Tailbone (coccyx) pain

Body: 

I have been searching and reading as many posts as I can for help with my coccyx pain.
It was getting to the point where I was considering pain relief which I have avoided for years even with other spinal issues.

I would llike to ask if anyone has tried this...

"Another option was offered to me by a therapist (ex-dancer) at a recent workshop. She reported she had suffered many of the symptoms outlined above, and had been instructed in Kegel exercises for her incontinence. She noted that these exercises had aggravated rather than helped her. A yoga therapist had then advised her to purchase a tennis ball and sit on it with the ball (placed on a firm surface such as a carpeted floor) strategically placed under the perineum, between anus and the vagina; and to allow the pressure onto the ball to deeply relax the pelvic floor muscles for five to 10 minutes daily. She reported that this procedure was somewhat uncomfortable at first, but that the effects were dramatic in terms of her symptoms. I have since recommended this to several patients for home use and all have reported benefit."

This is an excerpt from the below page after googling Levator Ani and trying to find an exercise to assist release of the tightness....

http://www.massagetoday.com/mpacms/mt/article.php?id=13515

I thought I read somewhere here on the forum - and just wanted to know if it is okay to sit on the tennis ball under the perineum (my perineum has dropped and is often the worst part of the rectocele)

I don't want to do any harm but I am looking for some way to ease the pull which results in the pain.

I am doing as much of the WW posture as my body can take as it is early days and very tiring.

Forum:

If your perineum has dropped I would think it doesn't need any more stretching. The deep and shallow perineal muscles, which run from side to side, near the surface, are not the same as the levator ani muscles which are deeper. You may do further damage to already damaged muscles by sitting on a tennis ball. If you have tightness in your levator ani then the Thiele massage (or something similar) would be a better option, as it is not just putting a large amount of your weight onto a tennis ball under your perineum, but is controlled massage.

Coccyx pain is notoriously hard to pin down to a cause. I still think the pain you are experiencing is *because* your perineum is low. Relaxing it further may exacerbate the sagging. I would rather see you gradually working on WW posture, which will tighten your perineum and your levator ani slowly, not by making it contract, but by moving their anchorage points further apart.

It won't get better overnight. It may take months. Just because a tennis ball can solve a problem in a few days doesn't necessarily make it a good treatment. The perineum is designed to stretch during labour, but not normally outside of labour . It's role is to be the elastic in the slingshot, where the 'rails' of the pubic bones are the two fork in the stick, and form a firm front edge for the anus to press against, and to support the baby's head after it engages.

Often more gradual adjustments are more effective in the long term.

Louise

Thank you
I have been doing the posture since knowing about it and unfortunately the tailbone pain is significant - after a year of this pain and much travelling coming up - as mentioned in a previous post - I have found instant relief from an internal massage by the PT (which only lasts a few hours) and also from doing extreme stretching diagonally through the body while laying down - bringing the right bent knee up to the side of my head and elongating through the straightened left leg and slightly twisting - I then sit up and the tailbone pain has disappeared - at least for a short while.
It seems an overly constricted tight area which I will be investigating with massage, trigger point and FSM therapy.
I appreciate the long term goal but I would prefer natural therapies before taking pain medication to get through difficult journeys.
It will probably take years to make changes but for now if I can make an instant change stretching something - I'm not even sure what that is - then there must be other short term remedies to alleviate the paint intermittently.
I did not feel right about the ball - sensing the overstretched perineum already - but willing to try anything to feel the mysterious sudden release I have felt before.
I hope to narrow it down to a specific move or stretch or treatment to keep the painkillers away.

This is interesting, you said that "relaxing it further may exacerbate sagging". I have no coccyx pain any more, but more feeling of fullness, sagging...it seems as if the rectocele bulge is bigger...
So it seems it is all about some balance...
Ivonush

Hi Takecare

I can see where you are coming from. I hope you can learn a lot more musculo-skeletal anatomy, and that you can figure out why this stretching exercise works. It is wonderful that you have been able to find a way to physically alleviate the pain. There may be other women who will benefit from this stretch. When you say, "elongating through the straightened left leg and slightly twisting" do you mean twisting to the right or left? And do you repeat it on the other side as well?

