Case Study Integration (CSI): Pelvic – Coccyx Pain

15.5 Contact hours/ 1.55 CEU’s – Online Course

This online self-paced course offers a global perspective of pelvic ring and pelvic floor concepts surrounding a case with the common patient complaint of coccyx pain: a symptom treated by both orthopedic physical therapists working with patients with low back pain as well as specialists in pelvic health.

Basic pathoanatomy, recommended ‘external’ extra tests to accompany a lumbar clinical assessment to rule in or out pelvic floor pathology, and external management suggestions are discussed and demonstrated. Recognizing potential pelvic floor dysfunctions that perpetuate orthopedic problems enhances every clinical practice and vastly improved patient outcomes. Special topics include 1) manual therapy and breathing, 2) dry needling, 3) sensorimotor control strategies, 4) urinary incontinence, 5) generalized lumbopelvic instability post-partum, and 6) considerations of communication and building rapport in compliance and optimal outcomes.

Target Group: PT, PTA

Educational Level: Basic

Course Outline

By the end of the course, the participant will be able to:

• Describe the general pathoanatomy, physiology, and biomechanics of pelvic floor and related pathologies with the ability to define the most common type of bladder problems.
• By means of a systematic process, identify the key findings from extra tests that accompany a lumbosacral clinical examination that would indicate involvement of a pelvic floor dysfunction.
• Be confident in the assessment of the coccyx and pelvic muscles externally to differentiate simple pathologies related to coccyx and or pelvic involvement in a lumbar or lumbosacral pain patient.
• Implement a variety of treatment strategies to positively affect coccyx pain including soft tissue mobilization, dry needling, sacrococcygeal joint mobilization.
• Employ generalized management strategies to include rib mobilization with proper breathing techniques.
• Effectively screen for pelvic health concerns and recognize when to refer to a pelvic floor specialist therapist.
• Manage rib dysfunctions and coordinate rib excursion with patient breath.
• Integrate common and specific psychosocial approaches to engage and promote a patient-clinician relationship to allow better functional and clinical outcomes. Effectively create a therapeutic alliance with the patient.
• Show 3 to 5 skills-based and/or functional neuromuscular and sensorimotor control strategies for pelvic floor-lumbopelvic segment pain/dysfunctions and/or healthy post-partum movement patterns.

• Financial: The instructor(s) receive an honorarium for presenting this course.
• Non-financial: The instructor(s) have no relevant non-financial relationships to disclose.
• Partial credit is not available. For online courses, passing module assessments and completing the course evaluation is required to earn continuing education credit. For live courses, attendance is confirmed by signing the attendance sheet at the course; ensure name and professional license number are accurate, and initial both morning and afternoon attendance.