310 | Tailbone (Coccyx) Pain

[00:00:05] [SPEAKER_00]: Welcome to the Optimal Body Podcast. I'm Dr. Jen.

[00:00:08] [SPEAKER_01]: And I'm Dr. Dom, and we are Doctors of Physical Therapy bringing you the body tips and physical

[00:00:13] [SPEAKER_01]: therapy pearls of wisdom to help you begin to understand your body, relieve your pains

[00:00:17] [SPEAKER_00]: and restrictions, and answer your questions. Along with expert guests, our goal of the

[00:00:21] [SPEAKER_00]: Optimal Body Podcast is really to help you discover what optimal means within your

[00:00:26] [SPEAKER_00]: own body. Let's dive in!

[00:00:29] [SPEAKER_00]: Alright, before we go in, I just have to say, oh my goodness, it has been so

[00:00:32] [SPEAKER_00]: much fun to go through this role into hit program again after already shooting it,

[00:00:37] [SPEAKER_00]: but now actually going through it in real time with people and getting the

[00:00:40] [SPEAKER_00]: feedback that we're getting. It's so much fun.

[00:00:44] [SPEAKER_01]: It's amazing to hear from the people who previously may have been scared of doing

[00:00:48] [SPEAKER_01]: things that they thought were high-intensity workouts or have gotten

[00:00:52] [SPEAKER_01]: pain going upstairs or pain just sitting and standing and the feedback they're

[00:00:56] [SPEAKER_01]: getting already from this program because of the way Jill and Jen educate

[00:01:01] [SPEAKER_01]: through rolling out the body, preparing the tissues and then doing higher

[00:01:05] [SPEAKER_01]: intensity movements and strength movements in a way that are protective to

[00:01:09] [SPEAKER_01]: the joints and are going to help strengthen your body to be able to do

[00:01:13] [SPEAKER_01]: these movements more pain-free.

[00:01:15] [SPEAKER_00]: Exactly. It's not about like most programs that you get, especially in

[00:01:19] [SPEAKER_00]: terms of hit, the modifications are going to be a little limited.

[00:01:22] [SPEAKER_00]: You're probably going to be only seeing the high intense version and then

[00:01:25] [SPEAKER_00]: trying to find a modification on top of that, right? Where we are literally

[00:01:29] [SPEAKER_00]: walking you through everything and you're seeing all different levels working

[00:01:34] [SPEAKER_00]: through it at the same time. So, you know, and based on the assessments that

[00:01:37] [SPEAKER_00]: we have coming into it, you know exactly who you're going to follow.

[00:01:40] [SPEAKER_00]: You know exactly what breathwork like you're ready to kind of dive into

[00:01:45] [SPEAKER_00]: at what intensity for that day.

[00:01:47] [SPEAKER_00]: And it's not about doing it every day.

[00:01:49] [SPEAKER_00]: It's about sprinkling this into your already existing movement so

[00:01:53] [SPEAKER_00]: that it only adds into what you're feeling and how you're moving.

[00:01:57] [SPEAKER_00]: You're going to learn so much from this program.

[00:02:00] [SPEAKER_00]: I'm just, I'm so thrilled that Jill and I really came together and made this.

[00:02:03] [SPEAKER_01]: And we've done podcasts.

[00:02:04] [SPEAKER_01]: I mean, we did one recently with Jill.

[00:02:05] [SPEAKER_01]: We've done podcasts with other people like Dr.

[00:02:08] [SPEAKER_01]: Stacy Sims who just preach and live by all of the benefits that doing

[00:02:12] [SPEAKER_01]: high intensity work as a regular part of your routine can impact and

[00:02:16] [SPEAKER_01]: improve nearly every system of the body.

[00:02:19] [SPEAKER_01]: Exactly. And when you pair that with the tissue work that Jill does,

[00:02:22] [SPEAKER_01]: it just sets you up for success.

[00:02:23] [SPEAKER_01]: It sets you up to move better, to feel better.

[00:02:26] [SPEAKER_01]: And to just have overall a better sense of well being in your body.

[00:02:30] [SPEAKER_01]: So check out the link done in the show notes.

[00:02:32] [SPEAKER_01]: Get into that program and start inserting some more high intensity work

[00:02:37] [SPEAKER_01]: into your daily routine.

[00:02:39] [SPEAKER_00]: Tailbone pain also known as coccyx pain or coxidinia.