It gave me great satisfaction to be able to free myself from having regular chiropractic treatments (which only helped for a couple of days afterwards), by learning new stretches. I used to get a lot of body pain all over. Not sure why, but it seems to have gone since I have been drinking red clover tea, and have changed to only organic and free range meats. The free range meats is to do with omega fatty acid ratios. It was a conscious action. The red clover tea has been another inflammation reliever, which I hoped might help my menopausal vagina. It also improved a skin condition I have and made my vagina more 'resilient'. It also seemed to stop early morning hot flashes, which would wake me and keep me awake.

Louise

Hi -- before you get into pharmalogical methods of pain relief, ask your PT about a TENS unit. It may help you with pain until you can sort your body out.

Louise it seems I have always had tight muscles and ligaments - all my life. I used to go to stretch classes many years ago and they really helped.
I have no idea why it works other than somehow I am releasing a strong contraction of an area. I have always 'guarded' my hips and pelvis due to pelvic instability, scoliosis, hypermobility in the joints accompanied by herniated discs - a contradiction of sorts. I used to go to chiropractors, osteopaths, etc - but found the only comfort really was with deep massage.
It is quite miraculous that one moment I am in deep pain with the coccyx (even laying down) - and then after doing this contortion like movement I can sit freely and comfortably - I did it today and six hours later am still in far less pain.
I would like to know what it is I am stretching or releasing - so that I can describe it correctly to a masseur.

I initially did it with bent right knee pulled up as high and as close to me as I could with left leg reaching down as far as I could and then turned as far to the right as I could. It was like a miracle. So to try and 'set' it I repeated on the other side but instinctively I tend to work more on the right side because my right hip is so tight ... however the coccyx pain is slightly to the left of the tailbone/rectum.

I do have body pain all over - neuromuscular I guess with the degenerative discs and then the contracted muscles - my legs are so tight very deep .... like the hamstrings and quads are constantly contracted.

The red clover tea may be a good help for me ... and while I eat very healthily and lots of salad and vegetables - I could probably refine even more. I rarely eat meat - tinned salmon occasionally and small amount of cheese ...

I really have to become an expert on all foods anti inflammatory ...

The ability to stretch out this pain is such a huge plus - the WW posture is the long term life change and for me with my poor spine and legs - I do get quite tired because I sit an awful lot with work and art.
Flying for 24 hours does worry me but if I perfect this stretch perhaps I can try and do it in the tiny airline loo - although here I do it laying on the bed with heaps of room.

I don't want to take anti inflammatories - one day I may have to but will cope with this the best way I can - the pain has been outweighing the prolapses until I found this stretch.
Perhaps for me the rectocele is tipping back as well as forward and down into the perineum - Ivonush saying her tailbone pain has gone means perhaps in time if my rectocele can tip more forward maybe that will ease things. At least I feel some sense of control if only for a short time. It keeps my head above water.

TENS unit was very helpful for me.
Ivonush

Hi Takecare, this is my body you are describing, with the overall pain, tight hammies and (for me) tight glutes; probably tight quads as well, pelvic instability, scoliosis, herniated discs etc. I was on 24 hours a day anti-inflammatories for a couple of years, but realised that it wasn't actually fixing anything so I stopped and started stretching. What relief it was to find that I could treat my own stiffness and soreness. I had this body pain for about ten years before I did anything about it. Now I have been doing Wholewoman posture for about eight years my discs rarely give me any trouble and my pelvis is much more stable. I don't even feel that I need to stretch every day! However, *but* I have never had coccyx pain.

The left/right thing is a bit weird, but I always feel that I am tight on the left, but my masseur always says the right side is tighter.

The free range meat adjustment did definitely help too.

L

Takecare - this is classic trigger point therapy, which is easy to do as a self-care technique and highly effective. Many, many symptoms of trigger points - small knots of contracted sarcomeres, the smallest unit of muscle tissue - are misdiagnosed as a myriad of other disorders, from angina to bursitis to appendicitis.

Trigger points were first described in 1942 by Janet Travell, MD. She and her colleague, David Simons, MD went on to develop trigger point therapy - identifying all the inflamed knots that occur in the 200 pairs of human muscles. Unlike Chinese acupressure points and meridians (which certainly have their usefulness), trigger points are real and have been photographed and "listened to" by sensitive electronic equipment. They paradoxically often refer pain to surrounding areas. Trigger points in tight pelvic floor muscles are likely to cause pain and contraction in the area of the coccyx. Creating deep pressure with a knob or ball is the classic treatment.

