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Treatment of painful sex, a physiotherapy story…


courtesy wackystuff

MA was a 32 year old female who reached out to the PhysioCraft team with complaints of pain in her hip and “very low back” region of about 7 months duration which began just before the birth of her 6 month old baby.

During consultation, she reported that childbirth was per vagina and certain movements like getting up, climbing stairs and getting into the car were also painful. Though her O&G physician had prescribed pain meds, she got only short term relief and was reluctant to take them because she was breastfeeding. She was also trying to shed the pregnancy weight and she was quite unhappy about her body and the effect pregnancy had on her. She had tried registering in the gym but walking on the treadmill and cycling made her pain much worse.

In the course of her examination, she admitted her real concern: sex was very painful. This pain was different from the previous pregnancy she’d had and she wasn’t happy at all.

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What is Coccydynia (Tailbone pain, Coccygodynia, Cocalgia)?


courtesy twitter

Coccygodynia is a debilitating pain around the coccyx. This pain is usually triggered by sitting or transiting from sitting to standing. The pain may sometimes radiate to the spine, sacrum, buttocks or thighs. Tailbone pain is more common in women than in men and is suspected to be related to increased pressure during pregnancy or childbirth.

Associated symptoms of Coccydynia

  • Limited movement in the thoracic spine
  • Limited movement or poor alignment in the lumbar spine
  • Limited movement in the hip musculature
  • Tension in the pelvic muscle floor


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What is Incontinence?

courtesy north eastern urology

Incontinence is when there is a leakage of urine while sneezing, laughing, coughing or doing exercises. Incontinence can also be occur when one cannot hold urine long enough to get to the bathroom and leakage occurs in the underwear. Incontinence is a fairly common occurrence in female population and in the senior citizens. Women are prone to incontinence after pregnancy and childbirth.

There are three types of incontinence

  • Stress incontinence
  • Urge incontinence
  • Overactive bladder
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Plantar Fascitis or Pain in the foot


Plantar Fascitis is the most common cause of heel pain in adults. It often occurs as a result of repetitive use or excessive load on the fascia of the foot. The fascia is a band of connective tissue beneath the skin which acts as a shock absorber, attaches and stabilises different segments in the foot. For a long time, plantar fasciitis was thought to be an inflammatory process but recent research is showing that it may be a degenerative process.

Plantar fasciitis can either be caused by traction or compression injuries.


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What is SIJ dysfunction?


The sacro-iliac joint is a system of joint connecting the lower spine and the pelvis. The lowest part of the spine, the sacrum which is also called the tailbone connects the two pelvic bones on the right and left called the ilia to form the sacro-iliac joint.

Normally, movement at the sacro-iliac joint is limited to a few millimetres but trauma and pregnancy can cause increased movement in this region which may result in SIJ pain.  Abnormality of movement and impaired muscle activation contribute to SIJ dysfunction and SIJ pain.

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What is Achilles tendonitis or Achilles tendinopathy

courtesy, shutterstock

This occurs when there is pain and swelling at the insertion of the tendon at the ankle joint, specifically at the calcaneus bone. It is almost always a posterior heel pain and it is associated with overuse of the calf muscles or abnormal biomechanical stress on the foot and ankle

Symptoms of Achilles tendonitis

  • Difficulty in performing strenuous activities such as running, jumping or making quick turns
  • Pain that is achy or occasionally sharp which worsens with increased activity
  • Increased pain in the area when contact is made with back of footwear
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What is Iliotibial band syndrome?


courtesy eorthopod

ITB syndrome is when there is discomfort or pain on the outside of the knees particularly in runners. The cause of the pain is commonly from repetitive friction from the sliding movement of the iliotibial band as the knee is bent particularly between 30 and 45 degrees.  The iliotibial band is a fibrous tissue that attaches to the femoral condyle at the knee. ITB syndrome falls under the category of repetitive trauma and overuse injury.

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What is Frozen Shoulder or Adhesive Capsulitis?

Frozen shoulder, also known as adhesive capsulitis is when the shoulder capsule becomes inflamed and the fibrotic adhesions limit shoulder movement resulting in pain and stiffness.

There are three stages of the frozen shoulder symptoms

  1. Freezing: initially characterised by pain around the shoulder, it is them followed by progressive loss of range of movement
  2. Frozen: There is minimal pain with no further loss of range neither is there any gain in range of motion. Pain is noticeable usually at end range only.
  3. Thawing: There is a gradual return of range of movement and there would also be weakness due to disuse



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What is shoulder rotator cuff injury?

The shoulder girdle has a relatively unstable ball and socket joint and it uses surrounding muscles to stabilise it. The rotator cuff muscles form a cusp around the shoulder joint and are responsible for shoulder rotation aside other movement in the upper limb. There are four muscles which make up the rotator cuff: subscapularis, supraspinatus, infraspinatus and the teres minor. These muscles or their tendons are susceptible to inflammation, tears, impingement and tears.

Some of the commonly encountered rotator cuff injuries are:

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What is Erbs Palsy or Brachial Plexus Injury?

Erbs Palsy is a paralysis or weakness of the muscles of the arm following an injury to a plexus of nerves in the upper limb region called the brachial plexus. An injury to part of this plexus results in weakness or paralysis of certain muscles in the arm. Though there are different types of injuries, Erbs palsy is the most frequently occurring one usually associated with assisted childbirth. The birth injury typically occurs when there is a stretch on the shoulder, arm or neck while assisting with delivery. This injury affects the C5-C6 nerve root and its deformity is commonly described as waiter’s tip deformity. Trauma, dislocation and gunshot can also cause brachial plexus injury in adults.

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