Managing and preventing tailbone pain during and after pregnancy

Every now and then, I see patterns in the symptoms that women consult with me about. Sometimes, I will see multiple patients with almost identical symptoms or diagnoses. Most recently it has been tailbone (coccyx) pain. I think I have treated 10-12 different women with coccyx pain in the last year alone! 

The coccyx is the point of attachment for many muscles and ligaments, including the pelvic floor muscles. The most common way to injure it is in a fall, but pregnancy and childbirth can also cause coccyx pain.

During pregnancy, the pelvic floor muscles work overtime to help support the weight of the growing baby in the pelvis. This can strain the muscles and cause them to tighten up, pulling the coccyx out of its usual position. Changes in posture during pregnancy can also cause tailbone pain especially if you do a lot of sitting.

During childbirth, the coccyx can dislocate or fracture. Most cases of coccyx pain after childbirth though are not that severe an injury. When the baby's head and body pass through the pelvis, they can cause the coccyx to move beyond its regular range of motion. This strains the joint between the coccyx and sacrum causing the pelvic floor muscles to tighten up. Imagine your shoulder joint was stretched beyond its usual range of motion - the shoulder muscles would have been stretched as well and would react by tightening up. The same thing happens around the coccyx. Or the coccyx can stay within its comfortable range of motion while the muscles get strained. The muscles can still react by tightening up and this pulls on the coccyx causing pain. So it can be a chicken and egg kind of situation but the good news is that regardless of what caused it - physio can help.

The key to preventing and managing tailbone pain during and after pregnancy then is making sure that the pelvic floor muscles are not tight. A trained pelvic health physio can use manual techniques to release tight muscles and teach you how to do this at home. They will also teach you about childbirth positions that allow the tailbone to move out of the baby's way.

For more information about keeping your pelvic floor happy and healthy through pregnancy, childbirth and postpartum, Natasha will be hosting a brand new FREE workshop on January 22, 2022. Pre-register by emailing Natasha at ntetreault.physio@gmail.com.