The coccyx, or tailbone, is a small, triangular bone at the bottom of the spine, formed by three to five fused vertebrae. It helps steady the body when sitting and serves as an attachment point for ligaments and muscles. However, this structure is not designed to bear the massive compressive and shearing forces of a heavily loaded deadlift. Pain in this area, medically termed coccydynia, during or after compound movements signals that mechanical forces are misaligned. This discomfort usually stems from technical errors that overload the area, underlying physical restrictions, or pre-existing structural issues aggravated by the lifting motion.
The Role of Pelvic Position and Technical Faults
The primary technical error leading to coccyx pain during the deadlift is the loss of a neutral spinal position, often called a “butt wink.” This occurs when the lifter’s pelvis excessively rotates backward, or posteriorly tilts, while descending to grip the bar. When the pelvis tucks under, it forces the lumbar spine to flex, placing stress on the lowest spinal joints, particularly the L5-S1 segment.
This posterior pelvic tilt directly transfers the load from the hamstring and glute muscles into the vulnerable lower ligaments and the coccyx itself. The coccyx and surrounding soft tissues receive direct pressure, especially during the setup and initial pull from the floor. The spinal column is less equipped to handle heavy loads under flexion compared to a braced, neutral posture, compounding the stress.
Setting up too low, or attempting a torso angle beyond one’s hip mobility limits, forces this tucking motion. This fault is often felt acutely right before the bar leaves the floor. Another technical fault is hyperextending the back at the top of the lift, which causes an aggressive anterior tilt that also stresses the sacrum and coccyx area. However, the posterior tilt is more commonly implicated in coccyx pain. Maintaining a neutral spinal cylinder throughout the entire lift is necessary to distribute the load correctly across the stronger muscle groups.
Underlying Mobility Restrictions That Increase Risk
Technical faults like the “butt wink” often stem from an underlying mobility problem that limits the hip hinge necessary for the deadlift. The most common restriction is tightness in the hamstring muscles, which attach to the pelvis. As the lifter bends over, tight hamstrings pull the sitting bones (ischial tuberosities) downward, forcing the pelvis into a posterior tilt.
This restriction dictates the lifter’s range of motion. Attempting to reach the floor without adequate hamstring length forces the body to compensate by rounding the lower back, sacrificing spinal neutrality to achieve depth. Tight hip flexors also contribute by limiting the pelvis’s ability to maintain an optimal position when the hips are in flexion at the bottom of the movement.
Limited internal rotation of the hip joint is another restriction that compromises proper deadlift mechanics. If the hip joint cannot rotate sufficiently, the lifter may be forced to shift weight or adjust their pelvic position to accommodate the movement. This compensation often results in the pelvis tilting and the lumbar spine flexing prematurely, transferring strain away from the glutes and into the lower back and tailbone. Addressing these limitations through targeted mobility work on the hips, hamstrings, and glutes allows the spine to remain neutral under load.
Non-Lifting Related Structural Contributors
Pain in the coccyx during deadlifts may point to pre-existing conditions that make the area sensitive to pressure and load, even with good form. The most straightforward cause is prior trauma, such as a hard fall directly onto the tailbone, which can cause bruising, fracture, or joint hypermobility at the sacrococcygeal joint. Such a history can lead to chronic inflammation (coccydynia), making loaded compression painful.
Prolonged sitting, especially on hard surfaces, is a common non-lifting behavior that aggravates the area by placing sustained direct pressure on the coccyx. This constant pressure can inflame the surrounding soft tissues, making the area hypersensitive when exposed to the high intra-abdominal pressure and muscle tension generated during a heavy deadlift. Furthermore, referred pain from surrounding musculature can be misinterpreted as coccyx pain.
Muscular issues like piriformis syndrome, which involves irritation of the sciatic nerve near the deep gluteal muscles, can cause a deep ache in the buttock region near the tailbone. Tension in the pelvic floor muscles, which attach directly to the coccyx, can also contribute to coccydynia. This tension may be indirectly caused by tightness in the adductor muscles or an inability to manage intra-abdominal pressure during the lift.
Immediate Steps and Medical Consultation
The immediate action when tailbone pain occurs is to stop the movement and significantly reduce the load, or switch exercises entirely. Practical adjustments include elevating the bar by performing rack pulls or block pulls, which reduces the required depth and often prevents the pelvic tucking. Switching to a hex bar deadlift, which allows a more upright torso, or adopting a wider sumo stance, can also be effective modifications.
Filming the lift from the side is beneficial to objectively identify the point where the pelvic tilt begins. This visual feedback allows the lifter to consciously limit their range of motion just before the fault occurs. Practicing the hip hinge movement with a PVC pipe held along the back can reinforce the feeling of a neutral spine and teach better body awareness.
If the pain is sharp, shooting, burning, or radiates down the leg, a medical professional, such as a physician or physical therapist, should be consulted promptly. These symptoms can indicate nerve involvement or a structural issue requiring professional diagnosis and specific treatment. A physical therapist is equipped to assess for underlying mobility limitations or pelvic floor dysfunction, creating a targeted rehabilitation plan to safely return to lifting.