Tail Bone Pain Exercises

Tail Bone Pain is pain that is experienced in the Coccyx region.

It is also referred to as Coccydynia.

This blog post will cover the best exercises to address your tail bone pain.

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Exercises for Tail Bone Pain

• Step 1: Implement These Tips
• Step 2: Reduce Inflammation
• Step 3: Releases
• Step 4: Stretches
• Step 5: Pelvis Movements
• Step 6: Strength Exercises
• Step 7: Referred Pain
• Step 8: Address The Pelvis
• Step 9: Alternate Treatment

Step 1: Implement These Helpful Tips

Completely Avoid, Reduce Exposure To or Modify the activities/positions/movements that aggravate the tail bone pain.

(Failure to implement this initial step may prevent the tail bone pain from getting better!)

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Helpful Tips:

a) Minimize Prolonged Sitting

The longer you are sitting directly on top of your tail bone, the more it is exposed to being compressed and irritated.

Aim to take break from sitting every 30 minutes.

b) Use a Tail Bone Pillow (While sitting)

This cushion is designed with a gap where the tail bone would normally come in direct contact with the seat.

c) Tilt Pelvis Forwards (When sitting)

Tilting the pelvis slightly forwards whilst sitting will lift the tail bone off the chair.

This minimizes the chance of directly sitting on top of it.

Aim to balance your weight between the Ischial Tuberosities (sit bones) and anterior Pelvic Floor region.

d) Use a Seat Wedge

This is cushion that you sit on which helps to orientate the pelvis in a forward tilted position.

e) Use a Standing Desk

If you tend to sit for long hours whilst using a computer, consider using a standing desk.

Aim to stand for at least 30 minutes before resuming sitting again.

f) Lose Body Weight

The more body weight that you have, the more potential pressure that will be placed on the tail bone whilst sitting.

g) Use Stool Softener

If bowel motion aggravates the pain in the tail bone, you may want to consider using a stool softener.

Step 2: Reduce Inflammation

If there is a significant amount of pain in the tail bone region, it is important to address the inflammation first.

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a) Anti-Inflammatory Gel

Apply an anti-inflammatory gel to the area of pain for 3 times per day.

These gels usually contain the active ingredient Diclofenac Sodium.

b) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

It is recommended that you take an anti-inflammatory medication consistently for at least 7-10 days.

Keep in mind – there are different types/strengths of NSAIDs and is best used if the prescribed medication is appropriate to the severity of inflammation.

(Note: Please consult your Primary Care Provider before taking any new medication.)

c) Cold Therapy

Apply an ice pack to your tail bone for at least 10-15 minutes.

Do this 3-5 times per day.

Note: Do not apply the ice pack directly onto skin as this may cause an ice burn. (Place a towel between the ice pack and skin.)

d) Natural Products

Some of my patients have reported that taking turmeric, ginger, chia seeds and fish oil capsules are natural ways that have helped to reduce their inflammation.

(Honestly – I am not 100% sure how effective this is but it is something that you might want to consider.)

e) Cortisone Injection

This injection consists of a steroid (cortisone) and an analgesic substance.

The aim of this injection is to reduce inflammation and numb the painful area.

(If you choose to get a Cortisone injection for your tail bone pain, make sure that you are also performing exercises for it! The pain can (… and probably will) come back once the effects of the injection eventually wear off.)

Step 3: Releases

The next step is to release the muscles that attach directly onto the tail bone.

This can help reduce any muscular tension that might be contributing to the tail bone pain.

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Muscles targeted:

It is important to be able to locate the target muscles so that you know where to specifically release. (You might need to use Google to help you with this!)

• Lower Gluteus Maximus
• Coccygeus
• Levator Ani (Iliococcygeus, Pubococcygeus, Puborectalis)*

(*Note: I would suggest that you see a healthcare provider who specializes in the pelvic floor IF you need the Levator Ani released.)