What is interesting about trigger point science is that if you reverse all the trigger points and muscle contraction (a cause or effect) that have been mapped in the body, what you are left with is....drum roll please....WW posture! It is quite true and one of the ways we can validate this work. Staying in WW posture will prevent trigger points and make them easier to resolve if they are generated by stress, overwork, etc.

I love the yoga of Patanjali and the Vedic tradition as a whole. It seems self-evident, however, that if a 40-year practice had been truly beneficial, Terpsichore, you would not have ended up with your guts jammed deeply down into the back of your pelvis. There are significant differences between the male and female body that yoga never understood and this is what WWY is all about. WWY1 explains these differences and the implications they have for female hips, knees and feet. I highly recommend it!

I'm so glad to hear you are feeling better, Takecare!

Christine

Hi Terpsi - Most of us will never know exactly which things, in what combinations, caused our prolapse. You don't know if your traditional yoga did or did not contribute to your prolapse, and you never will!

Christine calls things as she sees them. She has made the point numerous times on this site, that recommendations from any members will be challenged if they contradict her extensive research and findings. That's why we can trust what we read when we come here. So, take it or leave it. How about checking out her yoga videos? Doesn't sound like you have given them much more than a passing glance. - Surviving

I am so grateful to be able to serve the women who understand, benefit from, and support the Whole Woman work. I can't please everyone and I make no apologies for that. My job is not to be "nice" but to keep the WW work moving forward in a very conventional world.

The problem I have with physical yoga is very general. Many of our members are yoga practitioners and before long we will have many WW teachers who are also traditional yoga teachers. This does not negate the fact that yoga does not have a good grasp on female anatomy and many of the traditional postures are stressful for the female body. It was within this context that I made my comments and I am sorry if they came across as too personal.

Upward and onward,

Christine

I think this is a fair call, Christine. I am sad that Terpsichore thinks that your yoga has no more to offer her than Terpsi's yoga. Terpsi has obviously had a lot of benefit from her yoga practice, but does not seem to want to open her mind to the refinements you have made. Her knowledge of yoga would make her a credible critic of your yoga, and therefore enable her to debunk your yoga techniques if she found them wanting in some way, but sadly she has chosen not to investigate it.

Perhaps Terpsi thinks she may have to eat humble pie if she finds that she makes progress using your yoga? We have seen several times individuals refusing to engage in debate about Wholewoman posture, maybe because it crossed over their holy cows too far, and debunks some of their own techniques?

Anyway, Terpsichore may return to the fold later. That's OK.

Louise

Dear Terpsichore .. I hope you can still see that I would like you to thank you for also taking the time to respond. I appreciate any advice and support and non judgement on offer.

I have always liked yoga and have been to the gentler classes more focussed on stretching which have assisted with the great neuromuscular problems I have had for decades. I acknowledge your response in particular which I quote: " It sounds like Christine's DVD would also be a great place to start, although I confess I haven't purchased it because I have such a well developed yoga practice. I have read with interest her comments about the cautions needed because of the female body issues, and take heed."

I also appreciate Christine's comments re trigger point therapy and TENS machine - I will certainly be concentrating on those options and have appointments over the next month to make every effort to reduce the amount of muscular contraction so that I can maintain WW posture for longer periods of time and engage in more physical activity as one sentence I read echoed in my head "this work is best done on your feet", whereas I spend a great deal of time sitting and in intense pain. I have high hopes for great changes if I can address the other very painful issues which coexist with POP.

I have the WW Yoga video also and will be working with it along with making my way through the book.

My best wishes to you Terpsi and to all those who are compassionate towards each individual experience.

Hi Terpsichore,

Well, I think this is another case of differences in the ways people deliver and hear information. Your guts *are* jammed deeply into your pelvis and by your own admission of recently changing your yoga practice to better support your body, it is not out of left field to suggest that a years-long practice of holding in your belly might have led to your severe condition. I see the way I said that as blunt and to the point. Why you interpret my words as unkind and buffer the reality of your condition by insisting it was all caused by straining makes me scratch my head. As Surviving said, who knows the real cause, but in a case such as yours a traditional suck and tuck practice would be highly suspect.

