How is the Coccyx related to the pelvic floor?

The anatomy: The coccyx or tailbone is a small bone that attaches to the bottom of the sacrum. 

The impact from the surrounding muscles: The gluteus maximus muscles along with many pelvic floor muscles attach to the tailbone.

The movement: The tailbone can tilt forward or backward in space. If your tailbone is moving freely, when you slouch, your tailbone tilts forward (flexion) so it’s tip points toward your knees. When you sit with tall, the tailbone tilts so the tip is pointing backward (extension). Because of the muscular attachment, when you contract your pelvic floor, the tailbone will move into flexion.

How does coccyx pain typically present?

Tailbone pain may be related to specific movements or activities: Muscle tension, injury from a fall or child birth, or scar tissue following a local surgery can alter the ability of the tailbone to move freely. This can result in pain with prolonged sitting, moving between sitting and standing, prolonged standing, walking, or forward bending.

Tailbone pain from inflammation may be more persistent. This is often the result of direct trauma, such as a fall.

How is this addressed?

Flexibility: Muscle flexibility and resting tension can be improved with soft tissue work, breathing exercises, stretching, and addressing other driving factors such as posture.

Joint mobility: If the joint between tailbone and the sacrum is stiff, external or internal joint mobilizations may be recommended.

Other factors: Breathing patterns, habitual postures, bathroom habits, muscle weakness in the trunk and hips, as well as stress and GI issues can also play a role in pelvic floor tension. A lack of muscle development and soft tissue in the tailbone region can also contribute to sensitivity with sitting. Targeted strength training can improve this.