Don’t rely on donuts to fix your tailbone pain

Tailbone pain after having a baby is a common problem! Tailbone pain can happen during pregnancy and after delivery, and is usually due to a few factors.

Tailbone pain, also known as coccydynia (medical term for pain in the coccyx), is pain around the small triangle bone at the bottom of your spine. It is the smallest portion of the spine and attaches to several muscles and ligaments, particularly the muscles of the pelvic floor.

During pregnancy, there is a lot more stress and strain on the pelvic floor than usual. This means the pelvic floor can tighten up and the forces change in the pelvic region. For this reason, people who have cesarean births can also experience tailbone pain. However, tailbone pain is more common following vaginal delivery.

During active labor and the pushing stage, the baby's head is pressing against the pelvic bones and the tailbone. In the US, most women give birth on their backs or in a semi-reclined position. In these positions, the tailbone is not able to move freely, which makes it harder for the baby's head to navigate through the bottom of the pelvis, as it has to press against the tailbone to pass through.

Even if the tailbone is in a free moving position (such as squatting, side-lying, or hands and knees), the ligaments and soft tissues around the tailbone can be stretched and cause injury as the baby is born. The tailbone itself can also be bruised or fractured during birth, which can cause immediate pain post-delivery. Tailbone pain is more common following long labors, a prolonged pushing phase, and instrument-assisted deliveries.

It can be difficult to determine where the pain is coming from during the early postpartum days. It can be hard to differentiate between perineal tearing, low back pain, general postpartum discomfort, and tailbone pain.

The most common complaint is pain during sitting and pain when going from sitting to standing. Some women find themselves sitting on donut pillows, wedges, or nursing pillows to take the pressure off and decrease the pain. These can all decrease the pain temporarily, but they don’t actually address the problem. Chances are, when you sit without your donut pillow or wedge, the pain will increase again.

If there was ligament or bone damage (like a fracture) to the tailbone, that can obviously cause pain. The muscles of the pelvic floor can also contribute to tailbone pain. These muscles are stretched to extremes during delivery, and then can recoil and contract in a guarded state following birth. 

Tight pelvic floor muscles can cause tension on the tailbone since many of the pelvic floor muscles attach on the front to the pubic bone all the way to the tailbone in the back. If these muscles are tense, it can cause the tailbone to be pulled forward, or flexed, and reduce the amount of backwards motion, or extension, the tailbone has. We want the tailbone to have good forward and backward motion since it is part of the spine and should move with the spine as you move around.

Internal treatment of the tailbone and pelvic floor by a pelvic floor physical therapist can be extremely helpful in decreasing tailbone pain. Pelvic floor PT helps to correctly diagnose what is going on and what tissues and dysfunctions need to be addressed. 

A pelvic floor PT can help work on faulty movement patterns, posture, and daily activities to help you feel less pain. Hands on treatment is extremely valuable for tailbone pain and can significantly decrease discomfort and improve quality of life.

The tailbone can be treated with internal treatment via the vaginal or rectal openings. At Moms in Motion PT, we prefer to treat the tailbone transrectally, because we can more efficiently reach the problem areas and treat the tissues internally and externally at the same time due to the positioning used. We have seen excellent results with this treatment approach, but always defer to the comfort level of the patient.

If you have been suffering from tailbone pain or you aren't sure what is going on, call us today so we can go over your symptoms and see if pelvic floor PT would be a good treatment option for you! 612-568-2462

Tailbone pain can be isolating and debilitating. Don’t delay reaching out so you can get on a path to healing. If you know someone who has tailbone pain, please forward them this blog post! Many people suffer in silence because they simply do not know what treatment options are available. Pelvic floor physical therapy is a wonderful, noninvasive strategy to manage tailbone pain, and improve your ability to engage in all aspects of life you have been missing.