Tips and exercises

What can you do yourself if you suffer from tailbone problems?

The tailbone is the part of the spine that is most difficult to exercise. Excerises directly for the tailbone(s), don’t really exist. The well intended exercises I often encounter of trainers or therapists, mainly focus on the area around the tailbone. The mobility of the joints of the tailbone itself, is not practiseable because the individual bones that form the tailbone are inpossible to actively move one to another like that is the case in other parts of the spine or most other joints in the body. In other words; we as humans are unable to wag our tail.

The complaints related to the mobility of the joints of the tailbone, where the problems mostly arise from, are not solvable by doing exercises. Specific exercises can bring more freedom and relaxation for the tensed structures around the tailbone. This can often bring a relief in tension and pain and support recovery. Also avoiding pressure on the tailbone can help the selfhealing capacity of the area.

On this page you will find multiple tips and exercises that you can do at home to influence your problems in a positive way.

Reduce the pain during sitting

Sitting is the number one problem people experience when they have tailbone problems.
What to do here?

a) the tailbone cushion

There are specific cushions that reduce the pressure on the tailbone during sitting because there is a gap at the back of it. Of course this isn’t a solution for the problem, but it can significantly reduce the experienced pain during sitting and they can be very useful if you have to sit for many hours a day.

I have several of these cushions at my workplace work and you can try them out if you come in for treatment. In most cases though the treatment reduces or solves the pain is quickly, so buying one is not even necessary.

b) the towel

Using a small towel is often just as effective as the special cushion and a lot easier to take with you.

Sitting is often so unpleasant because there is an increasing pressure on the tailbone when the posture sloughes a bit (see picture on the left). Because the shape of the pelvis is a bit different for women, they often experience more problems with this. Sitting upright reduces that pressure and the pain is often reduced by it directly.

To help lessen the pressure on the tailbone, the distance to the surface below can be increased a bit. This can be easily achieved by folding a small towel into a flat roll of around ten centimeters, and place it under the sitting bones (the bony structures you feel when you sit on your hands and move back and forth a bit).

c) towel and back support

Sitting for a more extended period is sometimes inevitable. If you need to sit for a longer period of time like in a car, an airplane or on a train, you can next to the towel under the buttocks (and even better a tailbone cushion if you have one), also support the back with a vest, sweater, blanket or towel and this support will be a bit more in diameter then for underneath the buttocks.

Roll it up and place it at the deepest point of the lumbar lordosis. This is there where your forearm rests if you place it horizontally across your lower back. Make sure you don’t position it too low because then you push the whole pelvis forward and tilt it backwards. This leads to sitting more slouched and increases the pressure on the tailbone. Also make sure you zit in the back of the seat. In this way the towel will help to arch the back a bit more so the body weight is being transfered more to the front part of the buttocks, which frees up the tailbone.

Reduce the pain while lying down

Lying on the back is often painful for people with tailbone problems. The reason for this is that the deep hip flexor, the psoas muscle, is tight or tensed (often due to too much sitting and/or stress), what makes the lower back hollower. This pushes the tailbone more towards the surface below and that can lead to a painful pressure. A pillow or role below the knees often gives direct relief of this.

The most relaxed way for lying down is mostly on the side, if needed with a pillow between the knees. In this position you can also try to apply a bit of stretch on the tailbone by pushing the upper leg a bit forward and aiming for stretch to occur at the tailbone (best felt when the knees and hips are both at a 90 degree angle). This is a very subtle movement and needs some practice often, but can be very relieving.

Relax the pelvic floor muscles

The muscles of the pelvic floor directly attach at the tailbone. A lot of people have an increased tension in their pelvic floor muscles (often due to stress). A dysbalance in the pelvic floor musculature like an increased or asymmetrical tension (that also can be caused by a dysfunction or dysposition of the tailbone), can trigger tailbone pain because more force is applied to it. The ‘bekkenfysiotherapeut’ is the specialist in training and relaxation of these muscles, but there are some simple exercises you can do yourself already and can help a lot.

A good relaxing exercise for this area, is the following. Sit down on the palms of your hands with your fingers pointing towards each other and the tips just at the inside of the sitting bones. The fingers of the left and right hand don’t touch each other. This helps you to ‘sit wide’ and this relaxes the pelvic floor muscles.

Now try to let go of tension in the pelvic floor musculature. Most people have no idea where to locate them and to feel that, so you can softly contract them. You do this by pulling your vagina inward a little (or lift the genitals if you are a man) and do the same with the anus. Then try to consciously relax the muscles again as much as possible. If you notice that your whole body moves up a bit by the contraction, you are activating your superficial and bigger buttocks musculature. That shouldn’t be the case and the focus should be directed solely on the deeper the pelvic floor muscles.

