Resuming an Active Lifestyle After a Coccyx Fracture

After fracturing her coccyx in a cycling accident, Ashleigh* was referred to Sydney Pelvic Clinic by her local physio. She was experiencing severe muscle pain, which made it difficult for her to sit for more than a few minutes, walk at a normal pace, or sleep comfortably through the night.

Ashleigh had been using home remedies such as heat packs and stretching to try to alleviate the pain, but was eager to embark on professional treatment so she could resume the activities she loved, such as cycling and swimming.

The road back to an active life

Following her cycling injury, Ashleigh initially experienced a bony ache that lasted for around five weeks; this then developed into much more severe muscle pain, preventing her from undertaking many of her normal activities.

The issues Ashleigh was experiencing when she first came to Sydney Pelvic Clinic included the following:

• She could only sit for 5-10 minutes without discomfort
• Her walking pace was very slow and she could only manage around 10-15 minutes before experiencing irritation
• She could no longer sleep comfortably on her back, so was sleeping on her side but waking up regularly
• She didn’t feel comfortable engaging in sexual activity and reported feeling cautious and protective due to her injury

With the help of SPC, Ashleigh hoped to return to 3-4 hour bike rides within three months of treatment, be able to swim all strokes (including breaststroke and butterfly), sit and lie on her back without discomfort within six weeks, and return to normal sexual function within six
weeks.

A collaborative approach to treat coccyx pain

An integrated treatment plan helped Ashleigh manage her coccyx pain and move forward towards her goals of resuming her previous active lifestyle. The treatment plan included:

In-clinic treatment (starting with 3 sessions)

Over the course of three sessions, the physio worked on releasing Ashleigh’s per rectum (PR) with mindfulness/deep breathing focused on the coccyx area, as well as myofascial release of the deep hip rotators.

Home management plan

Ashleigh’s treatment sessions were supported by a home management plan which included mindful breathing (drawing on what she learnt in her physio sessions), awareness of releasing tension in the muscles around the coccyx, use of a Therawand to self-release muscle tension, and other muscle stretches prescribed by the physio.

Exercise therapy

Once Ashleigh’s coccyx and muscle pain had reduced, the physio prescribed an exercise regime to get her on track with her goals of swimming and cycling – this included weight resistance to build strength.

What were the outcomes of Ashleigh’s treatment?

After just three sessions, Ashleigh recorded a 90-95% improvement in her condition, only experiencing mild stiffness rather than pain. She could sit for two hours, lie down and walk normally, and cycle for an hour. At this stage, she was able to perform breaststroke but not butterfly.

After six sessions, Ashleigh reported zero issues with sitting, lying down or walking. She was up to 2.5 hours on her bike, with a 10% time increase each week. She can also swim both breaststroke and butterfly.

Ashleigh’s bowel function has returned to normal, and she no longer feels hesitant about potential coccyx pain during sex.

What’s more, Ashleigh now feels that she has the knowledge and strategies to understand and manage her pain.

*In the interest of patient confidentiality, names have been changed