Snowboarding fall

by Nicki
(Melbourne Australia)

Hello Dr. Lewis!
I fell onto my coccyx 12 days ago while snowboarding. It wasn't a particularly gnarly fall and I'm actually not even sure which fall was the culprit. I'm a beginner so I fell often. There wasn't a sudden onset of pain but I did sit out the rest of the day. Sitting in the car on my side for the 4 hour drive home was very uncomfortable and I soon realized when we stopped at a gas station that I had real trouble using my pelvic floor muscles to delay urination!

The next day I couldn't move. Absolute agony.

The next day I got a prescription for 30mg codeine and an xray. A physio and osteo looked at the xray film and said it is very difficult to see the fine coccyx bones but most likely not fractured. No comment on any subluxation etc.

I'm currently experiencing pain when sitting (of course), bearing down on the loo, and a huge amount with kegel-like exercises yes, intercourse/orgasm is very painful!

I'm icing, avoiding sitting, using a donut cushion and going for short walks every day. I'm used to training at the gym 5 times per week (mostly weight lifting) so this inactivity is driving me mad!

I'm a very proactive person and trying to not get ahead of myself, but I'm worried about long term problems with all those important muscles you mention in your article . Is it too soon to receive some kind of treatment? Can a chiropractor or other health professional tell if it's out of place even with a bad xray?

Thank you so much for your time, no one has been able to give me any answers and I feel a bit lost.


Hello Nicki,
It's a particularly nasty and sensitive part because of all the other joints and muscles around it.

It doesn't sound like a fracture, because you then have immediate pain; the coccyx is either displaced or bruised from repeated small bumps, and it sounds like there is muscular injury too.

The best way to treat it is internally via the rectum; that way you can reach the muscles too, but you may have difficulty finding a chiropractor who will do it. Ask your osteopath.

It's usually not too painful, the adjustment is done with breathing to the tolerance of your pain, and takes no more than two or three minutes, repeated perhaps three or four times. It is awkward though, obviously, though I guess you women are used to loss of dignity whilst doctors poke and prod!

Use the cushion, and ice the area; you can actually get a device that you keep in the freezer than you use rectally.

Often there is involvement of the sacroiliac joint too, and sometimes the lower back, so the whole area needs to be carefully examined. Good luck! Take your husband with you.

Find a safer sport like motor bikes or flying gliders! Those are my hobbies:

Good luck, let me know how you get on in a couple weeks.

Dr Barrie Lewis

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