5 Tips to Fix Postpartum Tailbone Pain
Postpartum tailbone pain (aka postpartum coccydynia) is a common problem after giving birth, but that doesn’t mean it’s a normal part of motherhood! The tailbone (coccyx) is that small triangular bone at the bottom of your spine. But this tiny bone can be a BIG pain in the butt if it becomes misaligned.
Tailbone injuries often happen during labor and delivery, especially after forceps and vacuum-assisted deliveries. Since the tailbone is also connected to your pelvic floor, pelvic floor injuries—like vaginal tears—can also tug on the tailbone and cause pain. Being pregnant can also lead to tailbone pain since pregnancy puts your tailbone under daily stress. Even if you’ve had a C-section, a growing pregnant belly can put pressure downward on the tailbone. When this pressure is suddenly overloaded after birth, you can experience tailbone misalignment and pain.
Usually, postpartum tailbone pain indicates your tailbone is “stuck” in the “wrong” position. This can be hard to locate yourself, but it’s not impossible. A Women’s Health PT can also help you figure out which direction your tailbone is flexing and work on repositioning it into its pain-free home.
Here’s how to assess, release, and re-align your tailbone yourself. Plus, tips on finding a Women’s Health PT to help fix postpartum tailbone pain.
What does tailbone pain feel like?
Tailbone pain can feel like a dull ache or sharp pain near your anus. The pain may also radiate up your lower back or down your glutes.
You’ll typically notice tailbone pain when you sit for prolonged periods or transition from sitting to standing. Sitting on hard chairs, pooping, and sex can also be painful.
Like many other areas connected to the pelvic floor, tailbone dysfunction can also contribute to aches and pains like sacroiliac (SI) joint pain, pubic symphysis dysfunction (SPD), and hip pain.
How to reduce tailbone pain
Tailbone pain isn’t something you have to power through for the rest of your life. If your tailbone is misaligned, you can work on adjusting the angle of your tailbone and loosening connected tissue. Here’s how to adjust your tailbone and ease tailbone pain.
1. See a Women’s Health PT
The best way to fix tailbone pain is by visiting a Women’s Health PT. These PTs have special training in the pelvis, and they can offer quick and lasting relief with external and internal tailbone mobilizations. If you’re dealing with tailbone isolation issues, a good PT can usually fix tailbone pain in 1-2 visits.
2. Reconnect with your breath
The pelvic floor muscles are attached to the tailbone, which can hold in tension. When things hurt—like your tailbone—we tend to hold onto tension even more. Deep inhales and exhales down the spine can help relax and release this tension in the tailbone/pelvic floor. Work on reconnecting to your breath by practicing diaphragmatic breathing.
As we inhale, the diaphragm goes downward and relaxes pelvic floor muscles that can pull on your tailbone. Focus on breathing into your back bra line. Expanding the back can also help you expand your backside (wink, wink). As you breathe into the back bra line, let that breath travel all the way down to the pelvic floor. To help you connect with your breath, try this:
Bend over and hold onto a counter.
As you bend over, breathe into the nose and move your breath down the spine (remember to focus on expanding that back bra line).
Grab the inside of your sitz bones with your finger pointed upward toward your head to check that your backside (pelvic floor) is also expanding with your breath. You should feel the tissue fall into your fingers. (squishy)
Breathwork takes time and practice. Don't worry, your brain will pick this up quickly!
3. Change your sitting position
Slouching at work or in the car puts a lot of extra force and pressure on the tailbone. Instead, sit tall and lean forward a little bit. Putting your feet flat on the ground or a box also creates more space and puts pressure on the legs instead of the tailbone. If you need more cushion, sit on a donut pillow (we love this one because it’s cut out around the tailbone area!). A donut pillow can help take off some unwanted pressure on the tailbone.
