* Permission has been granted to me by the client to share the case for educational purposes. The client’s name has been changed to protect privacy and confidentiality.
Cynthia came to my office roughly 2 1/2 weeks after a bad fall off of her horse. The horse was startled abruptly and he reared up and my client fell to the ground fracturing her tailbone. I gathered that Cynthia had activated her trauma response during the incident as she recounted to me how it took place. From what she described to me, it sounded like her body had went into a freeze or hypo-arousal response, but once we would move to the table work, I knew her body would be able to express the impact in a tangible felt-sense way. X-rays confirmed that the coccyx (tailbone) indeed was fractured. She was given pain medication and it was suggested to her that in roughly 3 - 4 weeks from the date of injury, she should begin physiotherapy.
As I observed Cynthia move, I could see she was in quite a lot of pain even after 2 1/2 weeks had passed. She walked with a stiff gait because of the pain, but also to minimize pain as a protective measure. She felt a lot of discomfort in her lumbar spine up to the waist upon standing and walking, but she was by now, okay to lay down on her back for the session with minimal pain.
I explained to Cynthia that the reciprocal tension membrane system (RTMS), the network of connective tissue that surrounds the central nervous system (and quadrants of the brain) and anchors it in place, is designed to spread-out the force of a blow to either end of the spine. In this way, the entire RTMS "shares" the localized impact of a blow to one area, which is life saving by design. Cynthia had mentioned she'd been having headaches since she fell which made complete sense based on the smart design of the RTMS.
As I began the session with my hands lightly touching at her feet, almost immediately Cynthia's nervous system began to express the charge that was being held in the nervous system (and connective tissue). Often this "held" charge results in pain and slows the healing phase if it does not find resolution through adequate discharge. The trauma response is usually one or a combination of hyper-arousal (fight or flight) involving the sympathetic division of the autonomic nervous system (ANS), or hypo-arousal (freeze or dissociation) involving the parasympathetic division of the ANS. When the nervous system calculates that it cannot remove itself quickly enough from a traumatic event (such as by fleeing), it can be pushed into a deeper level of self preservation that involves freeze or sometimes dissociation. Signs of hypo-arousal on the treatment table often involve numbness and an inability to feel localized areas or parts of the body or not feeling connected to the body at all. Cynthia had let me know that she wasn’t feeling her pelvis or legs clearly, though she had a good felt-sense of her head, torso and gut. I remained in frequent communication with Cynthia, and as the session progressed, her nervous system began to express via the sympathetic chain.
We often need to back-out of the trauma response in a sequential process. Hyper-arousal as mentioned, is the fight or flight response and it usually presents in a BCST session with various muscular twitching and increased blood flow and heart rate. It is a sure sign that the healing response is moving in a forward direction, and out of the more stressed state of hypo-arousal. It's like giving the nervous system that opportunity which it didn't have in the moment of impact or trauma, when the best case scenario was to "freeze", as if to have one foot on the gas pedal and one foot on the brake simultaneously.
Because of the pain at the tailbone and sensitivity of the spine generally and even to light touch, I maintained presence and contact at Cynthia's feet for the entire duration of the first session. It was quite apparent that her system wasn’t wanting to clarify too much treatment directly in the tissues at this initial stage but that it was more directed to release the force of the blow to the entire RTMS and its relationship to the stress response.
I had Cynthia see me four days later for her second session and her body continued to "dance" between an expression of hypo and hyper-arousal. She had mentioned that there had been a slight improvement in her pain and that she was sleeping a bit better since our first session. Cynthia was beginning to cut down on some of her pain medication as well. I was also able to lightly touch Cynthia along various segments of the spine during this second session which was an improvement.
One week later, I seen Cynthia for her third session. She reported to me that she had been having quite a lot of anxiety building up since the last session. She couldn’t put her finger on what was bothering her but that she felt it to be quite uncomfortable. I suspected her nervous system had more "held" tension (and potentially emotional content from the trauma) to release and this was causing the anxiety. On the treatment table and very soon into the session, there was a momentary expression of the freeze response, then her system moved very quickly into discharging hyper-arousal. It was indeed what I had suspected. As her nervous system continued to express and discharge the traumatic content via the sympathetic division of the ANS, there was now more tissue releases and reorganizations along the spine and at the head.
I seen Cynthia at her fourth and last session about ten days later. Her healing process had progressed very nicely from the previous session. She reported that her pain was now very minimal if at all, and her ability to be on her feet for longer periods had increased and that the anxiety had not returned. She had also discontinued her pain medication. Cynthia seemed happier generally. At this session I went directly to the coccyx and the occiput (base of the head), holding both poles of the spinal column at the same time. Most notable was the slight adjustment or reorganization at the coccyx which likely shifted from the direct fall onto the tailbone, (or it could have been holding a pattern even from previous falls).
The capacity for healing in Cynthia’s body is a clear example of how the body seeks to restore homeostasis to a time before a traumatic event. When it is given the support it needs, it surely can. I was pleased with how the treatment moved along for Cynthia and I suggested that if any pain return, that she consider further BCST work as her body requires it. So far at the time of writing this, I have not seen her again for treatment. She was going to schedule in with a physiotherapist at this point to be assessed and she was interested in implementing some specific exercises to strengthen areas of her body, especially her legs, that she felt had atrophied from not riding. She was eager to get back up on her horse. This was also a positive sign that healing from the trauma had proceeded nicely since it is not uncommon after traumatic events to remain in a state of fear or hesitancy about resuming the activity to which one was injured. I reminded Cynthia to take her time with getting back to riding and go back into it easily and gently as she listened to her body.
It would have been appropriate and safe to work even sooner with BCST after the traumatic event took place to help settle the nervous system and release the charge held up in the RTMS. From a long term perspective, supporting the body through traumatic release and healing from acute injuries such as this, and in this gentle way, can prevent other more chronic issues from developing such as long term pain, restriction, and losing connection to that part of the body through felt-sense.