Healing from the Bottom Up: Treating Tailbone Pain with Pelvic Floor PT

Tailbone pain, or coccyx pain, is a common yet often misunderstood condition that affects many individuals. Whether due to injury, poor posture, or long-term muscle tension, tailbone and pelvic pain can significantly impact daily life. We will explore the anatomy of the tailbone, the causes of pelvic and coccyx pain, and how physical therapy can help relieve discomfort and improve quality of life. 

Tailbone pain, medically referred to as coccygodynia, is pain at the bottom of the spine, specifically in the coccyx (tailbone). The coccyx is a small, triangular bone located at the base of the spine, and it serves as an attachment point for several muscles, tendons, and ligaments. When this area becomes irritated or injured, it can lead to sharp or aching pain that may worsen with prolonged sitting, standing, or certain movements. 

Though coccyx pain is often localized to the tailbone, it is frequently intertwined with pelvic pain. Both the pelvic floor muscles and the muscles that attach to the coccyx play a significant role in how pain manifests in this area. 

Causes of Tailbone and Pelvic Pain 

1. Injury to the Tailbone 

Injuries to the coccyx, such as falls or accidents, are a common cause of tailbone pain. Sitting or landing directly on the tailbone can cause bruising, inflammation, or even fractures, leading to pain in the coccyx region. This pain may persist for a long time, especially if the injury was not properly treated. 

2. Pelvic Floor Muscle Dysfunction 

The pelvic floor muscles are a group of muscles that support the bladder, intestines, and reproductive organs. These muscles also play a crucial role in maintaining proper posture and stability. When the pelvic floor muscles become too tight, weak, or imbalanced, they can put excessive pressure on the coccyx and the surrounding ligaments, leading to pain in both the pelvic and tailbone areas. This dysfunction can cause discomfort not just during physical activity but also while sitting or even during sexual activity. 

3. Posture and Prolonged Sitting 

Poor posture, especially when sitting for long periods, can contribute to tailbone pain. Sitting in a slouched position or on hard surfaces can place undue pressure on the coccyx and strain the surrounding muscles and ligaments. Individuals who work long hours at desks or spend extended periods sitting may experience discomfort at the base of the spine. 

4. Pelvic Girdle Pain (PGP) 

Pelvic girdle pain refers to pain in the pelvis and lower back, often associated with pregnancy. The pelvis becomes more flexible during pregnancy to accommodate childbirth, and this increased mobility can sometimes cause strain on the tailbone, leading to discomfort. Similarly, other conditions affecting the pelvic area, such as arthritis or fibromyalgia, can cause pain that radiates to the coccyx and surrounding muscles. 

5. Ligament and Muscle Strain 

The muscles and ligaments attached to the tailbone play a key role in maintaining stability and movement. Strain or tension in these muscles—often caused by overuse, poor posture, or injury—can result in pain in the coccyx. The ligaments that connect the coccyx to the pelvic region are also susceptible to strain, contributing to ongoing discomfort. 

Tailbone and pelvic pain can manifest in various ways, depending on the underlying cause. Common symptoms include: 

• Sharp or aching pain at the bottom of the spine 

• Pain that worsens with sitting, standing, or physical activity 

• Discomfort during or after sexual activity 

• Tenderness when pressure is applied to the coccyx 

• Pain radiating from the coccyx to the pelvic area or lower back 

In some cases, individuals may also have trouble with bowel movements or urinary issues due to the interconnected nature of the pelvic floor muscles and the coccyx. 

Physical therapy is one of the most effective treatments for managing tailbone and pelvic pain. A physical therapist trained in pelvic health can help address the underlying causes of discomfort by focusing on the muscles, ligaments, and joints that support the pelvic region and tailbone. 

Pelvic floor physical therapy focuses on strengthening, relaxing, and rehabilitating the pelvic floor muscles. A physical therapist will assess the condition of the pelvic muscles and use targeted exercises to relieve tension and improve muscle balance. These exercises may include: 

• Exercises to strengthen the pelvic floor and surrounding muscles 

• Relaxation and stretching techniques to lengthen tight muscles and reduce tension in the pelvic region 

• Breathing exercises to promote relaxation and reduce muscle tightness 

• Manual therapy to address muscle tightness and trigger points 

Working with a pelvic health physical therapist will help to improve posture, reduce pelvic pressure, and alleviate discomfort in the tailbone area. 

For individuals experiencing tailbone pain, physical therapy can include specialized techniques to address the coccyx. This may involve joint mobilization, soft tissue and trigger point release, or stretching to lengthen the muscles and ligaments around the coccyx. Physical therapists may also recommend posture correction strategies to reduce pressure on the tailbone during daily activities. 

A physical therapist can guide individuals in improving posture, especially for those who sit for extended periods. Learning how to sit properly, whether in a chair or on the floor, can significantly reduce pressure on the coccyx and alleviate pain. Ergonomic adjustments to workstations, such as using cushioned seating or standing desks, can also help prevent further strain on the tailbone. 

Targeted stretching and strengthening exercises can help correct imbalances in the muscles that support the pelvis and tailbone. By focusing on areas like the lower back, hips, and abdominal wall, physical therapy can help reduce the strain placed on the coccyx. Mobility also promotes blood flow and can aid in healing after injury. 

In addition to physical therapy, there are several other approaches to managing tailbone and pelvic pain: 

Tailbone and pelvic pain can significantly disrupt daily life, but with the right diagnosis and treatment plan, relief is possible. Whether caused by injury, pelvic floor dysfunction, poor posture, or muscle strain, addressing the underlying factors that contribute to the pain is crucial. Physical therapy, especially pelvic floor physical therapy, plays a key role in restoring function and alleviating discomfort. By strengthening and relaxing the pelvic muscles, correcting posture, and using targeted treatments, individuals can find relief from tailbone pain and improve their overall well-being. 

If you are experiencing persistent pain in the coccyx or pelvic area, it is important to consult with pelvic health physical therapist to determine the best course of treatment for your specific condition. With proper care and attention, it is possible to manage pain and enjoy a more comfortable, active lifestyle. 

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Disclaimer: This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you.