Tailbone Pain and Why Pelvic Floor Physical Therapy Helps

Tailbone pain can be such a frustrating and daunting issue that can not be pushed to the side or ignored. Many people believe that tailbone can and will go away over time after living with it for months or even years; the options for relief don’t seem plentiful. The term “coccydynia” is the medical term used to define the tailbone and pain related to its dysfunction. Many patients report significant pain during prolonged sitting, during transition from sit to stand and during certain functional activities such as exercise or even during intercourse. During an evaluation, I often find that several other symptoms make themselves visible that patients often did not recognize were related to their tailbone pain. These could include: posture/spinal alignment abnormalities, urinary incontinence, pelvic pain during sex, constipation, & sciatica.

All of the pelvic floor muscles attach to the pelvic floor, which is layers of muscle and other tissues. These layers stretch like a hammock from the TAILBONE to the pubic bone in front..For example, a female’s pelvic floor muscles support her bladder, uterus and colon. The urine tube (front passage), the vagina, and the back passage all pass through the pelvic floor muscles. Your pelvic floor muscles help you to control your bladder and bowel. They also help sexual function as this area is highly innervated by nerve endings. As you can see, this area is beyond important. When dysfunction at the tailbone area arises, many other area may also demonstrate signs of dysfunction as well.

What causes tailbone pain? The TOP 2 causes I see in my clinic are (1) trauma (ex. a fall, blunt trauma from forceps) &  (2) tight pelvic floor muscles. Usually, a combination of both cause significant pain. A broken tailbone can cause muscle imbalance as well as tightness secondary to tight muscles pulling the tailbone out of its normal mobility path. Pelvic Floor Physical Therapy addresses this by “releasing” or lessening the tension at various trigger points internally and externally using various techniques. Other symptoms such as urinary frequency and pelvic may be improved solely from “releasing” and restoring muscle balance in this area; while in some cases other treatment techniques in combination with this may be necessary.  Other treatment options for tailbone pain include: seat cushion, stress relief techniques (massage, yoga), acupuncture, antidepressants, steroid injections. Surgery usually has been less effective with treating this condition and requires additional rehabilitation post-op. At InHer Physique, we believe in offering a safe place for patients to choose what treatment course they feel is right. There is no right or wrong, but there is power in having the authority over your care.

Try proven and effective conservative treatment, pelvic floor physical therapy, to improve your pain. It is not a quick fix, but  over time I have seen several patients have improvement in symptoms and a better quality of life.

Dr. Jus

Why is Pelvic Floor PT at the bottom of the “To-Do List”?

The phone rings; “Hello, this is InHer Physique Pelvic Floor Physical Therapy! How can I help you?”

“Hi, I am interested in your services. Could you tell me the cost and how your whole treatment system works?”

“Absolutely! The initial evaluation cost is $125; with every visit to follow being $85 if you elect to remain a patient. Your first visit will be an hour to an hour and fifteen minutes of thorough hands on care with Dr Justine. With her findings, you both will come up with an optimal treatment program tailored specifically to you.”

“Okay, so about my insurance how does that work? Well, we can assist you with attempting to receive reimbursement; yet there is no guarantee that you will be based on your insurance plan.”

“Okay, great I understand.”

“Would you like to book an initial evaluation with Dr. Justine?”

.....this is the pivotal moment. Will or will they not book an appointment upon the first call. 

Usually, the answer is no. I find the top two reasons are:

  1. They are not covered up front by your insurance 

  2. The cost of the initial evaluation 

There is no judgment. I get it. A patient and I chuckled as she was on my treatment table...we both find that when we get a medical bill we open the envelope and ask DO I REALLY HAVE TO PAY FOR THIS. 

The way the American Healthcare system is structured we as citizen are truly bound to the rigid insurance system.

Recently, I have started to introduce what a patient gets at our office differently. I now truly tell you what makes us different:

1. You get over an hour of conversation and hands on technique with a doctor.

WHERE DOES THIS HAPPEN...EVER! Usually, the doc is in and out! Well, when I simply gently place my hand on your back or chest your body automatically relaxes. Usually, the body of a person that is pain or in discomfort has a “very active” sympathetic nervous system. A gentle touch helps the nervous system to calm down and more effectively adapt to treatment. Also, who doesn’t like to be listened to about their private, personal health issues. You completely have the floor. That is truly empowering! 

2. Pelvic Floor PT come few and far in between.

Not all Therapy is created equal. Pelvic Floor PT is an art but connecting with patients enough for them to leave the office, go home and implement the changes discussed and come back with a positive report is what make us different! I’ll rephrase this keynote. GOOD PELVIC PT, is special and is a rare delicacy. 

I am not here to conquer and change the insurance system. I am here to empower people who need Pelvic PT services to see the resource they have and use it.