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a) Releases

Instructions:

• Sit on the floor.
• Place a massage ball underneath the target muscles.
• Apply an appropriate amount of body weight on top of the ball.
• Make sure to cover all of the muscles.
• Continue for 2 minutes on each side.

Note: You may need to use a softer massage ball if this release is too painful to perform.

Step 4: Stretches For Tail Bone Pain

Stretching the tight muscles that insert onto the tail bone can help reduce the tension around the area.

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a) Gluteus Maximus

Instructions:

• Sit down on the edge of a chair.
• Place the ankle on top of your other knee.
• Tilt your pelvis forwards.
• Sit as tall as possible.
• Pull your knee towards the opposite shoulder.
• Aim to feel a stretch in the back of your hip.
• Hold for 30 seconds.
• Repeat on other side.

Note: If this sitting position causes more tail bone pain, you can perform this stretch in the lying down position.

b)  Coccygeus

Instructions:

• Stand in a staggered stance.
• (The hip at the back will be stretched.)
• Most of your weight should be on the foot at the back.
• Shift the hip (back leg) backwards.
• Hinge forwards at the hips.
• Reach your opposite hand across the body.
• Aim to feel a stretch in the back of your hip.
• Hold for 30 seconds.
• Repeat on other side.

c)  Pelvic Floor

Instructions:

• Kneel down onto the floor.
• Place your hips onto the back of your heels.
• Allow your lower back to be rounded.
• Reach your arms forwards onto the floor.
• Relax your body.
• Hold this position for 30 seconds.

Step 5: Gentle Pelvis movements

The following movements of the pelvis are designed to be performed without pain.

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a) Knee to Chest

Instructions:

• Lie down on your back.
• Bring your knees towards your chest.
• Hold your knees with your hands.
• Relax your legs completely.
• Gently rock your knees towards your chest.
• Perform 30 repetitions.

b) Pelvic Tilts

Instructions:

• Assume the 4 point kneel position.
• Tilt your pelvis forwards and backwards.
• Perform 30 repetitions.

c) Pelvis Rotations

Instructions:

• Lie down on your back.
• Keep your knees bent and feet on the floor.
• Rock your knees from side to side.
• Perform 30 repetitions.

d) Hip Openers

Instructions:

• Lie down on your back.
• Have your knees bent and feet on the floor.
• Spread your knees apart.
• Bring them back together.
• Perform 30 repetitions.

Step 6: Strengthening Exercises

Here is a list of exercises that can help strengthen the pelvis and hip region.

(Keep in mind – you may need to do more specific exercises depending on your individual presentation. The exercises listed below are very general and simply serve as a good starting point.)

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a)  Hip External Rotation

Instructions:

• Lie down on the side.
• Keep your knees bent and ankles together.
• Without moving your pelvis, lift your knee upwards.
• Aim to feel a contraction in the hip.
• Hold for 5 seconds.
• Perform 20 repetitions.
• Repeat on other side.

b) Hip Extension

Instructions

• Assume the 4 point kneel position.
• Make sure that your lower back is in a neutral position.
• Without moving your lower back, lift your leg up.
• Aim to feel a contraction in the back of the hip.
• Hold for 5 seconds.
• Alternate sides.
• Perform 20 repetitions.

c) Bridge

Instructions:

• Lie down on your back.
• Bend your knees.
• Keep your feet on the floor.
• Tilt your pelvis backwards to flatten your lower back on the floor.
• Drive through your heels and lift your hips upwards.
• Aim to feel a contraction in the back of your hips.
• Hold for 5 seconds.
• Repeat 20 times.

d) Pelvic Floor Strengthening Exercise

Instructions:

• Lie down on your back with your knees bent.
• Keep your feet on the floor.
• Focus on keeping your breathing relaxed.
• Activate your pelvic floor muscles: Imagine you are trying to stop yourself from going to the toilet.
• Feel the contraction between the pubic bone and tail bone.
• Hold for 5 seconds.
• Relax your pelvic floor muscles: Imagine you are trying to urinate. (Make sure that your bladder/bowel is empty before you attempt this!)
• Feel the pelvic floor muscle drop as it relaxes.
• Perform 10 repetitions.

