Specific exercises can relieve tailbone pain for some people. Results may not come quickly, so it needs a commitment to keep up the routine. But avoid any exercise that causes pain.
A patient writes: "My osteopath told me that it was essential to walk at a brisk pace for at least an hour per day to relax the spasms that tend to build up around the coccyx. I have started walking about 2 hours per day, to and from work. If I am tired and sore after a long day of work, my walking bring me back to as good as new." Also Anie found that a year of running and walking on a treadmill, 40 minutes a day, 4 times a week, got rid of her coccyx pain.
Amy writes: I have had tailbone pain for over 10 years. Since I started swimming 20 minutes a day with 5 mins of kicking warmup my pain is better - not gone, but better.
Repeatedly go from this position to standing. R. K. Hennessy, D Giberson, Lylima and Anonymous found that a programme of repeated weightless squats reduced or relieved their tailbone pains. Note that patients who have pain when rising from sitting should not do this exercise.
Anonymous found that clam shell exercises shown below reduced his coccyx pain when done with the squats above.
Two patients have reported success in getting rid of coccyx pain using yoga, Saurabh, AJ. The exercises that they used were:
Shalbasana, Bhujangasana and Ardha shalabh asana
On the other hand, Jo has used these exercises and said: "I would certainly agree that whilst yoga brings about relief from my symptoms as the affected area is stretched and relaxed in turn, it has not provided a cure." CE Forman found they seemed to help at first, but not for long.
Alem reported success in getting rid of coccydynia using these leg exercises. Anitha did a different leg excercise, described as the donkey kick exercise, along with other exercises.
Andrew found that physiotherapy and hamstring stretches relieved his tailbone pain.
Hengsoon found that doing an Anal Lock excercise reduced his coccydynia. It involves the same muscles you use to "hold on" when you need to go to the toilet but can't get there right away. Anitha used the same excercise, described as Butt muscle squeeze and relaxation
Two patients have reported success in reducing tailbone pain using breathing and relaxation exercises combined with deep massage: Kirin and Mike.
Many manual therapists prescribe exercises or yoga in addition to manipulation. The type of exercise depends on the cause of the coccyx pain. One physical therapy practice offers tailored yoga instruction for pelvic problems, including coccydynia.
See other treatments for tailbone pain here
(Please consult with your physician or physical therapist prior to engaging in any exercise program, whether specific to coccydynia or in general, to make sure that you are safe to participate.)
As a physical therapist I consider exercise and stretching important components in the vast majority of coccydynia treatment plans. Of course, the ideal is for every person with pain to be able to access a knowledgeable physician or physical therapist that can advise them on a safe and effective exercise regimen. However, that may not always be possible. If you are trying to choose exercises for yourself it may be helpful to consider the basic anatomy of the area:
The coccyx is affected by overall spine and pelvic alignment - therefore exercises that focus on posture, alignment, and core stability are usually helpful. If it's good for the rest of your pelvis/spine, it's probably good for your coccyx too! Same goes for any exercise that helps you to maintain good sitting and standing posture, such as exercises that target your core, stretch your hip flexors, or strengthen your upper back.
You also want to "zoom-in" and consider the structures that most directly affect the tailbone and its stability/movement. The muscles that attach directly to the tailbone are the gluteus maximus (hip extensors) and pelvic floor (sacrococcygeal flexors and important core muscles). There are also important indirect connections to the hamstrings (hip extensors, knee flexors). I have found that strengthening the hips, especially into extension, is often helpful in cases of coccyx pain. Learning to contract, and sometimes more importantly, to Relax the pelvic floor is also very helpful. Good balance between the glutes, pelvic floor, and deep core muscles, in combination with good posture and lumbopelvic alignment, will help to support the tailbone and reduce irritation.
However, not every exercise is right for every person. For example, some people with tailbone pain have their worst pain when they are moving from sitting into standing. This is because the glutes contract to lift you off the chair, and for some people this pulling on the inflamed tailbone causes increased pain. For those people, glute exercises have to be undertaken carefully or not at all. Another example would be many common "core" exercises, such as sit-ups, which put mechanical pressure on the tailbone and can make pain worse. Even many excellent Pilates exercises rely on movements that can directly irritate the tailbone through pressure against the ground.
My general rule of thumb is that you want to do as much SAFE, COMFORTABLE movement as possible, but if it hurts, don't do it. There are many people who may need to have their inflammation/irritation managed before they can engage in exercise. This is where evaluation by a knowledgeable physician or physical therapist can be especially beneficial.
Dr. Leslie Wakefield MS, PT, CSCS. See Doctors and specialists in the USA (Florida)
Updated 2021-05-28