Effect of Pelvic Floor Muscles Down Training on Postpartum Coccydynia

One complication of coccydynia is that it may become a chronic pain syndrome. Early and thorough medical attention may help patients avoid delays in diagnosis and treatment. The hope is that this will help decrease the chances of the pain becoming persistent and disabling. Many patients with coccydynia experience relief of symptoms within weeks or months of onset, whether or not they receive medical treatment. The success of conservative treatment has been reported to be 90% .

The significance of musculoskeletal and myofascial pain in chronic pelvic pain is becoming increasingly established. the findings suggest a direct link between impairments in coccyx mobility, pain, and muscle spasm and dysfunction of the pelvic floor muscles. Therefore, pelvic floor muscle impairments related to the coccyx may need to be addressed in treatment considerations .

There is a risk of pelvic floor dysfunction (PFD) from baby delivery. Many clinical guidelines recommend pelvic floor muscle training (PFMT) as the conservative treatment for PFD because pelvic floor muscles (PFMs) play a crucial role in development of PFD. PFM training is the most popular conservative intervention for PFD. Its role in PFM improvement is becoming more and more important along with the rapid development of rehabilitation medicine and it is more and more acceptable by women as their requirements for improvement of quality of life are getting stronger.

PFM function requires activation and relaxation at appropriate times and amounts to maintain pelvic organ support and closure, and enable passage. PFM tone that is greater than that required for a specific context (referred to as "increased" tone by the International Continence Society) could affect function and explain some features of pelvic health conditions, such as compromised relaxation or lengthening of PFM (eg, functional obstruction or interference with intercourse) and muscle ischemia (as implicated in some pain conditions). PFM tone could be increased by many factors, including stress, fear, anxiety, psychological trauma, injury, surgery or radiation, and hormonal, lifestyle, and occupational factors. Although plausible, evidence for increased PFM tone remains unclear

Inclusion criteria

• Their ages will range from 18 to 30 years.
• Suffering from moderate coccyx pain which assessed by VAS.
• Their body mass index will be equal or less than 30 kg/m².
• Primipara and multipara -2:3 times‖ women.
• Six months to one year after childbirth.

Exclusion criteria

• Neurological disorders.
• Musculoskeletal disorders as Abnormal coccygeal morphology or abnormal scoliotic deformity
• Infection or malignancy.
• Fibromyalgia or myopathy.