Idiopathic coccygodynia as a ‘mask’ of lesions caused by overload in sports associated with the art of movement
Authors:   Central State Medical Academy, Administration Department of the President of the Russian Federation, Moscow, Russian Federation, Vasilyev O.S. ,   Russian State University of Physical Education, Sport, Youth, and Tourism, Moscow, Russian Federation, Levushkin S.P. ,   Russian State University of Physical Education, Sport, Youth, and Tourism, Moscow, Russian Federation,   Institute of Developmental Physiology, Moscow, Russian Federation, Achkasov E.E. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Sultanova O.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Gridin L.A. ,   Moscow Center for Health Problems of the Moscow Government, Moscow, Russian Federation
Published: September 2021

In this study, we analyzed specific manifestations of idiopathic coccygodynia in children and adolescents involved in rhythmic gymnastics and choreography. The experimental group consisted of 34 individuals aged 10 to 14 years with complaints of discomfort and/or pain in the pelvis, sacrum, coccyx, and hip joints, increasing during professional movements and who had no history of injuries. The control group comprised 12 healthy adolescents from the same teams. We evaluated local muscle hypertonia, pain severity (using a visual analog scale) in all study participants. In addition to that, they have undergone sports and choreographic testing and isokinetic examination (using the multiarticular complex ‘Biodex System 4 Pro’). Individuals in the experimental group had a 2-week rehabilitation course that included modification of training; intramuscular injections of 2.0 mL of 0.1% lidocaine solution into the area of muscle hypertonia; application of ointment (2.2 mL); manual therapy; special exercises to relax spasmed muscles). We identified significant difference in pain severity when performing basic choreographic elements between the two groups in the beginning of the study. We also observed a significant decrease in pain in the experimental group after the rehabilitation course. We obtained an indirect proof of the hypothesis that local muscle hypertonia is the leading cause of discomfort and pain. The results of isometric examination suggest that the number of patients with a bilateral difference (according to two of the three parameters studied) significantly differed between participants in the experimental group after a course of physical rehabilitation and controls. This fact can serve as an indirect evidence that hypertonia affects functional activation of muscles, and a 2-week course of physical rehabilitation is not sufficient. The introduction of the concept of ‘sports coccygodynia’ will allow orthopedic traumatologists and sports medicine doctors to focus on several therapeutic and diagnostic measures and to avoid unnecessary instrumental examination, which will significantly increase the effectiveness of patient rehabilitation. Key words: children and adolescents, muscle hypertonia, coccygodynia, lesions caused by overload, choreography, rhythmic gymnastics