The coccyx, or tailbone, is a sensitive bone at the base of the spine. It can become bruised from a sudden fall or strain, causing sharp pain when pressure is applied. This injury, termed coccydynia, makes sitting extremely uncomfortable. While a bruised tailbone typically heals within a few weeks, remaining inactive is unnecessary. Working out is possible, but it requires careful modification to avoid aggravating the injury and prolonging recovery.
Understanding the Injury and Initial Rest
A bruised tailbone results from trauma causing inflammation, swelling, and damage to the surrounding blood vessels. Common causes include backward falls or repetitive actions like cycling that create excessive friction. Because the tailbone lacks protective muscle padding, it is vulnerable to direct impact and pressure.
The goal during initial recovery is to reduce inflammation and avoid increasing pressure on the injury site. Minimize time spent sitting, as this position directly loads the coccyx. Using a specialized donut or wedge cushion is highly recommended when seated. Applying ice for the first 48 hours and using anti-inflammatory medications manage acute pain and swelling. Gentle movement, such as walking, is encouraged to maintain blood flow, but any activity that causes increased pain should be halted.
Exercise Activities to Avoid
Exercises must be avoided entirely if they cause direct pressure or shearing forces on the coccyx. Activities involving prolonged sitting, such as stationary cycling or rowing, should be stopped. These seated exercises place body weight directly onto the tailbone, significantly delaying healing.
High-impact movements causing jarring or compression forces through the spine must be eliminated. This includes:
- Running
- Jumping
- Box jumps
- Plyometric exercises
These transmit shock directly to the lower spinal structures. Floor-based exercises involving lying on the back, such as sit-ups and crunches, are problematic because the rocking motion presses on the coccyx. Yoga poses like a full Bridge must also be modified or avoided if they cause the tailbone to press into the floor.
Movements requiring significant spinal loading or deep hip flexion, such as heavy deadlifts or deep squats, are contraindicated. Improper form can cause a posterior pelvic tilt, increasing tension on coccyx ligaments. Machine work requiring sitting, like a leg press or seated shoulder press, also poses a high risk due to sustained pressure.
Safe Workout Modifications and Stance
Most of a fitness routine can be maintained by focusing on standing, prone, and water-based activities that bypass tailbone contact. Standing upper body exercises (overhead presses, lateral raises, bicep curls) are excellent choices as they keep the body upright. Lunges and split squats are safe, provided the spine remains neutral or a slight anterior pelvic tilt is maintained to relieve posterior pelvic pressure.
Core work should avoid the rocking motion of traditional crunches, favoring positions like the plank or side plank, which maintain a stable, neutral spine. Prone exercises (lying on the stomach) are well-tolerated. Water-based workouts offer a zero-impact environment, allowing for walking or running in a pool, and swimming with strokes like the freestyle.
When performing standing exercises, maintaining a proper stance is paramount. The pelvis should be slightly tilted forward or kept neutral, rather than tucked under, which increases coccygeal pain. This slight anterior tilt shifts muscular tension away from the injured area. For exercises requiring momentary seated rest, use a V-shaped or wedge cushion on the bench for pressure relief.
Monitoring Symptoms and Return to Full Activity
Pain must be the ultimate guide when exercising with a bruised tailbone. The Pain Scale Rule advises immediately stopping any exercise if the pain level exceeds a 3 out of 10. While minor discomfort is acceptable, sharp, shooting, or increasing pain during or after a modified workout indicates further irritation.
Symptoms signaling the need for medical attention include worsening pain that does not improve with rest, new numbness or tingling in the legs, or difficulty controlling bowel or bladder function. These signs indicate a more severe injury or nerve involvement. Return to previously avoided activities must be gradual, using progressive overload applied to pain tolerance.
After the initial pain subsides, reintroduce activities like cycling or gentle jogging for short durations (10 to 15 minutes). Monitor symptoms over the following 24 hours. If pain remains stable or improves, slowly increase the duration and intensity. Although full recovery is typically around four weeks, progression should be guided by symptom management, not a strict calendar timeline.