Photo: woods wheatcroft photography

Does it hurt to sit down?

Tailbone or pain is often left untreated as most physicians and PTs alike are not trained to treat this little bone.  Most of my patients tell me that the doctor advises them to go home and sit on a donut.  The coccyx is a arrowhead shaped bone that lies at the base of the sacrum, which lies just below the lumbar spine.  It is the primordial tail.  Like any other bone it is connected to the adjacent bone via a joint and many strong, thick ligaments.  It is the most posterior anatomical point on the pelvic floor where many of the pelvic floor muscles attach.

The tailbone is most commonly injured with direct falls on the bottom.  Ever get bucked off a horse?  Fall on the ice?   Hockey players, roller skaters, gymnasts, and dancers all fall down.  I had a patient tell me she fell directly on a concrete curb! OUCH!

I think I like to treat this little bone so much because I’ve seen so many great benefits and it’s so easy to treat.  I treat the coccyx in the seated position.  I basically have the patient sitting on my hand.  From here I can use my middle finger to feel both sides of the coccyx as well as the tip.  Although patients should only feel pressure, it is often initially quite painful.  I can adjust my pressure according to how much pain someone is having to make the treatment tolerable.  After I release the ligamentous restrictions, I then mobilize the joint side to side as well as front to back, again looking for restrictions which I release.

Treating coccyx dysfunction has allowed me to relieve my friend’s lifelong migraines, eliminate low back pain, pelvic floor muscle spasms, as well as allowed one of my patients who was sitting on a donut for 20 years to finally sit normally again without pain.

Mary Boyd, PT is the owner of Mountain View Physical Therapy and can be reached for questions about the coccyx at 290-5575 or online at

Photo By ish called wanda

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