Background;
- 25y male, no earlier problems at all, highly active on sports.-- Paraglider accident 1y ago. Coccyx pain starting not long after that.
- Accident included; compression fracture T12, L1, L2 and burst fracture L4. Surgery; Posterior lumbar interbody fusion using pedicle screws, collectors. L4-root compression on the right side - included hip-rotators (out/in) - trendelenburg gait and drop-foot.
- Now; Osteosyntesis-metal was removed 5w ago. Almost back-pain free.
- He has little or no sign of the paresis (but strength is not full for none of the affected muscle-groups). Tendency of m. tibialis posterior cramps (functional pes planus with valgus).
- Coccyx pain is still persisting 1y after the accident and that's bothering him most (the pain lowered the first 2 months, stable since then - aggrevated by prolonged sitting (and standing).

Treatment given;
- Initally (1y ago); specific stabilizing exercises for the back and hip, hydrotherapy, training of the dorsal-flectors of the foot. Home-exercises and advices - specially on stability, and balance - terrain-walking and more. Stretching of the hamstring muscle group and hip flexors were not done - as the flexibility has increased as the stability of the back and hip was increased.

- The coccyx pain still persisting. The pain is purely localized on the 2nd coccyx bone (counting up) and over to the start of the sacrotuberous lig (left side - opposite to the paresis).

- Initially I thought the pain was due to strain on the sacrotuberous lig. because of either malalignment (the fixated L3-L5) or because the L4 paresis of the right side. Now to paresis is almost gone - and the pain's still there. Have tried deep stretching the sacrotuberous lig. and tried deep frictions of the ligament. Have not tried coccyx manipulation.

Also tried 1 month of not sitting at all (used diary and more), less pain that month, but it came back afterwards.

....

So? ... Suggestions? tips? any good explanations?

...

Best regards,
Øystein, Norway

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