I would like to relate a “new” muscle energy treatment taught and explained to me by Derek Jones, D.O., Family Practice resident at Westview Hospital. Derek and I exchange osteopathic treatments and ideas every few weeks. We continually try to explain what we have learned in school and in practice and improve our treatments.
This treatment is for coccydynia. The patient will show up with coccyx pain on sitting.
The treatment begins with the patient seated. The operator is behind the patient. The operator slides a finger outside the patients clothing under the buttocks in the midline until the tip of the finger is resting on the end of the coccyx. Flex or extend the patient in the sagittal plane until the motion occurs at the tip of the coccyx. The operator then gently motion tests the coccyx movement left and right to find the restriction. Gently hold the coccyx in the motion of greatest restriction (directly against the barrier). Have the patient take a deep breath and hold it (this increases intrathoracic pressure). Then have the patient bear down as if they were trying to have a bowel movement. This will activate the pubococcygeus muscle and begin to change the coccyx. Have the patient hold the breath and muscle effort for 3-5 seconds or until a change is noted. Then have the patient breathe out and rest. Repeat these steps until a full release is noted.