Very important: the emphasis with this exercise is on the relaxation. Let this fully occur and in between just slightly contract the muscles. If you got the feel of it, you don’t have to contract them in between, it is just a means to an end. If you contract them too much for multiple times, it can lead to an increase of the pelvic floor tension.

Do this relaxation as often as you think of it and it can be done in all postures.

While relaxing, you can also try to ‘let the tailbone go’ completely and to breathe towards the pelvic floor for an extra effect. More about this in the next exercise.

Relax the pelvic floor through touch and breathing

You can also help to relax the pelvic floor muscles by awareness and especially also by directing the breath towards it.

A good exercise for this is to sit on your hand and to bring your attention to that hand. The pelvic floor musculature is right above the perineum, the bit of skin that is located between the genitals and the anus and so right where the hand is. See if you are able to connect with that area through your hand.

Then find out if the opposite is also possible, if you are able to feel your hand with your perineum/pelvic floor. This is often a completely different sensation and directs even more attention towards it.

Then you can also aim the breath towards the hand. Not by forcing it, but to use the hand as an invitation for your breath. If you manage to breathe all the way through the belly to the pelvic floor so you can feel the breathing motion with your hand, there is definitely attention and relaxation in the pelvic floor. Breathe through the nose, this makes it easier to breathe low into the body.

Relax the total pelvic area with belly breathing

Every young child breathes towards the belly. Many times we adults have unlearned because of the stress we experience and we are ‘living in our heads’. In both cases the breathing moves upwards in the body. Breathing low has many benefits. Next to that it is our natural way of breathing, it also quickly brings calm and balance into our system, also in the pelvic area.

There is a very simple exercise to get to belly breathing.

• Lie down on your right side and pull the knees a bit up so you are in a stable posture.
• Place the left hand underneath your neck so your fingertips rest on the backside on the vertebrae.
• The right arm is now brought underneath the left arm and the right hand is placed on the backside of the armpit or the shoulder blade.
• Bring the elbows close to the chest and then let them relax on the surface below.
• Relax your face, jaws and hands and fingers. Breathe through the nose and leave the breathing to the body and let it breathe the way it wants to breathe.
• Notice that you will automatically start to breathe towards the belly. Because you actually give yourself a hug, it is harder to expand in the chest and the breathing movement will move to a lower place. This way the breathing matches a more calm and relaxed state.
• Feel if you can bring the breath so low that the perineal area, the region between the anus and the reproductive organs, moves along. In this way you massage and relax the pelvic floor muscles.
• With every exhale let all the tension and restlessness in you slide off, physically as well as mentally.

The more you practise this, the more the belly breathing will become natural again. It will also bring you a more structural relaxation of the pelvis and pelvic floor.

Stretch the deep pelvic floor muscles

The deep pelvic floor muscles, like of the anus, pull directly on the tailbone and can easily trigger existing tailbone problems. By stretching them you can create some relaxation of these forces.

Sit down on your hands and knees and make sure that your knees and feet are spread apart, and you would be able to sit in between of your feet if you wanted. The arms aim forward, like in the child’s pose in yoga. Now you can stretch the deep pelvic floor muscles by aiming with the anus to the back and also sides by moving to the left and right. You will feel when there is stretch and stay there if you find it. By bringing your pelvis a bit up or down to the floor, or arching or hollowing your back a bit, you can often further increase the stretch.

The wide kneeled child’s pose (all the way down and with the knees and ankles wide apart), can also be very pleasant to get some stretch on the pelvic floor.

Relaxation in a guided exercise

Would you like a more extended session for relaxation and connecting with the tailbone, where the above is applied?

I recorded an audio especially for that that guides you through this. You can find it here.

Reduce the pain while cycling

Riding a bike often is painful for people that experience pain at their tailbone. Make sure you aren’t sitting too much on the front part of your saddle (like most people do).

The more you position yourself toward the rear end of the saddle, the less pressure there is on the tailbone and you use the saddle like it is meant to be used. The wider back part of the T-shaped saddle is what is supposed to support the sitting bones.

There are also saddles with a special gap at the back to take away the pressure on the tailbone and that works in the same way as the tailbone cushion. But also in this case; before you invest money in attributes for relief, a treatment of a specialised therapist often leads to a quick and durable relief or solution of the problem.