Wishing you well,

Christine

Hi Takecare,

I actually was thinking about you early this morning before our teacher-training class, hoping to inspire you further to stand up and walk out of your pain. I’m so happy to now read your words because they speak to me of realization and determination.

Women really have no good choice but to do the WW work. This sounds like an outrageous statement coming from the creator of a work that is completely revolutionary and therefore highly suspect in a world of conventional therapy and exercise.

However, anatomical realities bear out this truth. Fibromyalgia is interpreted by many as trigger points throughout the body that have referred pain and tightness just about everywhere. Pulling into WW posture balances the muscles in such a way that holding the body becomes effortless while sitting and standing. Deep massage is the very best adjunct to the WW work.

Disgruntled women come and go from the forums - it’s been that way from the beginning. Sometimes they come back to tell how well they became by doing all manner of things except the postural work. All we can do is smile because in reality the pelvic organ support system *is* this postural system. They are one and the same and if women resist learning how to hold the body in this way, so be it. There is not much else to be said.

But to women who are receptive to hearing about the breathing, the belly and all the rest I rejoice in the hope that they will understand this is the best we will ever know for prolapse. Any surgery that disrupts fascial structures in the slightest way pulls the whole pelvic interior off-center. Living ones whole life with slight prolapse is infinitely better than losing the hub of the wheel. Making the body well through proper posture is a gift.

Thanks for believing in the work and please keep us posted on your progress.

Wishing you well,

Christine

It's easy to be confused by all of the different feelings going on in our bodies, and it's easy to believe what we want to believe when we're confused. Those who understand and give us gentle encouragement to keep moving forward help us to feel that we're not alone. That's half the battle right there.

May I ask to consider this a little more please.
For me - prior to the sudden descent just over a year ago - I was not bothered unduly by internal problems other than not being able to go regularly enough.

My main issues for decades has been the hip, back and leg pain which I struggled with. Prior to the sudden descent I was walking at least 4-5 times a week and this greatly helped regularity ... without doubt.

When I went through a trauma a year ago it was immediately after that everything dropped. I was greatly concerned as I thought everything would fall outside of my body - I had been told six years prior that I had a rectocele and cystocele by a urogyn - and that I should have a hysterectomy but at the time my physio asked why on earth that would help when my main issue which was - pain from the hip and back. I had gone to the urogyn at that time because of deep hip pain and after having complete uterine inversion I thought perhaps I had scar tissue or a problem with my uterus - not expecting to be told I needed hysterectomy. On reflection the troubles heightened back then due to a horrendous flu which resulted in weeks of coughing to the point of nearly vomiting, being hospitalised for a week with viral pneumonia and being very aware that everything was falling after the coughing fits.

I cannot stress enough if I ever got another cough like that I would be very worried about what it can do to your pelvic organs ... and to follow advice about posture for coughing - although if you are coughing 24/7 it's difficult when you are exhausted beyond belief.

Now though I have the two separate issues with the same hip, back and leg pain. As mentioned before, I have had bone scans, MRI etc and been diagnosed with 'advanced severe disc degeneration'. I have thought that the pain in my back, hip and leg is due to the state of my lower discs - now I wonder if the pain is referred from the trigger points and deep muscular contractions? I do feel I 'hold' or guard myself due to pelvic instability and previous herniated discs - so therefore if I am able with trigger point therapy, FSM and deep tissue massage regularly to loosen the muscular contraction in these areas - maybe in general the pain will recede to the extent that I can do a lot more. I can't walk far without having to stop and stretch constantly ....

If my discs are in this state - and everyone around me is telling me to have spinal fusion - from your knowledge of anatomy - doing the WW posture and having these therapies done will obviously make a big difference to my comfort and elongating everything - but if the discs are in bad shape they can't regenerate can they? Therefore with the compression on nerves perhaps the pain will continue ... you see I don't know how to treat the spinal disc issue on top of everything else.

I just read the article on enterocele on the December News - can I say that seeing diagrams makes everything a lot clearer. The more you can show means that the way I 'see' myself inside enables me to visualise better what is needed. It was from looking at those diagrams and really applying to myself that I am connecting - sometimes words are overwhelming - particularly anatomically - for those with medical and well informed backgrounds they can follow right along - for me and for many others I expect - the pictures say a thousand words.

