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PT Corner with Friends

Coccydynia: The Enemy of Sitting

By Ashley Newton

Jun 2, 2023

By Ashley Newton, PT, DPT

 

Pain in the butt? That could be your tailbone talking to ya! The coccyx, aka tailbone, is a small bone at the base of your sacrum. Believe it or not, it’s a joint! The tailbone can flex forward and extend backward. It moves in coordination with your breathing and its position is influenced by your pelvic floor and hip musculature. Depending on its position, when we sit, we may feel pain in this tiny bone. So, why does this happen and what can we do to reduce tailbone pain to make those long drives, meetings, and flights more tolerable? 

 

The pelvic floor and the ligaments at the back of your hip stabilize the tailbone. If that support system is compromised, whether it be the pelvic floor is overactive and pulling abnormally on the tailbone or underactive and not providing support to this tiny bone, when we sit, the pressure of sitting can cause pain. 

 

But posture may overwhelmingly be to blame. If we are slumped, overly arched, cross-legged in seated, we are ultimately putting excess pressure down on the pelvic floor and tailbone. Thus, working on our endurance in upright posture in seated, and working on neck and shoulder girdle stability, can help relieve pressure and pain at the tailbone!

 

Now, if working on posture and stability doesn’t cut it and you still have pain, a pelvic floor evaluation, and treatment may be the next step in figuring out symptoms. Pelvic floor physical therapists assess and treat the muscles of the pelvic floor and teach clients techniques as well as stretches and exercises to provide relief to the tiny tailbone! 

 

Pillows and taping techniques (kinesiotape) are also useful to provide support to the tailbone while the root cause it being uncovered. The pillows are designed with cutouts to relieve pressure on the tailbone. These can be used in meetings, at home, you name it! The taping techniques can provide stretch to tissues as well as compression and support that can also alleviate that nagging pain in the butt.

 

Long story short, don’t just live with your tailbone pain! There are plenty of resources, exercises, and modifications to be able to support that tiny bone! Get started with my top three exercises for tailbone pain below!

 

  1. Supported squat stretch: hold onto a counter or other stable surface and sit the buttocks down into a low squat. Initiate deep breathing into the rib cage, focusing on making space between the SIT bones as you inhale. Perform for 5-8 breaths
  2. Frog stretch: In hands and knees, bring the knees wider than the hips and kick the feet out to the side (mimicking frog legs). Rock the hips backward as you take a big inhale in through the nose. Remain in the frog position for 5-8 breaths, again focusing on reaching the inhale phase of your breathing down to the tailbone and SIT bones 
  3. Open books: open that mid back! Lay on the side and straighten the bottom leg and bend the top knee so that it is supported on the ground. Bring the hands together in front of your chest with the elbows extended. Rotate through the upper back to bring the top hand to the other side. In that position, take a deep breath into your side waist and return to start. Try 10x on each side.

 

Hope this helps!

 

Xoxo Ash

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