Coccydynia, a persistent, deep ache at the base of the spine (the tailbone or coccyx), is a common discomfort during pregnancy. This pain can make simple actions like sitting, standing, or shifting position difficult. While acute, this pain is usually a normal physical response to the extensive changes the body undergoes to prepare for childbirth. Understanding the underlying causes and implementing safe, targeted stretches can often provide significant relief.
Causes of Tailbone Discomfort During Pregnancy
Discomfort around the coccyx results primarily from hormonal and biomechanical shifts as pregnancy progresses. Hormones increase the laxity and flexibility of pelvic ligaments to accommodate the growing baby and facilitate delivery. This increased mobility can destabilize the coccyx, which serves as an attachment point for pelvic floor muscles and ligaments.
The expanding uterus and weight gain shift the body’s center of gravity forward. This postural change causes the pelvis to tilt, adding substantial pressure to the tailbone, especially when sitting. In later stages, the baby’s position can also exert direct physical pressure on the coccyx. Increased strain on the pelvic floor muscles, which anchor to the tailbone, further contributes to tension and pain.
Safe Stretches and Movements for Immediate Relief
Targeted movements focusing on pelvic mobility and gluteal muscle release help alleviate tension pulling on the coccyx. All stretches must be performed slowly and gently, stopping immediately if sharp pain occurs. Since lying flat on the back should be avoided after the first trimester, exercises are modified to be done on hands and knees or while seated.
Cat-Cow Movement
The Cat-Cow movement, performed on all fours, gently mobilizes the spine and pelvis. Start with hands under the shoulders and knees under the hips. Inhale, dropping the belly to arch the back slightly (Cow position). Exhale, rounding the spine upward, tucking the pelvis, and releasing the head toward the floor (Cat position). This rhythmic pelvic tilt promotes movement in the lower back, easing pressure on the tailbone.
Modified Child’s Pose
A modified Child’s Pose provides a gentle stretch to the hips and lower back. Start on hands and knees, separating the knees wide apart to accommodate the belly. Extend the arms forward and allow the chest to sink toward the floor, resting the forehead down if comfortable. This modification allows for a restorative release of tension around the pelvis.
Seated Figure-4 Stretch
Stretching the piriformis and gluteal muscles is important, as tightness in these areas can pull directly on the coccyx. The Figure-4 stretch can be performed while seated in a sturdy chair. Cross one ankle over the opposite knee, keeping the foot flexed. Lean slightly forward from the hips until a stretch is felt in the outer hip and buttocks of the crossed leg.
Gentle Hip Circles
Gentle hip circles or figure-eight movements performed while sitting on an exercise ball are effective. This technique allows for non-weight-bearing, rotational mobility in the pelvis. Maintaining an upright torso, gently roll the hips in small circles or figure-eight patterns. Focus on movements that feel unrestricted and comfortable to encourage the joints and surrounding muscles to loosen without strain.
Supportive Practices and When to Seek Help
Passive support complements active stretching for managing coccydynia. Specialized coccyx cushions, often U- or wedge-shaped, immediately relieve pressure on the tailbone when sitting. These cushions redistribute weight to the sitting bones, allowing the coccyx to float freely.
Proper sitting posture involves leaning slightly forward to place weight onto the thighs rather than the tailbone. Avoiding prolonged sitting, especially on hard surfaces, prevents pain aggravation. Applying ice or a cold pack to the painful area for about 15 minutes a few times a day helps reduce inflammation and dull the pain.
Consult a healthcare provider, such as an obstetrician or pelvic floor physical therapist, if the pain becomes severe or is accompanied by other concerning symptoms. Red flags warranting immediate medical attention include pain radiating down the legs, sudden numbness, fever, or bleeding. A physical therapist can provide a personalized assessment and use techniques like soft tissue release to address underlying muscular tension contributing to coccydynia.