I’ve had some people come in the office and say I’ll pay whatever it takes! I want this! While others won’t sign up the reasons they feel are truly valid. 

I understand what it’s like to not be able to afford a medical based service. It actually set me back finically to show up weekly and cough up $80/visit to my therapist/strategist. But, it was working! From day 1, it started working; and because I was committed I graduated from caseload in about 7 months! 

Not everyone is fortunate enough to have the money for services and that is why we have programs for that! We never turn someone away based on inability to pay in full first visit. Yet, a person has to commit and want to succeed. This is where I must work harder to educate my community and world on this beautiful art! Once people truly know the benefits, it will speak for itself in every individuals life that tries it out in some capacity.

Do me one favor! Think of one thing you sacrificed for and how everything turned out in the end. What drove your desire for change and what drove you to remain consistent with whatever it was?! Hold on to that drive against any of you may come up against! This drive is the game changer!

Keep Fighting The Good Fight

Dr Jus

Change Makes All the Difference

Let me set the scene for you. I’m sitting here in my living room next to my other half on Super Bowl LII 2019 Sunday. Now instead of actually watching the game, the television is turned off and we have been discussing our future business endeavors for the entire duration of the game….well, more specifically mine.

In retrospect, it happened naturally and we didn’t really even care that we had missed the game (Go Saints! I am still a little upset in regards to that, but anywhoo). What was profound about the time we spent talking ,in my opinion, was that we were doing something completely different than about 90% of the people we knew on that day at that time. We had been invited to a Super Party, yet after I quickly whipped up some BBQ cocktail sausages, Rotel dip, and chicken bites right after church; we figured we would hide our gluttony. We weren’t going to let others see our stomachs poking out of our shirts. We like to keep things in house and rub our bellies together in our no judgement zone ie. our living room.

I remember a time when I suffered from F.O.M.O (Fear of Missing Out) severely. Even if I knew I wasn’t going to go and the person or people who were to invite me also knew I would never come…I STILL WANTED TO BE INVITED. I’m sure some of you can relate. The lack of regret for not showing up to partake in the festivities didn’t haunt me; nor did flare of F.O.M.O occur. I had officially become different. Consumed with this new season of life, I have found comfort in being different. I have also realized that, this mindset is exactly what it takes to make progress in life. Habits have to change in order for you or your circumstances to as well. This mantra is something that I am currently living by. That is even the more reason I can preach it so strongly to my patients.

After 3 years of working in Washington, DC as a physical therapist within different settings of the field, I had finally realized what I loved doing the most. I loved getting close to my patients and being a positive figure in their lives by implementing changes to their lifestyle. Pelvic Floor Physical Therapy probably takes the cake of being the most intimate form of rehab. In order for it to be effective, the patient has to do the following: 1. Trust their practitioner 2. Trust the environment in which they are receiving treatment 3. Change various habits that are apart of their current lifestyle. All of these things things require a person to take a hard look at their current situation and be brave enough to accept the challenges that come with the entire package. I have the privilege of helping people completely change their lives when they decide to become different, and I love it.

You may ask, “Dr. Justine, what is Pelvic Floor PT really and why would I want to come to see you?” Well the “obvious” or the “not so obvious” is that you may have some form of pelvic dysfunction inhibiting you from performing daily life functions in a typical manner. Examples could include: pelvic organ prolapse, pelvic pain, urinary or fecal incontinence during certain activities, and other various issues.What I often find is that people have an issue truly knowing what is normal and what is not. So my job is to evaluate, diagnose and treat conditions as well as confirm diagnoses that may have already been suspected by another health professional.

I do quite a bit of educating on not only what Pelvic Floor PT is but why it is relevant. The most common example is a mother who is post-partum and leaks when she laughs or coughs. This is not normal, yet many people including MDs will assume that it is normal.

Realizing a condition is not normal is only the beginning. They must then desire to make a change as discussed earlier in this post. Believe me, so many people disclose their symptoms to me, yet are not at a point where they desire treatment. The issue with this is that their symptoms CAN AND WILL get worse over time. So, when you ask why would a person want to come see me; I answer by saying I can help change your life now. I can only hope to change your life later. Many women and men shed tears in my office because of the shame and embarrassment associated with their symptoms. So, I do not take it lightly that my office is a safe place for people to fall apart with the hopes of me helping them get put back together. Some women can’t have sex with their husbands; some men can’t have sex with their wives. This is huge. So, coming to see me goes past a regular treatment visit as you can see.

I will wrap this chat up by saying my earnest attempt to educate my community drives my practice. This blog will serve as a platform to do just that educate. I will post my professional opinions that are backed by scientific evidence. I hope this will empower and be the first step for people to begin making steps towards change. Ready to make an appointment with me ? Book your appointment now.

Keep Fighting the Good Fight.