The fourth trimester is full of sitting and feeding baby. Unfortunately, many mamas struggle with sitting after childbirth.
This is because the pelvic floor can tear during vaginal childbirth, resulting in painful sitting as wounds are healing.
But other issues can also arise, these include pelvic floor muscle dysfunction and tailbone pain.
Tailbone Pain (Coccyx) Issues
The tailbone has to lift and extend during birth in order to allow the baby to pass through the vaginal canal. Injuries to the ligaments or muscles that attach to the tailbone during this process can result in postpartum issues, as well as a fracture to the tailbone (coccyx) itself.
The coccyx is an important structure with many significant structures attached to it, including the anal sphincter, the gluteus maximums muscle and the pelvic floor.
Dysfunction around the coccyx can result in:
Painful sitting
Tailbone pain with movement
Painful bowel movements
Constipation
Fissures
Coccyx pain, or coccydynia, is a big issue for postpartum moms, but can also be problematic for people who have not given birth or who have given birth but not gone through a pushing phase, such as through planned c-sections.
Coccyx pain and its associated dysfunctions can also arise from falls landing on the tailbone, prolonged sitting postures, or issues with activation of the hip extensors.
Pelvic Floor Physical Therapy For Coccyx Pain
Pelvic floor PT is the best treatment option for people suffering from coccydynia, period.
For people suffering from tailbone pain or related dysfunctions will benefit tremendously from pelvic floor physical therapy.
Your pelvic floor physical therapist will perform a thorough external exam, vaginal exam, as well as a rectal exam if appropriate, for people suffering from tailbone/coccyx issues.
A rectal exam you ask? Although a rectal exam may sound scary, it is the most direct way to access the coccyx and assess its surrounding musculature and tissues.
Your pelvic floor physical therapist will need to be able to assess these tissue to get a good idea of what is going on in your pelvis and around your pelvic floor.
If you are feeling intimidated by this concept but still want to get help for your symptoms make sure you let your therapist know. We can always work externally and try to access the coccyx that way, or until you feel ready for an internal exam.
Conclusion
Pain with sitting postpartum can arise from trauma during the birth to either the perineal region, or tailbone.
But birth trauma is not the only cause for tailbone pain, people who have delivered via planned c-section (did not go through the pushing phase of birth), and even those who have never had children can develop painful sitting/coccyx pain.
A rectal exam performed by a pelvic floor physical therapist is the most specific and direct treatment for this type of dysfunction.
If you are dealing with this, make sure you book your appointment today!