Why Is My Tailbone Hurting Without Any Injury?
My first job out of PT school was stressful. I moved to a new city, didn’t have any friends, was learning how to be a real adult with a professional job and learning a new speciality (hello pelvic health!). One day, about 6 months into that job, my tailbone started hurting. At first I only noticed it when I was sitting on my stool for a couple hours and it felt better if I stood up. Then it started bothering me during my drives to and from work. After a month or so, I was feeling it all the time. Driving became pretty uncomfortable, my spin bike became nearly intolerable and sometimes by the end of the day I was so achey that I’d entirely avoid sitting on my couch and stand while I watched TV with my husband at night.
This pain started out of nowhere. I didn’t have an injury. I didn’t fall on my butt. I didn’t change up my workout program or do anything differently over the previous few weeks. But I had started a new, stressful, job rather recently and I am a Type A person who tends to manifest stress quite physically.
Now, lucky for me, at this point in my life I was a pelvic floor PT, surrounded by other pelvic floor PTs. I understood what was happening (though it still took me about a month to realize what was going on) and I understood where to get treatment. Unfortunately for most people, where to go for help isn’t as clear.
So let’s talk about why tailbone pain can pop up seemingly out of the blue and what you can do if it’s happening to you.
Tailbone pain, also known as coccydynia, is a literal pain in the ass. While tailbone can happen with a traumatic injury, like a fall directly on your butt or during childbirth, it can also pop up with no clear cause.
If you’re experiencing tailbone pain following an injury, please contact your medical provider to rule out fracture or dislocation. If that’s ruled out, the information below may still be relevant for you! If you’re experiencing tailbone pain without a clear cause, read on.
Your tailbone is a small bone that attaches to the bottom of your sacrum at a joint, allowing your tailbone to move. There are a number of muscles that attach to the sides of tailbone including your glutes and your pelvic floor. When these get tight or shortened, they can tug on the tailbone, causing it to deviate from it’s neutral, centered position. Oftentimes that deviation, or bending of the tailbone, causes pain. This is why tailbone pain is often a muscular issue and can be successfully treated with pelvic floor physical therapy!
Pelvic floor muscle tension is an extremely common cause of tailbone pain. But why do we develop this tension? Here are some common reasons for developing pelvic floor tension:
Injury to our ankles, knees or hips:
Injuries to our lower body can change the way that we walk, the way we move and the way we load our pelvis. These changes can lead to tightness further up the body, like in the pelvic floor.
Jaw clenching
Your jaw and your pelvic floor are connected. When we clench one, we tend to clench the other. That’s why TMJ pain and pelvic pain are so often correlated!
Stress
I know I’m not the only one who holds stress in our body. Stress changes the way we breathe, the way we move, the way we hold ourselves. Stress can play a huge role in pelvic floor tension!
Changes to activity level
When we become more or less active, our body notices! Ramping up a new exercise program too quickly can cause us to hold tension in different areas of our body, and moving less can cause us to hold stress in different places, too.
Kegels
Kegels are a pelvic floor muscle contraction. If your muscles are already tight, contracting them over and over again can cause more tension.
If you’re experiencing tailbone pain, your best option is to see a pelvic floor physical therapist who can talk with you, evaluate you and provide you with personalized information and a plan to treat your pain. Everybody is different and treatment for tailbone pain can vary.
Treatment for tailbone pain typically includes:
Manual therapy (hands-on work) to address glute, pelvic floor and surrounding muscle tension
Teaching you how to relax your pelvic floor and surrounding muscles
Stretches and exercises to perform at home
Modifications to activities that are aggravating your pain
While I recommend an evaluation before beginning treatment for your pain, here are 3 simple tips you can try if you’re hurting:
Unclench your glutes! Relax that booty. Try to catch yourself clenching throughout the day and send reminders to your butt to let go. This can take time, practice and mental effort!
Keep your belly soft. When you suck in your gut, you alter the way you breathe and the way your pelvic floor moves throughout the day. Try to fight the urge to suck in and avoid waist trainers!
Stop kegeling. While pelvic floor muscle strengthening isn’t always a problem, if you’re struggling with tailbone pain it’s possible that contracting these muscles over and over again isn’t helping. Take a break and see how you feel!
And then call us or shoot us a message to schedule an evaluation with a doctor of physical therapy who can treat the root cause of your pain.
For more tips on managing pain through pregnancy, preparing for birth or recovering postpartum, sign up for our newsletter! For more on postpartum recovery, check out our 6 week postpartum program, Baby Steps Fitness. And as always, if you’re interested in working with us 1:1 either in our Austin clinic or virtually from anywhere in the world, give us a shout!
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.