Tailbone pain and How Pelvic Floor PT Can Help You! Plus Some Self-Care Tips!

Tailbone pain, coccydynia

A common problem that we treat is Tailbone Pain! Pelvic Floor PT is the solution you have been looking for! It works!

Coccydynia is the worst! You can’t sit!

Coccydynia means that the tiny bone at the very end of your spine, located just above your anus, hurts! And, boy, can it be a bugger! This is a very common problem and we treat it all the time. We help both women and men who experience coccydynia and they can experience complete resolution of their pain by getting the right pelvic floor PT to treat it! If you are dealing with tailbone pain that is persistent, don’t get frustrated and go from provider to provider looking for answers that they don’t have. Call us today at 616-516-4334 and let’s get you feeling better! Read on for more information about this condition and some tips to help yourself.

What Causes Tailbone pain? Is Coccydynia permanent? How will Pelvic Floor PT Help?

We treat tailbone pain (Coccydynia) by providing expert pelvic floor PT to both men & women. No, it is not permanent! We know it is persistent and you’ve probably had your pain for a while, but it will get better with the right treatment.

Sometimes the cause is trauma (you fell on it, your labor & delivery strained it). Other times the cause is pelvic floor dysfunction, specifically spasm of pelvic muscles that attach directly to the coccyx. And still other causes of tailbone Pain (Coccydynia) for which pelvic floor PT is warranted are misalignment of your pelvis and low back, postural strain or constipation. When you work with us we conduct a thorough evaluation to discover the multiple things contributing to your pain so that we can treat all of these. We provide holistic care, which means that our treatment is directed anywhere from your jaw to your knees because we know that fascial tension or restrictions in areas far away from the coccyx will pull on the coccyx and contribute to your pain.

Both Men & Women Can Have Tailbone Pain & Benefit from Pelvic Floor PT

It is common to experience persistent tailbone pain (Coccydynia) and to benefit from pelvic floor PT when postpartum and sometimes during your pregnancy. Women often come to us and report that when they sit down or stand up they experience excruciating tailbone pain in the midrange of moving. This is because the injured tailbone and pelvic floor muscles are experiencing stress with the positional changes. They also report they cannot sit, they must sit on their side or shift their weight because of tailbone pain.

How Pregnancy & the Postpartum Period Might Contribute to Tailbone Pain

When pregnant your entire pelvis and abdomen are changing, which alters the pressure and pulling within the pelvic floor and all of the pelvic joints. The tailbone experiences changes as your posture changes and the uterus and baby grow. For some women, this causes the pelvic floor to spasm or may strain the joint between the coccyx and the sacrum (the bone above the coccyx that it attaches to). Because numerous pelvic floor muscles attach directly to the tailbone, if you have spasms or stiffness in these muscles it will tug on your tailbone and cause you pain. The tailbone needs to be able to float and move freely, when this cannot happen and you sit down, you will sit right on that stiff and sore area. During labor and delivery a woman may experience trauma to her tailbone, which is a common reason why we treat women when postpartum for coccydynia. Pelvic floor PT is a crucial component to getting your pain resolved.

For men who have tailbone pain (Coccydynia) and come to us for pelvic floor PT we commonly discover considerable myofascial restrictions, pelvic floor dysfunction and hip, leg and low back tightness or lack of joint mobility that are contributing to their pain. They may have constipation and a history of straining to have a bowel movement, which might strain their coccyx. The coccyx needs to be able to freely move backward when you have a bowel movement and if everything is stiff, you might not get that motion and, therefore, cause strain to the tailbone. High quality pelvic floor PT will address the stiffness, muscle guarding and loss of joint mobility in the coccyx, hips and entire abdominal, low back and pelvic complex.

What should I do if my provider says I should get my tailbone surgically removed?

