Coccydynia = A Pain in the bum
The cause of my tailbone pain... That is actually me! Somehow managed to land my first and only jump ever. (Photo credits to Julian Tejada www.procrasnow.com)
Coccydynia is the fancy term for a sore tailbone. It can be caused by several different things but is often prolonged by pelvic floor muscle dysfunction.
What is it?
Coccydynia is essentially pain in the tailbone (Coccyx = Tailbone, Dynia = Pain)
This can present as an achy/dull pain or sometimes more intense/sharp pain particularly with movement (eg. rising from sitting) or sitting for a long time.
What causes it?
Tailbone pain or coccydynia can be caused by a direct injury to the tailbone, however, this does not necessarily mean that there is a fracture or dislocation of the bone or joint. Some related causes can include:
Direct impact or a fall directly onto the tailbone, eg. while snowboarding or from a height
Sustained pressure to the tailbone during childbirth (vaginal delivery)
Strain of the pelvic floor muscles from pregnancy
Prolonged sitting with your weight on your sacrum and tailbone eg. flights/long car rides (see Travelling Pelvic Floors)
Gradual onset of soreness with no apparent cause
In the presence of pain, nearby muscles tend to tighten in order to protect your body. However, because the pelvic floor muscles attach directly to the tailbone, this shortening and tightening of the pelvic floor muscles can create a constant pull on the joint and lead to ongoing tailbone pain. This can be especially noticeable when the muscles move from a relatively shortened position (sitting) to a more lengthened one (standing) or as the pelvic floor muscles contract. Check out the pelvic floor anatomy to see how the muscles connect to the tailbone.
If the muscles remain in a shortened or contracted position, it is difficult for them to perform all the functions necessary including maintaining bladder and bowel control, sexual function and maintain your core stability. Therefore, tailbone pain should not be ignored or just put up with as it can have dire long term consequences.
What can be done about it?
Prevention: When sitting, try to sit tall and avoid slumping backwards which puts more pressure on your tailbone. Avoid sitting for long periods (no more than 45mins at a time) and stretch where possible. Maintain good hip flexibility and squat regularly for gentle opening of the pelvic outlet to lengthen the muscles (see Katy Bowman's You Don't Know Squat)
Pelvic Health Physiotherapy: When the pelvic floor muscles are very shortened and in spasm, they may require releasing internally and the coccyx may need to be mobilized in a posterior (backwards) direction. A Pelvic Health Physiotherapist can assess your body alignment, pelvic floor muscle function and provide detailed education on how to optimise your pelvic health to prevent recurrence or future injury.
Happy snowboarding season!