My Dear Sarah Fern Striffler and Paul Duffy ,Jason&Will,
and list members,
Thanks for your valuable inputs ,I
have few points to consider
when we study the X-rays of these patients in sit-stand position we know the
lesion better.
The physiologic movements of the coccyx are restricted to flexion and
extension. Active flexion (movement in a forward direction) is performed by
the levator ani and the sphincter ani externus muscles. Extension (movement
in a backward direction) is due to relaxation of these muscles and to the
increased intra-abdominal pressure which occurs during defecation and
parturition . It is a passive movement. Surprisingly, the movements of the
coccyx in the sitting posture have never been reported in the literature as
far I know .When we talk about PA mobs are we moving coccyx into flexion
if so which part proximal/distal .Use of a finger placed in rectum is
required ?during this procedure ? can any one guide us regarding
massages of the pelvic floor as described by Thiele and manipulations
consist in mobilisations of the coccyx in joint mobilisation and stretching
of the coccyx (and of the attached muscles) with the rectal finger. This
latter maneuver was described by R Maigne or a technique, consisting in a
mild levator and external sphincter stretch without moving the coccyx .
At last coming to my original question can we
support the coccyx by placing some sort of splint/orthotics /supporting this
bone till it heals .
Thanking you.
DrSarveshwar Chander Sood
Orthopaedic Surgeon ,
Member American Academy Of Pain Management.
Member Mckenzie International Institute USA
E-mail [log in to unmask]
http://personal.vsnl.com/sarveshwar
----- Original Message -----
From: "paul duffy" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 15, 2003 10:05 PM
Subject: Re: cocydynia!
> Dear Dr Sood & list members
> I recently successfully treated one such patient with PA mobilisations,
> pelvic floor/TA exercises and seating advise. Although this is getting
away
> from the question posed I was wondering was it still current practice
> (evidence based) to recommend inflated rings/cushions for these patients
> whilst sitting.
> I was told by a senior physio that these were no longer recommended as
they
> had an adverse effect on blood flow to the area and thus reduced healing
> rates. ( she did not state the source of her evidence)
> Paul Duffy
> Sen 2 PT
>
> >From: Uri Yaros <[log in to unmask]>
> >Reply-To: - for physiotherapists in education and practice
> ><[log in to unmask]>
> >To: [log in to unmask]
> >Subject: Re: cocydynia!
> >Date: Wed, 15 Oct 2003 06:53:00 +0200
> >
> >-----Original Message-----
> >From: Dr. S.C.Sood [mailto:[log in to unmask]]
> >Sent: Friday, December 31, 1999 9:14 PM
> >To: [log in to unmask]
> >Subject: cocydynia!
> >
> >
> >Dear friends,
> > We come across many cases of postraumatic pain in
cocyx
> >which is very much painful and diabling ,we offer proper sitting advise
> >and
> >NSAIDS drugs I wonder if at all there is ANY known way to stabilise and
> >support this small naughty bone to relief the pain,
> >
> >Thanking you all,
> >DrSarveshwar Chander Sood
> >Orthopaedic Surgeon & Head Department of Physical
> >Medicine & Rehabilitation,
> >Member American Academy Of Pain Management.
> >S.B.L.S.Hospital
> >812/1,Housing Board Colony
> >Model Town,Jalandhar city
> >Punjab State.India
> >E-mail [log in to unmask]
> >http://personal.vsnl.com/sarveshwar
> >"Physicians add years to life whereas physiotherapist add life to
years.
> >
> >dear dr Sood.
> >
> >It is very useful to treat cocydynia with .p.r.t ---positional realese
> >therapy.
> >in my exspiriance 1--2 treatments and the pain is over.
> >uri yaros -israel
>
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