Physiotherapy Now

Jerusalem physiotherapy by Tamara May

Back pain

Coccydynia: A dislodged tail bone

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Well this one is often missed, put down to the trauma of delivery. However, come three months post delivery when the bleeding has stopped, the stitches have healed and you are starting to feel half human again there is still pain lingering in the tail bone.  You have spoken to your friends about it, and got all types of possible and probable reasons why you could still be in pain so long after giving birth. Most likely, none of these friends suggested coccydynia. 
Although you can suffer from coccydynia without going through childbirth, it is thought to be the most common cause. Once again the hormone relaxin plays a part in this condition, by relaxing your ligaments and soft tissue, including the tail bone. During child birth the tail one bone needs to move a little to give way for the baby, and in some cases the coccyx bone does not go back into its correct positions, leaving you in pain and with a condition called coccydynia. 
Quite often the main indicator of coccydynia is pain while moving from sitting to standing. Other symptoms can also include back ache, shooting pains down the leg, pain before or when you pass stools, pain during sex, painful buttocks and hips and increased pain during periods if they have started already. You may also have difficulty sleeping but often this goes unnoticed with a new baby round the house.  It is therefore not commonly suggested post partum as there could be pain anyway from the birth. 
How can it be treated?
Ibuprofen is very useful in this scenario as coccydynia always comes with swelling and inflammation. If the pain still persists then a physiotherapist can use a technique called spinal manipulations to put the bone back into its correct position, relieving the patient of pain.  
If you feel direct pain over your tail bone and you are in great discomfort, you do not need to wait three months before seeking help from a physiotherapist. It can be diagnosed and treated directly after giving birth.
If you are suffering from tail bone pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.  

SIJ Dysfunction: Not to be Confused with SPD

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Sacroiliac joint dysfunction (SIJ) is a condition that one can suffer from during pregnancy which completely resolves itself after birth or shortly after.  Although it can be very painful during pregnancy, fortunately there is a lot a physiotherapist can do. 
Personally, I had never heard of SIJ until I started my training to become a women’s health physiotherapist. One of the reasons I and many others had not heard of it is because quite often if you suffers from SIJ, you also suffer from SPD.  Because patients often have the same symptoms from the two conditions, such as pain when using the stairs, the diagnosis of SIJ is missed.
What is SIJ? 
The sacroiliac joint is the joint at the back of your pelvis. When you have SIJ, pain is felt over the buttock and/or back of the thigh. Occasionally the pain is also felt over the groin and the entire back of the leg. SIJ is the misalignment of the sacroiliac joint.  The misalignment can take place in a few ways: it can be rotational in one of two different directions or the joint can slip upwards.  
The cause of this misalignment and the resulting pain is the hormone relaxin, which has come up a few times on this blog. Yes, the one that relaxes your ligaments and soft tissue. Relaxin has been the cause of most of the problems I have written about on this blog. But I promise you it is a useful hormone overall, as it prepares your body for birth and helps make room for the growing uterus. 
Can it be treated?
The job of the physiotherapist is this case is to diagnose the problem and then simply put the joint back in place. It sounds like it would be painful, but it is not.  This procedure will leave some patients completely cured and free of any more problems, while with others the misalignment can keep occurring and the physiotherapist will simply have to keep realigning the pelvis.  
In addition to this treatment, your physiotherapist will also advise you on stability exercises. This is because it is really important to strengthen the muscles around your pelvis and those that help with core stability. This helps to share the responsibility for your stability between your muscles and joints together, and not leaving it all to your joints. 
If you are suffering from groin and buttock pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.  

Back Care Advice: The best head start for your body

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First of all I would like to start off with a big mazal tov to Kate (aka HRH the Duchess of Cambridge) on the birth of a baby boy. Now although I don’t normally make personal announcements on my blog, I have decided this one is very fitting. I am sure Kate is getting the best treatment in town for her and her new royal son. It is not routine for a women’s health physiotherapist to visit a woman directly after birth if she is neither having any problems nor fits into a high risk category for having problems. There is still however a lot of advice that can keep you pain-free and let you focus on being a good mum.
As the well-known saying goes, prevention is better than cure. Looking after your back is imperative before back pain starts to kick in. It is easy to forget about looking after you with the mountains of washing loads that have come out of nowhere and the constant changing of the baby’s nappy and clothes, along with the feeding. You could just say to yourself “what harm will it really do to change the baby on the floor right here, after all it will save me a good minute which I can spend doing another chore around the house”. 
Bending, twisting and lifting are all bad for your back. These are probably the three actions that mothers or anyone really does the most and without even thinking about it. If you can take on board a few tips on how to improve certain actions it can save you a lot of back pain in the future. 
Babies need to be changed a lot throughout the day. It is therefore important to have a place in your house that is a suitable height for changing them. A chest of drawers is normally the correct height for most people. This will avoid bending or over stretching when doing this task throughout the day.  
Another action repeated many times after birth is feeding the baby. Whether by breast or bottle, make sure you are sitting in a comfortable position with your back properly supported. If you are breastfeeding make sure the baby is at the height of your breast instead of you bending towards your baby. You can buy fancy pillows for this or even just use a regular pillow to prop the baby to the right height. 
When you are lifting something heavy, whether it is the laundry or something else make sure you bend down on one knee with your back straight and hold the item close to you as you lift it up; this is much better than bending your back over to pick it up. 
I have only mentioned a few activities but the principles are the same for everything you do in life, so make sure you applythese principles to your lifestyle for a healthy, happy you. 
If you are suffering from back pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.