We Help With: Sacroiliac and tailbone pain (coccydynia)

The Backpod can be used to free up a tight sacroiliac (SI) joint problem which can commonly occur during or after pregnancy or from a fall onto the low back or tailbone. The impact can often leave the sacrum ‘jammed up’ along the SI joints and not moving. This leaves the tailbone more exposed to impact/pressure when sitting down and can create ongoing pain from the repeated banging on the tip of the tailbone.

This type of tailbone pain doesn’t respond to purely local treatment of the tailbone itself but clears when the SI movement is restored to normal. The extremely tough mix of capsule, ligaments and fascia around immobile SI joints means that good results from mobilisation and manipulation techniques often don’t last, because the surrounding shortened collagen just tightens them up again. The Backpod is ideal for stretching this so the SI joints can stay free.

How to stretch tight sacroiliac joints on the Backpod: Lie on your back on the floor, thighs vertical, shins horizontal, ankles crossed and heel supported on the edge of a table or chair. The Backpod should be positioned lengthwise under the sacrum and you relax onto it for several minutes, once daily.  This uses your own lower body weight to stretch the tight SI joints.

It can still take weeks before the SI joint movement frees up reasonably, and often they are tight enough to also need the greater force of specific therapist mobilisation or manipulation techniques. The Backpod is the ideal follow-up tool, to stretch things further so they stay free – see our video on Youtube.

Clinical caution: The Backpod should be used to stretch only tight or frozen sacroiliac joints. Stretching already excessively moving SI joint problems will make them worse. The best test to clinically distinguish between the two is Andry Vleeming’s test for SI hypermobility: you lie on your back and actively lift one straight leg as high as you can. This is repeated with your friend or therapist manually pushing both sides of the your pelvis together (i.e., artificially compressing and stabilising the SI joints). If your leg raise is clearly higher and without pain, it indicates an unstable, excessively moving sacroiliac joint. This should not be manipulated or mobilised with the Backpod or any other technique. These problems are best treated by support muscle strengthening and stabilisation belts, and you should ideally go see a physiotherapist.

Sacroiliac pain during and after pregnancy is common. Usually it is explained as arising from excessively moving (i.e. hypermobile) and strained SI joints, due to the loosening and softening effect on the ligaments of hormones released during pregnancy to allow the sacrum to hinge open fully to let the baby come through the pelvic basin. This surely happens, however it doesn’t explain SI pain just on one side, since all the ligaments are presumably loosening equally. Unpublished research and extensive clinical experience suggests that one-sided SI pain appearing partway through pregnancy is more usually from a tight or immobile SI joint. These patients generally have a history of a fall or impact on the low back, pelvis or tailbone, presumably leaving the legacy of an adhesed and immobile SI joint. The interpretation is that as the pregnancy continues, and the surrounding ligaments get looser, the adhesed SI joint becomes relatively tighter and then painful.

These problems generally respond well and quickly to mobilising the tight sacrum with manual physiotherapy techniques, or simply by lying on the Backpod. This validates the model as the patient is no longer sore – even though the pregnancy is continuing and the baby is getting bigger – so the pain can’t just be coming from the stresses and strains of pregnancy.

If SI or tailbone pain persists months after the baby is born it is then usually coming from SI joint immobility after the ligaments have tightened up again after the birth. The Backpod is equally effective in this situation to gently mobilise the tight SI hinges as described above.

Backpod TV

We have created an extensive selection of tutorials and informative videos, and posted them on YouTube for your easy access.