Thanks again.

Hi Takecare

I used to have one herniated disc for many years, and scans showed several others that were pretty ragged. I cannot believe that I now do not have any trouble from these discs. One day I may have another scan to see what they are doing now. I can only think WW posture has taken the pressure off them, and all the muscles supporting these discs are now working much better than they were, with much less muscle spasm and pain in my whole body. The muscles no longer have to contract to protect these inflamed spinal joints by limiting my movement.

Hi Takecare,

I only have a moment, as my little granddaughter is staying with me. These are remarkably common chronic conditions. I will be writing more about backs and hips in the future. Of course spinal discs can regenerate, but because they are avascular they require proper pumping action to move ions in and out of the disc. That pumping only happens when the spine is in its proper configuration. Surgery is no longer routinely recommended for herniated discs. Do you place a pillow between your legs when you sleep? This is a must for hip health as we age. It is the lumbar curve that seats the torso completely over the hip joints, covering the ball of the femur so it doesn't begin to wobble around in its socket. Even a partially tucked pelvis ("neutral" pelvis) slightly uncovers the joint. WW posture resolves improper alignment head to toe.

Christine

Just wanted to let you know I have had three sessions of FSM treatment...
Also had a couple of trigger point therapy and massage sessions ... some nutritional medicine ...
staying in WW posture as long as possible.
And for me, the absolute instant remedy - my very strong stretch as described above ...
I now know if the pain returns I can do this stretch and the pain subsides... I have no idea why - but it works for me - after a year of intense pain on sitting.
It is a great relief to know I can travel and sit for long periods - and if it gets too painful I will do the stretching.
It has given me a good sense of optimism - pain is debilitating and affects everything you do. I hope in some way this helps someone else.

Takecare, that is GREAT!!! I know this pain so well. I get it less often at present, maybe because I sit less. For me acupuncture was very helpful...but I don't have any more refund from my insurance for this treatment.
I am going tomorrow to see PT (she assessed me before), as I get some pains/aches etc. For example since doing exercises, I have tingling on my back, which comes and goes...
What is FSM treatment?
I want to ask the PT for trigger point treatment...

I am so happy for you, I know how it is to FEEL NO PAIN :)
Ivonush

Hi Takecare

Takecare, Would you mind describing it in greater detail please. As I understand it, you lie on your back and bring your bent right knee up to the right side of your head, then put it down, and sit upright on the floor. Is that right? You don't do it both sides? You said it was a strong diagonal stretch, but I can't figure out how.

It sounds like a gluteal muscle stretch, but could also move your sacroiliac joint on that side. More detail will allow me to do it and figure out what it is stretching.

How did you find out about this exercise?

Louise

I lay down - bring the bent right knee up as far as possible and clasp it to my chest ...while keeping the left leg outstretched as far as possible.
To increase the stretch I will also put both hands under my right foot (still with bent knee) and pull further up into the stretch, all the while keeping the left leg stretching straight out as far as possible
.
Sometimes that is enough to do it ... although if needed I will do it on the other side as well - or even add anything Instinctively think will assist the lengthening ... while laying down clasping the knee I may even rotate torso in the direction of the bent knee to lengthen the area of elongation.

Once I have done the stretch - takes less than a minute - the severe tailbone pain has 'lifted'.

When I say diagonal - the mental image is from left toe across the centre of the body to right knee brought up high on the other side. I don't know what is lifting or changing - but I see it as a diagonal shift.

The stretch was a result of sheer frustration from nothing helping - however when the PT did an internal exam and pushing down on certain areas to test pelvic floor etc - when I sat down after the pain had gone. I realised then it had to be a muscle/ligament/nerve pain and that there had to be some way of achieving a shift.

If you imagine I feel the main stretch is somewhere from bottom of left front side of pelvis to top of right hip - in that internal space. If you drew a line between there and went inwards .... that's where it seems to lift .... sorry if it doesn't make sense.

It's like a miracle to be in such pain one minute - take a brief moment to do this move - and I can do it standing up too - bringing the knee up really tight and pulling it up as hard as possible ....
and then - no pain. I get a longer stretch when laying down as I can move around more.

