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chronic pain patientEllen had fallen off a horse at the age of 14 and landed on her left hip and buttocks. When we palpated the site of the trauma, we felt very thick adhesions running down both sides of her sacrum and down into her tailbone. Above the injury, adhesions were running up the left side of her low back, thickening the quadratus lumborum or “hip-hiker” muscle between her ribs and low back. When we questioned her further, we discovered that she had landed in a position in which her right leg was pulled back, over-stretching her psoas muscle and the hip flexors, at the front of her right thigh. The psoas muscle neighbors the fallopian tube, ovary and kidneys, so any inflammation of the psoas could affect those structures. In fact, upon palpation, her digestive system apparently received and absorbed some of the force of the trauma, as did her right kidney.

The adhesive healing process spread into the nearby bowels, causing inflammation there. The force of the fall also pushed her tailbone forward, creating a physical barrier to her descending colon, causing constipation. Thus, the original injury caused inflammation to spread to various areas of the abdomen, pelvis, hip, and low back. Intercourse pain with deep penetration was a direct result of her partner hitting her tailbone, which had been pushed forward by the fall. Thus the tailbone created a physical block whenever she attempted to have intercourse with her husband and contributed to constipation, as it created a physical barrier at her descending colon. She also complained of neck and TMJ (jaw) pain, which we felt was exacerbated by an unstable pelvis.

damage to coccyx from a fallHaving thus surmised the history and progression of the injuries and symptoms our patient experienced, we were able to see, treat, and deal with the wide range of symptoms as a whole-body approach. Our next challenge was to ask ourselves, “Where do we begin and where do we take this next?”

Like taking apart nylon rope one strand at a time, we began to palpate, detach, and free the major adhered tissues and structures from each other, one by one.

Like taking apart nylon rope one strand at a time, we began to palpate, detach, and free the major adhered tissues and structures from each other, one by one. To us it feels like we are pulling out the run in a three-dimensional sweater. As we free restricted areas, we move on throughout the body, following the “run” wherever it goes.

As the strong collagenous bonds began to slowly release, symptoms dissipated and normal range of motion returned. As entrapped nerves were freed, Ellen’s pain decreased. As the pelvis and low back were freed, we were able to return symmetry to the spine so her neck and TMJ symptoms could resolve at last. Direct treatment at her tailbone and nearby structures resolved her constipation and intercourse pain.