Lynn Schulte | Following the Tissues: The Clinical Reasoning Behind a Complex Pregnancy Case Study
Show Notes:
When the Symptoms Don’t Add Up…
What do you do when a pregnant client presents with tailbone pain, SI joint dysfunction, painful intercourse, and persistent uterine cramping – but nothing quite explains the full picture?
In this fascinating case study, Lynn walks through the clinical reasoning behind treating a first-time pregnant client whose symptoms continued to evolve over multiple visits. As the pieces slowly came together, an unexpected finding challenged assumptions and reinforced the importance of following the tissues rather than chasing symptoms.
This episode explores how careful assessment, respectful hands-on treatment, and clinical curiosity uncovered a restriction that could have had significant implications for both comfort during pregnancy and preparation for birth.
Key Takeaways from this Episode:
- Why persistent tailbone pain and painful intercourse may be connected to much more than pelvic floor muscle tension.
- How following tissue restrictions over multiple treatment sessions can reveal the true source of dysfunction.
- The relationship between the sacrum, uterine support structures, and changing symptoms throughout pregnancy.
- Clinical reasoning behind treating complex pregnancy presentations while respecting the safety of both mother and baby.
- Why stepping back and reassessing the entire kinetic chain can change the direction of treatment.
Clinical Application
Sometimes the biggest breakthroughs come from listening to what the tissues are telling you rather than forcing a diagnosis to fit the symptoms. This case is a powerful reminder that pregnancy-related pain often requires ongoing reassessment, thoughtful clinical reasoning, and
If you enjoy complex case discussions that challenge your thinking and help refine your clinical reasoning, you won’t want to miss this one.
Frequently Asked Questions
Why does tailbone pain happen during pregnancy?
Pregnancy tailbone pain can result from changes in pelvic alignment, ligament tension, muscular guarding, and altered mobility of the sacrum and coccyx. This case demonstrates why evaluating the entire pelvic system may provide more answers than focusing on the tailbone alone.
Is painful intercourse during pregnancy always caused by tight pelvic floor muscles?
Not necessarily. While pelvic floor muscle tension may contribute, this case illustrates how restrictions involving connective tissues, uterine support structures, and pelvic mobility may also influence symptoms.
Why is reassessment important throughout pregnancy?
As pregnancy progresses, tissue tension, biomechanics, and symptom patterns continually change. Regular reassessment helps clinicians refine treatment as new findings emerge and supports better clinical decision-making.
Where can I learn more?
Download the Institute for Birth Healing’s FREE Pregnancy Pain Treatment Guide to learn more about working with the pregnant body.
About The Speaker
Lynn Schulte, PT is a pelvic health physical therapist with more than 30 years of experience helping practitioners understand the biomechanical, myofascial, and nervous system influences affecting pregnancy, birth, and postpartum recovery. Through the Institute for Birth Healing, she teaches evidence-informed continuing education courses focused on practical techniques that help clinicians achieve meaningful outcomes for their clients.
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Love Dr. Rachael! She is such a gem in the Metro Detroit area. She was my pelvic floor PT during my first pregnancy and postpartum and inspired me to pursue pelvic health certification (coming from an Ortho PT clinic). I’m now working through Holistic Treatment of the Pregnant and Postpartum Body.
Thank you so much for this presentation…I am an osteopath and also trained in SER (love love Upledger!)…the piece about ‘freeze’ related to transgenerational trauma was very informative and a reminder to look further…I have had a client who lost a baby and when I treated her she felt she needed to give birth to this child…and then went back several lives and saw that she had also lost a baby many lives prior! This relieved her of some stress…so every piece of the puzzle counts…keep the nuggets coming, so appreciative! Best, Judith
Great interview, Lynn and Susanne, for pushing us beyond “hands on, hands in”, confirming our need as therapists, for wide, grounded personal presence for our clients to feel safe and then willing to bring forth those physical/emotional/transgenerational, traumas/beliefs that lead to more complete healing and return to function. Appreciate the shout out, and listened delightfully to two of my favorite teachers and mentors. All of this was gold!