You should also avoid crossing your legs when you sit, which creates asymmetrical pelvic floor tension. (Even when you cross your ankles!) You may notice that when you sit with crossed legs, your neck and back feel strained when you try to turn your head. To avoid this, plant your feet wide and sit back into the chair, grabbing and pulling your booty wide as you sit back into the chair. This helps stretch the pelvic floor and reduces tension. You'll also notice it feels good to rotate your neck.
4. Isolate which side is stuck
Tailbones can deviate to the right or to the left side. Figuring out which side of your tailbone feels tight (like there is no space) is where you want to work on relaxing the surrounding tissue. To figure out which side of your tailbone is stuck:
While lying on your stomach, move your fingertips to your lower back and trace down your spine until you feel the little ridge of your tailbone.
Move your fingertips to the right and left sides, noting the space next to your tailbone.
One side of your tailbone may feel like it has a lot of space, while the other feels crowded. For me, the right side feels like I could fit the Grand Canyon in there. The left side feels like a little NYC apartment.
The crowded “apartment” area side is where your tailbone is stuck.
As you feel for any tightness, you may also notice the tailbone feels flexed underneath. This will feel like a 90-degree angle flexed inward toward the front of your body.
5. Loosen up tight tailbone tissue
Once you isolate the part of your tailbone that is stuck, you can work on manually massaging and stretching the connected tissues. We recommend the following exercises to loosen up any tightness causing tailbone pain:
Prone hip internal/external rotation: While lying on your stomach, locate your tailbone and press your fingertips into the tight side of your tailbone. Then, bend your knee on that same side (the sole of your foot should be parallel to the sky). Rotate your foot/lower leg in and out to loosen up the tissue.
Foam roll the hip: Foam roll up and down your glutes on the tight side, focusing on any tight areas. Make sure you don’t foam roll directly on the tailbone. You want to focus on loosening up the tissue and glute muscles.
External pelvic release: Lying on your side with the tight side up, slightly bend your knees. Grab your sit bone by placing your hand under the curve of your upper butt cheek. Pull up the sit bone to stretch that tight side and relax the tissues. Linger in this position as you hold up the sit bone for 6 breaths. This stretch should feel good and a little sore at the same time.
Pigeon stretch: Position yourself into a runner’s lunge with the leg on the tight side moving forward. Gently slide your front knee between your hands until your thigh rests on the ground. Extend your back leg straight behind you and keep your spine long. Lower onto your forearms for a deeper stretch. This stretch helps create more space without tugging on the tailbone.
Deep squat with diaphragmatic breathing: Position yourself into a deep squatting position by holding onto a countertop or placing your hands flat on a wall. Your knee should be in and your ankles out. Shift some of your trunk weight onto the wall or counter. Breathe into the bra line all the way down to the pelvic floor. Exhale like you’re fogging up a mirror and contract your pelvic floor muscles.
Need to find a PT for tailbone pain?
Tailbone injuries can be tough to fix yourself, but a Women’s Health PT can do a lot to help you! A Women’s Health PT can perform external and internal tailbone mobilization to move your tailbone back into a pain-free position, especially if it's flexed underneath. Most mobilizations can be done externally. But if your tailbone is stuck in a severely flexed position, the tip of your tailbone may be too deep to reach externally. In those cases, internal mobilizations are performed rectally. Yes, that means getting up close and personal with your butt. This is often the easiest way to fix a flexed tailbone!
Call your desired clinic before you schedule and check if they have PTs with experience in treating tailbone pain. You want a PT who can perform the manipulation intra-rectally, just in case you need it to treat your tailbone pain.
Need more help? Check out our tips on finding a Women’s Health PT. You can also find a pelvic PT here or here.
Sources
Márquez-Carrasco ÁM, et al. (2019). Coccyx pain in women after childbirth. https://pubmed.ncbi.nlm.nih.gov/30862389/
Maigne JY, et al. (2012). Postpartum coccydynia: A case series study of 57 women. https://pubmed.ncbi.nlm.nih.gov/22820826/
Foye PM. (2017). Coccydynia: Tailbone pain. https://pubmed.ncbi.nlm.nih.gov/28676363/