Your Pelvic Floor and Tailbone Pain

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woman holding pelvis pointing towards tailbone

In this blog we’re talking about the pelvic floor and tailbone pain. Tailbone (also known as coccyx) discomfort is literally a pain in the butt! You may notice that simple, everyday activities become bothersome. Sitting can be extremely irritating, and you may constantly feel the need to change positions or even avoid hard surfaces. Pooping may become painful and more difficult, and you may even notice increased discomfort with intercourse. Even movements like transferring from sitting to standing can increase your symptoms.

Why does tailbone pain happen?

Coccyx pain can occur due to various reasons including trauma from a fall directly on the tailbone, poor posture when sitting or prolonged sitting on hard surfaces, an injury during childbirth, constant clenching of your butt cheeks, or increased tension in your pelvic floor muscles. Oftentimes, your pain may decrease or resolve within a few days or week with self care measures such as changing your seated posture, using ice or heat as needed, and taking anti-inflammatories. Occasionally, however, it may become a chronic issue. It may be a lifelong condition in rare cases.

How does pelvic floor physical therapy help tailbone pain?

First, let’s talk about your pelvic floor anatomy. Your pelvic floor muscles actually run from the back of your pubic bone and attach at your tailbone. Your tailbone is located at the bottom of your spine. If these muscles become tense, they can pull on the tailbone causing pain and discomfort. (Want more info on what your pelvic floor actually is? Click here). So how can a pelvic floor physical therapist help? They can help in the following ways:

  • A pelvic floor physical therapist can help to release any muscle tension in the glutes and pelvic floor, which may be contributing to pain.
  • They can assess and correct any postural or alignment problems, perform soft tissue mobilization and trigger point releases to both internal and external tissues, and even use modalities such as cupping and dry needling to help with the healing process.
  • A therapist can show you breathing and self massage techniques and stretches to help promote pelvic floor relaxation. This can help you to manage your symptoms on your own.
  • When you improve relaxation and coordination of your pelvic floor muscles, this may help improve pain during bowel movements. Straining to pass a bowel movement will increase pain.

Tailbone pain after sex

Tailbone pain after sex is common. The Journal of Sexual Medicine says up to 40% of women and 23% of men experience tailbone pain during sex. The exact cause of tailbone pain after sex isn’t known. But, it’s believed to be due to the intense pressure on the tailbone area during certain positions. The tailbone can take a lot of stress during sexual activity. This can lead to pain and discomfort after sex.

Tailbone pain after sex doesn’t always cause concern. It can resolve itself with rest. But, if yours persists or worsens after sex, consult your doctor. To help reduce tailbone pain during and after sexual activity:

  • Change positions
  • Use lubrication
  • Take liberal breaks from physical activity

Tailbone pain during pregnancy

Tailbone pain during pregnancy is common. It’s a common complaint among expectant mothers. The extra weight and pressure of the baby pressing on the tailbone at the base of your spine causes this. Changing posture as you adjust to carrying a heavy load can also cause tailbone pain. Below are some tips to reduce tailbone pain during pregnancy:

  • Stay active. This will help relieve the discomfort by strengthening your abdominal and back muscles.
  • Exercise will also improve circulation, which helps reduce tailbone pain.
  • Wear supportive clothing.
  • Positioning yourself correctly when sitting or sleeping.
  • Use a tailbone shaped cushion or pillow to help provide relief. These cushions have a wedge shaped cutout to fit around the tailbone. This helps keep pressure off this area while sitting.

What can I do to help with tailbone pain?

1. Monitor your posture when seated. Try to avoid sitting in a slouched position as this puts increased pressure on your coccyx. Make sure to sit up tall with your feet flat on the floor. Leaning forward slightly when sitting may also help relieve some pressure.

2. Avoid sitting for long periods. Try to stand up and walk around to take rest breaks from sitting. Sometimes, the use of a specialized cushion with a coccyx cutout can be helpful to redistribute pressure away from the tailbone when seated.

3. Stretching your buttocks and pelvic floor muscles can also help with the pain. Stretches such as the piriformis stretch, deep squat, and child’s pose may help stretch the tense muscles which are causing your pain.

4. Using a stool like the Squatty Potty during bowel movements will help put you in a position to promote pelvic floor relaxation leading to easier emptying. In addition, making sure you are drinking plenty of fluids and decreasing consumption of processed foods will help keep stool a soft consistency. If you have constipation, consider taking stool softeners. This will help prevent straining, which can make tailbone pain worse.

5. Anti inflammatory drugs (NSAIDS) can help relieve pain in the affected area. 

How do I sleep with tailbone pain?

Sometimes heat and/or ice can relieve pain. Your choices for sleeping when you have tailbone pain are on your side or your back. If on your back, use support pillows (like a wedge or doughnut pillow) and place it between your knees to help alleviate pain. Do not sleep on your stomach. A firmer mattress as opposed to a soft one may also help ease the pain. 

What are the best exercises to do for tailbone pain?

Below are some of my favorite stretching exercises to help with tailbone pain. Do them as your body tolerates them and what feels comfortable to you for pain relief. 

  • Child’s pose. This is often a favorite. 
  • Cat-Cow
  • Cobra 
  • Kegels 

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If you have pain in your parts, download this free guide to find out if pelvic floor tightness might be to blame—and what to do about it.
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Some links may be affiliate links. The products we recommend are products we use or recommend to clients.

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