How Pelvic Floor Therapy Can Help With Tailbone Pain in Men

Tailbone pain, or coccydynia, is a frustrating issue that can affect men more than people realize. It can make sitting uncomfortable, workouts painful, and even impact sexual function or bowel movements. While many men assume it’s just bruising or “sitting wrong,” tailbone pain is often influenced by deeper issues in the pelvic floor and surrounding structures. Pelvic floor physical therapy is one of the most effective ways to get long-term relief because it addresses the source rather than just the symptoms.

Why Men Develop Tailbone Pain

For men, tailbone pain is often linked to tension and imbalance in the pelvic floor muscles that attach to and surround the coccyx. These muscles include the pubococcygeus, iliococcygeus, coccygeus, and parts of the glutes. If they become tight, overactive, or irritated, they can pull the tailbone into a painful position.

Common male-specific contributors include
• prolonged sitting for work or driving
• heavy lifting or straining at the gym
• constipation or chronic straining during bowel movements
• cycling or rowing
• pelvic floor overactivity from stress or sympathetic nervous system overdrive
• sexual dysfunction issues that cause guarding or clenching
• previous falls directly onto the tailbone
• post-surgical changes in the pelvis or abdomen, such as after hernia repair

These factors don’t just irritate the tailbone itself. They often create a cycle of tension in the pelvic floor and surrounding fascia, causing pain that lingers or worsens with sitting, standing up, or leaning back.

How the Pelvic Floor Affects Tailbone Position

The tailbone is essentially the anchor point for several pelvic floor muscles. When these muscles are balanced and functioning well, the coccyx moves gently during breathing, bowel movements, and sexual activity. When they become tight or inflamed, they can pull the tailbone forward, tuck it under, or limit its mobility. This leads to irritation of the joint between the sacrum and coccyx and inflammation of the surrounding soft tissue.

For men, tight pelvic floor muscles can also show up as urinary frequency, hesitancy, testicular pain, painful ejaculation, or hard flaccid symptoms. Tailbone pain and these male pelvic symptoms often coexist.

How Pelvic Floor Therapy Helps

Pelvic floor physical therapy is uniquely effective because it evaluates and treats the root causes inside the pelvis, around the hips, and along the spine. Treatment typically includes:

Internal pelvic floor muscle release
Many men have deep tension in muscles like the coccygeus and levator ani. Internal techniques help release trigger points, restore mobility of the tailbone, and reduce nerve irritation.

External myofascial work
Therapy focuses on the glutes, piriformis, obturator internus, hamstrings, and low back, all of which can affect tailbone loading when they are tight or weak.

Tailbone mobilization
Gentle external or internal techniques help restore normal coccyx movement, reduce inflammation, and improve sitting tolerance.

Posture and sitting mechanics
Many men sit with a tucked pelvis or rounded spine, which increases pressure on the coccyx. Therapy retrains neutral sitting posture, hip hinge patterns, and core engagement.

Breathing and nervous system regulation
Overactive pelvic floors are common in men with chronic stress. Learning proper diaphragm mechanics and down-training helps the pelvic floor stop clenching around the tailbone.

Bowel mechanics and constipation relief
Straining increases coccyx pressure and pelvic floor tension. Therapists teach correct defecation mechanics, abdominal pressure management, and pelvic floor relaxation for bowel movements.

Strengthening where it matters
Weak glutes, deep core muscles, and hip stabilizers lead to increased load on the tailbone. Strengthening restores balance so the tailbone is no longer overloaded.

Male-Specific Considerations

Men often develop tailbone pain alongside symptoms like penile base pain, perineal pressure, or post-ejaculatory discomfort. Treating the pelvic floor improves circulation, reduces nerve irritation, and directly addresses the muscles involved in sexual and urinary function. Therapy is especially helpful for men who sit for work, cycle frequently, or hold tension due to stress or hard flaccid–type patterns.

When to Seek Care

If tailbone pain lasts longer than two weeks, worsens with sitting, or starts to affect sexual function or bowel movements, pelvic floor therapy can make a major difference. Many men find that once the pelvic floor is treated, tailbone pain that lingered for months finally resolves.

If you're local, we treat male pelvic floor conditions one-on-one at our clinic at 78 Main Street Suite 3, Madison NJ. Tailbone pain is very treatable when you address the entire pelvic system rather than just the coccyx itself. Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.