The pain does come back - but I can relieve it, and I think by doing this it lessens the inflammation overall. It has changed the way I sit, move, cope etc. And I spent over a year having tests and seeing specialists to find out what the tailbone pain is - nobody could tell me. It's obviously the drop with the sudden POP when the pain came on immediately ... and the stretch somehow shifts the positioning of everything so the pain disappears.

I really hope this helps someone else. I also hope it makes sense .... one of the other great advantages is the confidence it gives me in my ability to know my body, sense what it needs and react instinctively ....

This makes sense, Takecare. I do a similar stretch. I think it stretches the gluteal muscles and that allows the pelvic crests to drop forward. Getting relief by doing it on one side only makes me think it is something to do with your pelvis and/or legs, maybe realigning your right sacroiliac joint?

I also take the right knee over to the left, which stretches the glutes around the side as well as down the back. Probably a different glute, because there are three. http://stemcelldoc.wordpress.com/2009/03/10/trendelenburg-test/

The only caution I would give you is to do it on both sides anyway, to try and keep both sides evenly stretched, and to do torso extension stretches as well this torso flexion stretch, so you don't end up with muscles stretched down your back, but not stretched down your front.

It is so liberating to be able to fix your own body, rather than being dependent on a professional!

Louise

Hi,

I I'm not mistaken, this sounds quite similar to the stretch given by the "Psoas Lady". The article is in the Library with a link to her site. Yay or nay?

Grandma Joy

Oh - wanted also to mention that I have bought a foam roller ... it is a miracle worker - for all those really tight muscles and ligaments - so you can to some deep tissue massage on yourself.
I have a lot of problems with legs, hip, back etc and pain - this roller is fantastic ... you can google foam roller exercises on youtube and will see what it is if you don't already know it.
Hope that helps too ...

Which article, Grandma Joy? There are a lot of articles on her site. I couldn't find anything about the stretch in her Library article.

Well Louise, I've been poring over the Psoas Lady website - the link is at the bottom of the article in the library and goes to coreawareness.com. Basically, the first position she shows is the Constructive Rest Position to relax the psoas. I thought I read or saw on her pages to then pull one leg up to the chest and the other left flat on the floor as takecare describes, although there was no mention of torquing the body to either side. It was a simple stretch; however, I now cannot find this second stretch on her website. Maybe I'm losing my mind? I do have this same (second) stretch in my stretching book, but it doesn't mention the psoas as being affected.

The article for Constructive Rest Position is listed on her "articles" page and titled "The One Muscle that does not need Strengthening". I will keep digging trying to figure out why I added the second stretch to the CRP or where I found it.

Grandma Joy

This is an exact position my PT suggested to me at the last visit. I have to do it 5 times a day...Apparently, I have very tight muscles, which obstruct BM...

I am just recovering from a stomach flu. I was really ill and this upset my BMs greatly....
Ivonush

For checking into it .. I would like to know what I am stretching any why it releases the coccyx pain.
I checked out the site also and couldn't see anything similar but I have always though the psoas may be a real problem for me, as for many - she relates to it often with trauma .... and believe me in my life I have had some trauma particularly around my young female experiences ... it's too personal to say but suffice to say I have had good reason to 'guard' after some terrible experiences.
Following on as an adult to have miscarriage and traumatic childbirth followed by compound problems with spine, pelvis and hips - the instability is prolific and I catch myself guarding - my leg, hip and psoas area is rock hard and difficult to release. It keeps me up nights with the stiffness and pain but I am very grateful I have been able to stretch 'something' to help the tailbone pain which was making life really difficult along with all the POP symptoms.
Thank you.

I would agree with trauma...and apparently the body heals longer than the mind...the body can also be re-triggered easily...
When I read her article she spoke a lot about fight/flight response...
I am just beginning to see it in my body...still body represents more unconscious processes...I hope that one day I will figure it out...
At present what helps the most are exercises, posture and being mindful what I eat...
Ivonush

... flight from yourself?

...maybe from experiencing myself...it is quite alien...

In the past I had to be ALWAYS ready for something difficult to happen...my body still gets to the alert response very quickly, even if there is nothing really to be alerted about (e.g. neighbours slamming their door...I know there is no danger there, but I still jump...)

This is very helpful, especially Christine’s remarks about the science behind trigger point relief and how that relates to whole woman posture. There is more as well, here.