Dr. O’Keefe recalls years ago working closely with an orthopedic surgeon who recommended surgical removal of the coccyx when a person had coccyx pain. Please, if this has been recommended to you, first come see me or a very experienced pelvic health PT so you can receive quality and effective treatment for your coccydynia. Surgeons perform surgery, so that is what they will offer you, but it often does not work to relieve your pain. A tailbone that persistently hurts may be a bit of a mystery to your provider, but it is not a mystery to Dr. O’Keefe and other experienced pelvic health PTs. We can help you!

Will Pelvic PT help my Tailbone Pain? Do I really Need it?

Let’s use an analogy: Your knee hurts everytime you bend it, the joint is stiff and the muscles are tight. Do you need treatment to your knee? Treatment that addresses your knee joint mobility, your muscle strength and flexibility? Yes, you do.

With coccydynia the joints around the coccyx (tailbone) are stiff and the muscles are tight. There is imbalance in the pelvis and your hips, abdominals, back and thigh muscles are probably throwing off your tailbone. You need pelvic PT to figure this stuff out and to treat it. There are several pelvic floor muscles that attach directly to the coccyx and we find that our patients who went somewhere else to get their tailbone pain treated and who did not get better, did not get the right kind of hands-on treatment to the muscles that attach to the coccyx. We have numerous gentle techniques we use to help ease your problems. Some of them involve myofascial mobilization, or trigger point release, dry needling, postural correction, visceral mobilization, joint mobilization, myofascial stretching and pelvic floor release techniques. And our patients tell us they feel so much better after a pelvic floor PT appointment, it is all so helpful! If you’d like to read a research report summarizing treatments and evaluation for coccydynia, here’s a paper.

Here are some tips for Self-Care for your Coccydynia:

  • Watch your standing posture and figure out what positions bother your tailbone & adjust accordingly. It may be that having your head down, looking at your phone (even when you are standing up), worsens your tailbone pain.
  • When sitting, a cushion can help. I’ve had people use a cushion that’s the shape of a donut. Other people say that rolled up towels under their sit bones on the right side and left side help. Another cushion that can work is V shaped.
  • Sitting up tall often bothers the tailbone, so while we don’t recommend slouching the reality is that you often have to weight shift to get the pressure off of your tailbone and the posture doesn’t look fantastic, but it is necessary for the moment.
  • Take breaks often when sitting
  • Manage your constipation and avoid hard stools, which can aggravate the tailbone come BM time.
  • Try to massage the area adjacent to your tailbone. Sometimes applying gentle pressure here can release some of the tension.
  • Some activities should be avoided if you know they might aggravate your tailbone. Common things that patients tell us bother their tailbone include bike riding, motorcycle riding, horseback riding, lots of squats & lunges and gardening. The up/down movements of gardening and squats/leg workouts can bug a tailbone.
  • Play with ice or heat and see if either helps you. If you use either one, limit it to ten minutes.
  • Practice diaphragmatic breathing because your tailbone will respond to the gentle rhythm of your abdomen and ribcage moving.
  • Work to drop and release your pelvic floor. This can be very tricky and nearly impossible to do before getting good quality pelvic floor PT to release your muscles. But, if you can practice on releasing your pelvic floor it can help you.

I specialize in treating tailbone pain using effective pelvic floor PT methods! Because there are numerous pelvic floor muscles that attach directly to the tailbone as well as pelvic joints around the tailbone, the quality, hands-on, gentle treatments I offer help resolve your condition.

Purple Mountain Physical Therapy, located in Grand Rapids, Michigan, is a specialty pelvic health physical therapy clinic. We help women and men with pelvic floor dysfunction, bladder, bowel and sexual health problems recover so they can live an active life! Our program for pelvic pain, including coccyx pain, SI joint pain, pubic bone pain and low back pain, is comprehensive and results oriented! We have been exclusively focused on pelvic health for over 20 years and offer a level of expertise and holistic care that you won’t find elsewhere! If you are wondering if we may be able to help you, call 616-516-4334 to talk to Dr. Maureen O’Keefe, DPT. We can discuss your symptoms and condition and determine if pelvic floor PT may help you!


Dr. Maureen O’Keefe, DPT