Tailbone pain can be confusing and debilitating. Fortunately, the fix is often much easier than you think.
If your tailbone pain is caused by muscles, you can exercise your way out in just 3 steps right at home. The guide below will show you the exact muscles, pain charts, and exercises to master tailbone pain for good. Sections 1 & 2 describe the root of the problem, while section 3 contains actionable tailbone pain exercises for relief.
1. What Causes Tailbone Pain?
Tailbone pain can have many origins. In most cases, however, the source is predictably muscle spasms and muscle tension that manifest pain in and around the tailbone. In fact, a consistent 4 muscles most prominently cause pain in the tailbone area. You may have an issue with any number of these muscles - take the time to read the sections and pictures below to pinpoint which muscles and exercises to focus on for the best chance at tailbone pain relief.
The 4 tailbone pain muscles:
- Quadratus Lumborum (QL): see QL Pain
- Gluteus Medius: see Gluteus Medius Pain
- Piriformis: see Piriformis Muscle Pain
- Gluteus Maximus: see Gluteus Maximus Pain
2. Tailbone Pain Referral Patterns
Each of the 4 muscles can cause pain independently, or with a combination of others. I'm going to briefly touch on the symptoms and trigger point chart of each muscle - make note of which pattern(s) most accurately resonate with your tailbone pain.
1. QL Pain
QL Pain Pattern [1]
QL pain is commonly felt in the bright red areas above [1]. Even though the QL muscle lives in the lower back, its attachments can pull the pelvis and hip out of place and refer pain to the tailbone area.
QL Pain Symptoms:
- Instability and weakness in the lower back
- An overall feeling of fragility in the lower back, hips, and glutes
- Pain and difficulty bending forward
- Pain lifting objects off the ground
- Pain and weakness side-to-side in the hips and lower back
2. Gluteus Medius Pain
Gluteus Medius Pain Pattern [1]
Gluteus Medius is a wide, fan-shaped upper buttock muscle that causes a ton of pain in the lower back and tailbone when tight [1]. Gluteus Medius supports the body while standing on one leg, and tends to develop pain and tension from overuse.
Gluteus Medius Pain Symptoms:
- Pain while walking or climbing stairs
- Flattened lower back (pelvis tucked into posterior pelvic tilt)
- Instability while standing on one leg
- Pain bending forward or lifting objects
- Stiffness in the glute muscles
3. Piriformis Pain
Piriformis Pain Pattern [1]
Piriformis is a deep buttock muscle that attaches directly to the tailbone on both sides [1]. Piriformis tailbone pain is often felt at the top of the buttock crack and in the outer glute area. In severe cases, the Piriformis muscle can contribute to sciatic pain by impinging the sciatic nerve.
Piriformis Symptoms:
- Stiffness in the buttock muscles
- Sciatic nerve sensations running down the leg
- Numbness and/or tingling in the outer glute and leg
- Pain while "cutting" side to side in a lateral sport
- Tailbone pain made worse by sitting
4. Gluteus Maximus Pain
Gluteus Maximus Pain Pattern [1]
Gluteus Maximus is the biggest of the buttock muscles and one that can cause a lot of pain and stiffness when tight [1]. Gluteus Maximus may be your primary tailbone pain suspect if your pain pattern is a bit lower on the body.
Gluteus Maximus Symptoms:
- Pain bending forward
- Inability to bring the knee to the chest while lying on your back
- Pain climbing stairs
- Pain standing up from sitting
- "Pulling" pain preventing hip and glute mobility
3. Tailbone Pain Exercises For Relief
Now that we know where the pain is coming from, we can pick the appropriate set of exercises. The general 3 step formula for finding relief in any of the tailbone-pain-inducing muscles is 1. massage, 2. stretch, 3. strengthen. This process can be done over the course of a day in mild cases, and over weeks in severe cases (spending multiple days on each step).
Tailbone Pain Exercise 1: Massage
Deep tissue massage is always step 1 in fixing muscle pain. Without massage, your muscles may be too tight and rigid to stretch, and strengthening won't rid them of their tension. Massage can be done by the hands of a trained professional or a willing friend/family member - or at home with a purposefully made tool like QL Claw.
How to massage: Using your tool or partner of choice, spend 2-3 minutes thoroughly working each muscle of interest on each side of the body. Slow the breathing and relax the body - this signals to your muscles that they are safe to release their tension.
One 2-3 minute session per muscle may be enough to rid your muscles of tension, but you will likely require 3-4 massage sessions over a few days. This is a lot of time - keep in mind we are undoing potentially years of muscular imbalance and tension. It doesn't happen instantly, but it can absolutely be your ticket to relief with diligent and focused massage sessions.
Here are links to our tutorials on how to release the 4 tailbone pain muscles:
- QL Release
- Gluteus Medius Release
- Piriformis Release
- Gluteus Maximus Release (coming soon)
*Massage and trigger point therapy are what unlocked my 4 years of debilitating lower back pain. I can't overstate the importance of buying into this step if you are struggling to overcome your tailbone pain!
Tailbone Pain Exercise 2: Stretch
After thorough massage, our muscles should be primed to lengthen and stretch. The reason we want to stretch is to increase the slack length of our muscles so they give us a) more range of motion, b) fewer nerve impingements, and c) less tailbone pain.
How To Stretch: Stretching is a lifelong journey, but stretching specifically for tailbone pain relief can be quick. A handful (5-7) of diligent stretching sessions over 2 weeks is often enough to create a tailbone-friendly adaptation in the body and help provide relief.
Spend 45-60 seconds stretching each muscle or position for the best results. I enjoy picking a handful of stretches and doing them in a 2 round circuit, cycling between each exercise on each side twice.
Here are links to stretching each of the 4 muscles, in addition to a few of my favorite individual tailbone pain exercise stretches:
Individual stretches:
- World's Greatest Stretch
- Pigeon Stretch
- Figure 4 Stretch
Tailbone Pain Exercise 3: Strengthening
The final step to overcoming tailbone pain and making sure it never comes back is strengthening. Without strengthening, we are susceptible to setbacks, spasms, and fragility when doing anything physical. For a plug-in program containing the best tailbone pain exercises check out Back Of Steel - lower back strengthening program.
Perform lower back, hip, glute, and core strengthening exercises 2-3 times per week for the best results. I love the simplicity and structure of the McGill Big 3, check it out at the link or work in the exercises below:
By Muscle Group:
Top Movements:
- Side Plank
- Fire Hydrant
- Paloff Press
- Bird Dog/Bird Dog Row
Thank you for reading my take on tailbone pain exercises! Leave a comment or email us at ben@backmusclesolutions.com if you have any questions. Best of luck finding tailbone pain relief - check out the links above for more on muscle pain and what you can do to fix it.
Sources:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.