Step 7: Trigger point referral

Increased tension in the following muscles can refer pain to the tail bone.

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Instructions: Use a massage ball or your fingers to apply a firm pressure to the areas as indicated below:

a)  Adductor Magnus

b)  Piriformis

c)  Obturator Internus

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Note: It is also possible for issues in the Lumbar Spine (lower back) to refer pain into the tail bone. If you suspect this may be the case for you, I would strongly suggest that you get a scan of the lower back.

If you have a disc bulge in the lower back, I have some great exercises for you on this blog post: Bulged Disc Exercises.

Step 8: Address Pelvis Position

For best results – you may also need to address the position of your pelvis as this can affect the amount of tension around the tail bone.

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a)  Sway Back Posture

Sway Back Posture is where the hips are pushed forwards relative to the line of the feet.

This posture tends to place more muscular tension around the tail bone.

See post: Sway Back Posture.

a)  Rotated Pelvis

A Rotated Pelvis is where the pelvis is facing more towards one side.

This posture can place pressure more towards one side of the tail bone.

See post: Rotated Pelvis.

a)  Posterior Pelvic Tilt

A Posterior Pelvic Tilt is where the pelvis rotates backwards causing the tail bone to be tucked underneath.

This exposes the tail bone making it more prone to getting compressed when sitting down.

See post: Posterior Pelvic Tilt.

Step 9: Alternate Treatment

If your tail bone pain persists despite following the suggested exercises as mentioned in this blog post, the following are more invasive forms of treatment that might need to be considered.

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a)  Internal Manipulation

If you have had an X-Ray showing that the tail bone has deviated towards one side, you may need to consider having it manipulated back into position by a health professional.

b)  Nerve blocks

A nerve block is an anesthetic that can be injected into the Coccygeal nerve to numb the tail bone region.

c)  Surgery

Coccygectomy is a surgery that involves the complete removal of the tail bone.

It is not commonly recommended and in my opinion, is rarely the solution to addressing tail bone pain.

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Any Questions?

Feel free to ask my any questions regarding your tail bone pain in the comment section below.

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a) What causes Tail Bone Pain?

• Fall onto the tail bone
• Prolonged sitting
• Sitting on hard surfaces
• Sitting with pelvis in a posterior pelvic tilt
• Being overweight (Increased compression)
• Low body weight (Increased bony protrusion of the tail bone)
• Strain to the muscles that attach onto the tail bone
• Pregnancy*
• Pelvic Floor Issue*

(*Note: If you suspect that your tail bone pain is directly related to a pelvic floor issue and/or being pregnant, I strongly recommend that you see a healthcare professional who specializes in treating the pelvic floor.)

b) What structures can cause coccyx pain?

• Coccygeal Nerves
• Coccyx bone
• Sacrococcygeal ligaments
• Muscles that insert into the tail bone
• Referred pain from other structures

d) Can you exercise with tail bone pain?

Yes – But you will need to assess how your body is responding to the specific exercise you are performing.

There should be no increase in pain.

d) Is walking good for tail bone pain?

The more walking you can do without aggravating the pain in the tail bone, the better it is for your body.

e) How should I sleep with tail bone pain?

The best sleeping position is where there is a minimal amount of pressure on the tail bone.

I recommend sleeping on your:

• Back with your knees supported with a wedge pillow or
• Side with a pillow between the knees.

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Conclusion

The exercises suggested on this blog post are a great way to address your tail bone pain.

If the pain you experience is directly related to the pelvic floor muscles, it is recommended to see a healthcare professional who specializes in this area.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. For more information: Medical Disclaimer.