. Jan Dommerholt <dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> > Subject: Re: Coccyx pain To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Date: Wednesday, January 19, 2011, 7:40 PM Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda PhysiocareR, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> www.bethesdaphysiocare.com Anne Arundel PhysiocareR 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... <mailto:dommerholt%40myopainseminars.com> <mailto:dommerholt%40myopainseminars.com> http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 I have also done some internal work for soft tissue, manual trigger point release, and joint mobility of the coccyx. This works as well as does the intramuscular manual therapy to the muscles stated by Jan Dommerholt in an earlier reply. Ruchin, PT, DPT Atlanta Rehabilitation and Performance Center, Inc. bruchin@... www.atlantarehab.com <http://www.atlantarehab.com/> ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Sandi Pomeroy Sent: Monday, January 24, 2011 9:56 PM To: PTManager Subject: RE: Coccyx pain Bed Bath and Beyond sells a v cut cushion (Seat Solution) but if the patient needs more support the Seat Solution Ultra is only available on their website. They are never in a logical place in the store, ask at the desk for the black angled cushion with the u cut out in the back in the blue box as seen on TV. Sandi Pomeroy, PT Pomeroy Therapeutics Dayton, Ohio _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of AOD Physical Therapy Sent: Monday, January 24, 2011 8:48 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Re: Coccyx pain Speaking from recent experience, (fx of coccyx) I did very well with a v-cushion instead of a doughnut. The cushion was like a regular wheelchair cushion with a v cut in the back allowing the ischial tuberosities to share the brunt of the force versus the doughnut which requires the subject to recline if they are to take the pressure off the coccyx. Best of luck! Jill Sedmak, PT, MSPT, ATC Shelby Twp, MI From: Dr. Jan Dommerholt <dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> > Subject: Re: Coccyx pain To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Date: Wednesday, January 19, 2011, 7:40 PM Many instances of coccyx pain are the result of referred pain from the QL, lumbar multifidi, gluteus max, etc., especially if the history reveals no direct traumatic impact and an insidious onset. In those cases, I would recommend using dry needling of the respective trigger points in these muscles, or manual trigger point release. Jan Dommerholt Bethesda PhysiocareR, Inc. 7830 Old town Road, Suite C-15 Bethesda, MD 20814-2440 United States + (voice) + (fax) dommerholt@... <mailto:dommerholt%40bethesdaphysiocare.com> <mailto:dommerholt%40bethesdaphysiocare.com> www.bethesdaphysiocare.com Anne Arundel PhysiocareR 127 Lubrano Dr, Suite L-3 polis, MD 21401-7322 + (voice) Myopain Seminars, LLC + (voice) + (fax) www.myopainseminars.com dommerholt@... <mailto:dommerholt%40myopainseminars.com> <mailto:dommerholt%40myopainseminars.com> http://www.linkedin.com/in/jandommerholt Quote Link to comment Share on other sites More sharing options...
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