Tailbone pain physical therapy in Carmel, Indiana

Sitting puts direct pressure on the coccyx, especially when you lean back, so a bruised, sprained or irritated tailbone hurts most in a chair. Standing up can bring a sharp jolt as the coccyx and surrounding muscles shift. Leaning forward onto the thighs usually takes pressure off it.

Common causes include a backward fall onto a hard surface (icy Indiana driveways and parking lots in January are a classic setting), childbirth, long drives or desk days on firm seats, and cycling on a poorly fitted saddle. Sometimes no clear cause is found.

The NHS lists pregnancy and childbirth, falls, repeated or prolonged strain, poor posture and joint hypermobility among the causes. The pelvic floor muscles attach to the coccyx, so when they tighten or spasm they can keep the area sore well after the original bruise should have healed.

A wedge cushion with a cut-out at the back takes pressure off the tailbone while you sit, and many people find it the single most helpful change. Pair it with sitting slightly forward with your weight on your thighs and sit bones, and avoid slumping back onto the coccyx.

Break up sitting time, especially at a desk or on long drives up US-31 or I-69. Standing for phone calls, using a sit-stand desk and taking short walks all help. When you must sit for a long event, bring the cushion. Cyclists may need a saddle with a central cut-out or a different bike fit, as discussed on the physical therapy for cyclists page.

Car seats deserve attention as well. Many slope backward, which tips weight onto the tailbone; a cut-out cushion or a folded towel under the thighs can level the seat. On longer trips, plan a stop every hour or so to stand and walk for a few minutes.

A cushion made for the coccyx, which is also what the NHS recommends, tends to give more consistent relief than a soft seat: softer chairs feel better at first but let you sink back onto the tailbone. Ice or heat can help short term.

• Wedge cushion with a rear cut-out
• Lean forward slightly onto the thighs
• Stand or walk every 20 to 30 minutes
• Stand for calls and short meetings
• Check bike saddle shape and fit if you ride

Pelvic floor therapy becomes part of treatment when tight or spasming pelvic floor muscles are keeping the tailbone painful, which is common in chronic coccydynia and after childbirth. Techniques may include external and internal muscle release and gentle mobilization of the coccyx, performed by a therapist with specific pelvic health training.

Pelvic health is a specialty that requires extra training beyond general physical therapy. Whether a therapist in the network offers it depends on who is in the network at the time; the matching team will tell you honestly before anything is booked and point you elsewhere if no one does. The pelvic floor physical therapy page explains what that care involves and how to choose a provider.

If you are pregnant or recently postpartum, mention it in the questionnaire. Tailbone pain during pregnancy and after delivery has its own considerations, and the pregnancy back pain page covers the overlap with pelvic girdle pain.

Even without internal work, a general orthopedic therapist can help with sitting strategies, breathing and relaxation, hip and glute strength, and lower back mobility. To get started, the two-minute questionnaire lets you describe your symptoms so the matching team can propose a fit.