Discussion
functional disability, pelvic floor muscle, Pain, piriformis muscle massageIn, pelvic muscle contractions, spasm, vestibulodynia, PFE, pain, pelvic floor muscular reaction, coccydynia pain, post-colonoscopy coccydynia, overactivity, coccydynia
INFLAMMATION, CONTRACTION
The findings of the current trial showed that after 4 weeks of intervention, all groups reported substantial differences in PNRS and ODI relative to baseline, with more enhancements in the two experimental groups. Differences between the experimental groups were notable in terms of NPRS, where the major change was in favour of group CT-KT. Nevertheless, there was no difference between them with respect to their impact on the ODI. Pelvic muscles are 70% slow-twitch, striated skeletal muscles that include the muscles of the coccygeus and the muscle complex of the levator ani, including the puborectalis, pubococcygeus, and iliococcygeus. These muscles preserve the tone of the pelvic floor and protect the connective tissues from overloadInjuries to the coccyx or coccygeal joints, or where the underlying tissues were the seat of inflammation, any tightening of the muscles attached to the coccyx would induce the coccydynia's characteristic pain Pain is caused primarily by the tonic spasm of the pelvic floor muscles. ThieleThe efficacy of KT for pain relief and functional disability enhancement has been reported in several studiesIn a study conducted by Donec et al. that investigated the effect of KT on the post-operative pain of total knee replacement and discovered that KT, when combined with other rehabilitation modalities, had a pain-relieving effectSeveral types of manual therapies have been recommended for Coccydynia, including levator ani, coccygeus, and piriformis muscle massageIn terms of the effect of PFE on hypertonic muscles, our findings are consistent with those of Gentilcore-Saulnier et al., who examined women with induced vestibulodynia before the implementation of PFE and found that their superficial pelvic floor muscles had higher tonic surface electromyography activity relative to controls. After eight sessions of PFE, women with vestibulodynia had a decreased pelvic floor muscular reaction to pain, decreased pelvic floor muscle tone, and enhanced pelvic floor muscle capacityThe changes in patients undergoing reverse Kegel may be a function of the muscle length-tension relationship. Patients with overactivity have mechanically shortened muscles, thereby reducing the number of cross-links necessary to produce the desired force of contraction. By relaxing the pelvic floor and increasing the length of the muscle, there are further crosslinks to create a stronger and more efficient contraction. Overactive pelvic floor muscles often cause trigger points to develop. Returning the muscle to its optimal resting length can help reduce coccydynia pain while also increasing the intensity and synchronization of pelvic muscle contractions and hence functional abilityThere are some potential drawbacks to the present trial. First, the relatively small sample size, although adequate to identify statistically meaningful differences between groups, However, it would be more advantageous to execute randomized trials with larger sample sizes to obtain more reliable results. Second, we used a convenience sample that may not be representative of the whole population of individuals with post-colonoscopy coccydynia, Furthermore, there are no follow-up details on the participants' health status, which would help us track the long-term effects of both interventions. Therefore, it would be beneficial to address this in future studies.