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It is expected that the swelling or pain of a torn meniscus will resolve within a few days when a nonsurgical and conservative approach is taken. When the knee joints are free of swelling the rehabilitation process is given to increase strength of muscles, which are surrounding the knee. Those who are elite athletics they generally return to their practices within 1to 2 weeks after surgeries.
Coccydynia, also known as coccygodynia, is characterized by pain in and around the region of the coccyx. The coccyx is a weight bearing structure during sitting and is stressed further when leaning backwards. Coccydynia is the cause of less than 1% of all reported cases of back pain and is five times more common in women1-3. The biggest complaint for patients with coccydynia will be pain in and around the coccyx and pain during sitting, especially in a backward-leaning sitting position. The most common etiology for a coccyx injury is trauma to the coccyx from a fall or a direct blow during contact sports.
Diagnosis can be made with a good subjective exam in conjunction with pain in the coccyx region, usually provoked during sitting.
The conservative approach to a coccyx injury includes the use of NSAIDs to reduce inflammation and pain. Manual therapy can also be used as a conservative treatment for a coccyx injury by aiming to relax and extend the muscles in the area to help move the coccyx back into a correct position.
The internal mobilization is done using a gloved hand and inserting one finger into the anus and massaging the muscles and ligaments attached to the coccyx.
As with many trauma related injuries, cryotherapy can be beneficial to reduce pain and control inflammation and edema. Following the acute inflammation stage of healing, thermotherapy through the use of heat packs or warm whirlpool can be used to help relieve pain, promote tissue extensibility, and help with healing. If the tear is not severe, located on the meniscus’s outer edge and it is small then by rehabilitation it is possible to cure meniscus. Rehabilitation and recovery is a commitment for long term and you should maintain regularities in the recovery approaches to get better results. When this approach is taken the rehabilitation processes of meniscus tear balances swelling caused by meniscus tear and heals the affected area.
The cause is most often of a traumatic nature but it can also be from an infection or tumor. It is the final segment of the vertebral column and is comprised of three to five fused segments. Consequently, patients with coccydynia may find relief when sitting in a forward-leaning position.


The increase in incidence in women may be related to the increased pelvis width compared to men. The pain onset is usually due to a traumatic incident to the area and may be accompanied by a bruise. This type of injury can result in a fracture or dislocation at the sacrococcygeal junction that causes abnormal movement during sitting and significant pain.
During the last trimester of childbirth the coccyx becomes more mobile, allowing for greater flexion and extension, which can cause damage to the tissues that attach to it as well as an inflammatory response. Some less common causes are pudendal nerve injury, pilonidal cyst, obesity and piriformis pain.
Lateral X-rays can be taken in a standing then sitting position and can be used to measure the angle of the coccyx in each. The two manual methods that can be used are an external or internal manipulation and mobilization.
This positioning can be used to do anterior-posterior, lateral and medial mobilizations of the coccyx.
For patients who require coccyx mobilization, heating the tissue prior to mobilizing may help with loosening the muscles that attach the coccyx.
Ultrasound uses sound waves that penetrate tissues and can help with accelerating metabolic rate, reduce or control pain, decrease muscle spasm, alteration of nerve conductivity, increase circulation, and increase soft tissue extensibility.
In cases where the knee is stable and the symptoms of meniscus do not persist or do not hamper your daily lifestyle then non-surgical options treatments are possible.
Rehabilitation and recovery approaches are to make certain that the muscles, surrounding your knees, are strong.
The main goal of rehabilitation process is to restore the range of motion to your knees at the earliest possible time.
Other patients however return to their mild routine activities with 6 weeks after a surgery. Between the first two segments an intervertebral disc may be present and can potentially be a site for hypermobility.1 The coccyx is attached to the sacrum via a fibrocartilaginous joint, called the sacrococcygeal symphysis, as well as the anterior sacrococcygeal ligament. Also a coccyx injury can occur during childbirth from increased pressure as the baby descends through the pelvis. The physical examination should include clearing the lumbar spine and the SIJ, as these regions can cause pain to the coccyx. If the coccyx is out of place, the therapist can use this positioning to move it back into a correct position.1 This is a sensitive procedure and it is important to explain its importance for physical therapyand the procedure to the patient. If a fracture is suspected, use caution, as ultrasound causes severe pain over fractured bones. By stimulating more A-beta fibers than pain fibers (A-delta and C fibers) pain perception is decreased.


However, whether a patient will go for surgical treatment or a nonsurgical one completely depends upon the nature of the knee joints. The anterior side of the coccyx serves as an attachment site for the muscles of the pelvic floor including the levator ani (puborectalis, pubococcygeus and iliococcygeus) and the coccygeus muscle. After holding for a period of 10-60 seconds the tissues surrounding the coccyx should begin to release. To minimize edema and the painful effects of inflammation, cryotherapy should be applied immediately after the injury and up to 72 hours after. If the joints of the knee are functional and do not cause any limit to the patients to participate in his or her preferred or regular activities then the patient can think for meniscus treatment without surgery.
You need to maintain ideal body weight as sometimes over weight or obesity puts pressure on knee joints and this further turns to meniscus tear. Most of the therapists work in coordination with the orthopedic surgeons to restore the normal state of motion to a patient.
The coccyx can be palpated internally or externally, however, proper palpation requires a rectal examination. The use of cooling agents is thought to decrease the activity of the A-delta pain fibers, thus cryo therapy can be used following the acute stage of inflammation for reducing pain as well. Increased blood flow to the injured area accelerates healing by helping to bring oxygen and other nutrients as well as removing waste products from the area.
As the procedure is not unplanned and is planned in advance, many healthcare professionals advice . To palpate, using a gloved hand, the index finger is inserted into the anus while the patient relaxes the sphincter muscles. As the coccyx is pulled posterior, the patient is asked to do a gentle contraction of the pelvic floor muscles for 3-5 seconds. So if you are suffering from meniscus tear and opting for nonsurgical treatments then you need to be careful about maintain your rehabilitation and recovery approaches to get the best result within a short time. The finger is inserted as far as possible while feeling for the anterior surface of the coccyx. Regularity of maintenance of rehabilitation and recovery approaches of meniscus treatment without surgery also prevent further problems.



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