“You’re the first person who has touched it.”

This is what a mother of three with severe coccyx pain said to me when I assessed her coccyx relative to the sacrum.

I’ve been mulling this over since I had this experience last week. We have all done it before—neglected to assess something—either out of laziness, or out of lack of confidence or inexperience with an area.

Going back to my years teaching at the massage school, it was always an interesting conversation with the new students entering the program in the fall, when the pelvis is the region of the body that they are delving into. Imagine never touching a body before, and your first week in massage school you are palpating a pubic ramus, the ischial tuberosity, the pubic crest, and all of the other bony landmarks in the area.

Often times, we would have a conversation about ethics before we would even start getting hands on. It is such a sensitive area, and so often, there is someone in the class who has some kind of trauma related to the pelvis, so it can be a rude awakening for some people to start working, and receiving work, in that area.

Lots of conversations as a class, and with individual students, have come out of this learning opportunity.

So it is not out of judgment that I posted on social media last week about the coccyx, and how the client told me I was the first practitioner in two years of her seeking help for intense pain at the tip of the coccyx to actually touch it. At first, I was outraged to hear that she had been to physical therapists, doctors, chiropractors, and even pelvic floor therapists, seeking relief, yet not one of those supposedly very qualified professionals either thought to assess the actual site of her pain, or had the skills to do it. Why did no one even touch the coccyx to see what was going on? But then I realized that it is a sensitive area, and not every practitioner of every modality has the personal skills to be able to get right up in someone’s business and assess this. Perhaps they have never been taught how to do it, the importance of doing it, and how to get past their own mental blocks of touching someone so close to the anus.

When I assessed the coccyx, I could immediately feel that it was rigidly pulled to the right, relative to the sacrum, and the coccyx itself was also rigid. It had no give coming to the left. It made me feel so bad for her that she had wasted two years, looking for the right therapist to help her with this, when it was just getting more and more rigid. Or maybe it had been that way for years, and something happened that she wasn’t able to compensate around any farther (perhaps the birth of her child), so strain got driven into the area, causing pressure on nerves, which equals pain. It actually felt to me like it had been broken, or the joint capsule had been damaged at some point, and fused to the sacrum in the process of healing. She had told me of one event that might have caused that.

She had been made to feel like a whiny, wimpy, lazy mom who didn’t want to get better, by the people who worked on her. What a travesty!

The coccyx is embedded into the tissue of the pelvic floor, so anyone doing pelvic floor work should know how to assess and treat the coccyx. Otherwise, they are missing a major piece of it. Sometimes, working on the pelvic floor can free up the coccyx. Sometimes you have to address the position and condition of the coccyx first, for the pelvic floor to have any give.

The fact that she was offered intravaginal therapy without them even assessing the coccyx made me feel so indignant. Why would anyone rush to internal work without even assessing the bony parts of the pelvis?

Then the lightbulb came on for me.

I knew that the bar needs to be raised in manual therapy, but I thought that at least the people who say they specialize in pelvic floor therapy and spinal mechanics would automatically be checking this. It reminds me of a quote my mentor taught me, that one of his mentors taught him: “Never assume that the professionals before you did their job.”

Now I realize that my mission is a worthy one: to provide high-level local training for therapists of all kinds. This will be more cost effective for therapists to attend classes. It makes good education accessible to more therapists. Therapists learning together will build networks together, so that they can practice on each other and discuss the things learned… study group, anyone?

I feel like it is so important to share this knowledge with all kinds of therapists, especially in smaller towns where the big names in education don’t show up.

Of course, those big name classes are very, very good. I wish all therapists could afford to travel to those big classes.

I remember being a single mother when I was starting out as a therapist, trying to make ends meet. Those classes were completely inaccessible to me. Even once I had a thriving practice, to pay for those kinds of classes seemed insurmountable while raising a child on my own. By the time you pay for the tuition, the travel, the lodging, the rental car, plus eating out for all of your meals, you rack up quite a bill. So as much as I longed to be able to go geek out in a class like that, it was little by little that I could afford to do it.

I feel so blessed finally to have been able to work closely with an osteopath for 10 years, assisting him in the classes he taught, and working together on clients, as well as taking several Upledger and Barral classes. I have a much broader viewpoint now than I did in the beginning, and the more I learn, the more people I feel like I can help.

The last few years I have loved sharing the knowledge I have acquired with newer therapists in local continuing education classes, at a much lower cost than I had to pay for all of those classes, and without having to travel to them. To be able to send clients to some of my students when the clients can’t wait long enough to get on my schedule makes me feel like I’m doing something worthwhile by teaching this stuff.

If you would like to bring my classes to your area, please contact me, and we can get it on the schedule!

(Please note: I know that many practitioners are trained in very good work. The story above is the experience of one person who seems to have drawn the short straw…several times in a row.)