A real pain in the backside!

By the time patients with coccydinia present at my clinic they may have suffered for a long time from pain in their tailbone or coccyx. Coccydynia  is a throbbing or aching pain in and around the area of the tailbone ( coccyx). If you have had trauma to,  or pain in your coccyx, chances are you have been advised to rest and take anti-inflammatories. Sometimes this works and the pain goes away, other times the pain persists especially when you sit for a long time and when you rise from the sitting position. In my experience coccyx pain can be treated successfully using specific manual techniques.

Because it requires high doses of radiation to show the small coccyx on X-ray, because all tailbones have a different “normal” position, and because an X-ray rarely changes the course of treatment, X-rays are not used routinely to diagnose coccydinia or abnormalities in the coccyx ( correct me if things have changed if anyone reading this is an Irish medical professional or has had a different experience!)

Risk Factors for Coccydynia include prolonged sitting, poor sitting posture, difficult labour and delivery, and activity involving repeated blows to the coccyx such as horse riding, bicycle,tractor..and surgery involving lying on the back with knees flexed.Up to one third can be idiopathic ie of unknown cause ( Lyons et al 2009)

Coccydyinia occurs 5 times more frequently in women than men, with onset at mean age of 40 years ( Patel et al 2008). The fact that giving birth puts substantial pressure on the coccyx is thought to be a factor in the increased risk for women ( Foye et al 2009)

The coccyx projects distal to the sacrum, curving posteriorly and then anteriorly at the tip

Tailbone coccyx pain spine Anatomy of the Human Body” 1918, by Henry Gray

The coccyx, along with the two ischial tuberosities, bears weight when a person is sitting, with an increased weight load on the coccyx when a person leans back in the sitting position.

The coccyx (tailbone) is a small triangular bone made up of 3 – 5 rudimentary vertebrae. These segments may or may not be fused together.—The coccyx flexes forward during contraction of the pelvic floor muscles,It extends backwards during labour and defaecation and it can also bend to each side and rotate a little on it’s long axis. The degree of movement is very different from tailbone to tailbone so when it comes to treatment it is different to treating other joints that have defined normal ranges of movement to aim for.

Two important pelvic floor muscles attach to the tip of the coccyx; these are the iliococcygeus and the ischococcygeue. Gluteus Maximus has an attachment to the lateral border of the coccyx

—Causes of Coccydinia

  • Trauma
  • Direct blow to the coccyx – can be fractured and bruised – may lead to posterior subluxation
  • Inflammation of the sacro-coccygeal joint.
  • Referred pain from other sources e.g Pelvic Floor Muscles, Sacrospinous / Sacrotuberous Ligaments, Gluteus Maximus

If you have had a recent trauma to your coccyx or have noticed a gradual onset of pain, it is worth visiting your GP first to ensure that all investigations are done in case anything strange is going on and to ensure that you use suitable pain relief. If the paindoes not go away after 8-10 weeks this is a good time to think about attending a physiotherapist who is specialised in the area.

Personally I love treating coccydinia as it generally responds quickly to manual techniques if it is going to be treatable by physiotherapy.

Pregnancy and Post-Natal Pilates

Places available on Pregnancy Classes held on Monday evening at 7.40pm. Join in any week depending on numbers, give me a shout with any questions!

Next blocks of post-natal Pilates classes as follows:

Friday 10.45am-11.45am: Block of 8 classes starting March 4th

Tuesday 10.45am to 11.45am: Block of 8 classes starting March 15th

Enjoy exercise and build your strength  under the guidance of a Chartered Physiotherapist specialised in delivery of Pilates classes and in Women’s Health; Challenge yourself while following relevent precautions to exercise during pregnancy and in the post-natal period. Please give me a shout if any questions!



Pregnancy Pilates Classes

New Block of 6 Pregnancy Pilates starting Monday 4th January at 7.40pm

This class has been designed to allow you to work your upper body and lower body muscles to a good challenging level, while allowing your body to adapt and change as your pregnancy progresses. So we work the arms, upper back, chest, Gluts, Hamstrings, calf muscles, pelvic floor and deep abdominal muscles ( trans ab muscles) while avoiding the lying down position and avoiding strenuous abdominal exercises ie sit-ups. This is a great class for preparing yourself for the demands of pregnancy, and looking after your small baby. It also will help to promote endurance during labour and a faster recovery afterwards. Give me a shout on 0872524225 to book your place, Muireann


Next block of Post-natal Pilates NOVEMBER 3rd

Book your place in the next block of Post-natal Pilates classes, starting Tuesday 3rd of November for 8 weeks. Babies welcome; Cost 100euro.


Enjoy learning and practising Pilates exercises under the guidance of a Chartered Physiotherapist specialised in the area of Women’s Health. Class suitable for mothers after vaginal ( including instrumental) and caesarean deliveries as well as anyone who suffered from Pelvic Girdle Dysfunction during pregnancy.

Individual assesssments can be booked for anyone who has special concerns about their ability to start exericing in  a class setting ( e.g Diastasis Recti concerns, Pelvic Girdle Dysfunction, Pelvic Floor issues. I can prescribe a pilates-based exercise program based on assessment to follow at home if the timing of the class, or other factors make it difficult to attend.

Give me a shout to book your place or to ask any question on the class ( look up the classes on my website for the content and benefits) on 087 2524225