[00:02:45] [SPEAKER_01]: Coxidinia.

[00:02:46] [SPEAKER_01]: I read it somewhere.

[00:02:48] [SPEAKER_01]: Dom's making up words.

[00:02:49] [SPEAKER_01]: I read it.

[00:02:49] [SPEAKER_01]: It was in a research study.

[00:02:52] [SPEAKER_01]: Okay.

[00:02:54] [SPEAKER_00]: And anyways,

[00:02:56] [SPEAKER_01]: Some smart scientists wrote that in that journal.

[00:02:59] [SPEAKER_00]: This is fairly common, especially if you sit pro long periods of time.

[00:03:04] [SPEAKER_00]: So we want to definitely address it.

[00:03:07] [SPEAKER_00]: This has actually been requested as well.

[00:03:09] [SPEAKER_01]: Yeah.

[00:03:09] [SPEAKER_01]: I mean, it's a topic that I don't feel like is the first thing

[00:03:12] [SPEAKER_01]: that pops into people's mind.

[00:03:13] [SPEAKER_01]: But if you are ever somebody who has tailbone pain or has sensitivity

[00:03:17] [SPEAKER_01]: in your tailbone area when you're sitting, do you notice it?

[00:03:21] [SPEAKER_01]: And you notice just how much we sit and how we sit every day.

[00:03:25] [SPEAKER_01]: I've never had tailbone pain specifically, but I've had what's called a

[00:03:30] [SPEAKER_01]: pylodenocyst, which is a cyst like right in the tailbone area.

[00:03:34] [SPEAKER_01]: And that caused a lot of pressure and a lot of discomfort.

[00:03:37] [SPEAKER_01]: And I really struggled sitting comfortably for a while until I got that taken care of.

[00:03:43] [SPEAKER_00]: Well, you got it taken care of.

[00:03:45] [SPEAKER_00]: And then we went on a big road trip.

[00:03:46] [SPEAKER_01]: Yeah, I actually got it taken.

[00:03:48] [SPEAKER_01]: I got it removed.

[00:03:49] [SPEAKER_01]: But two days before we drove across the country and spent a few days.

[00:03:54] [SPEAKER_01]: Perfect timing.

[00:03:55] [SPEAKER_01]: Spent a few days in Colorado and yeah.

[00:03:58] [SPEAKER_00]: Yeah, everywhere.

[00:03:59] [SPEAKER_00]: I know.

[00:04:02] [SPEAKER_01]: So I just need to pause quick to talk about one of our podcast sponsors.

[00:04:05] [SPEAKER_01]: And that is Element, which is Jen and my absolute favorite

[00:04:08] [SPEAKER_01]: electrolyte drink mix that helps keep us hydrated throughout the day.

[00:04:11] [SPEAKER_01]: One, by drinking a lot more water because the element is just so darn delicious.

[00:04:15] [SPEAKER_01]: But two, by replenishing the electrolytes that we're losing throughout the day,

[00:04:20] [SPEAKER_01]: like sodium, potassium and magnesium.

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[00:04:30] [SPEAKER_01]: Everyone loves this grapefruit flavor.

[00:04:32] [SPEAKER_01]: Every time we talk about it, people are like, oh, I got to go get my element.

[00:04:36] [SPEAKER_01]: But all their flavors are so incredible.

[00:04:37] [SPEAKER_01]: Jen's favorite is the raspberry.

[00:04:39] [SPEAKER_01]: I kind of waffle between the watermelon and the citrus.

[00:04:43] [SPEAKER_01]: But these electrolytes are so much more important than we think.

[00:04:47] [SPEAKER_01]: They help us.

[00:04:48] [SPEAKER_01]: So many vital processes within the body like production of energy,

[00:04:52] [SPEAKER_01]: contraction of our muscles.

[00:04:54] [SPEAKER_01]: They can help with brain fog and fatigue.

[00:04:56] [SPEAKER_01]: They can help us with our sleep, with our digestion.

[00:04:59] [SPEAKER_01]: So you really want to make sure that you're replenishing these

[00:05:03] [SPEAKER_01]: electrolytes because we lose them in ways that we don't even think

[00:05:06] [SPEAKER_01]: through our urine, through sweat.

[00:05:08] [SPEAKER_01]: Every time we sleep, we're losing electrolytes.

[00:05:11] [SPEAKER_01]: So that's why Jen and I have incorporated this on a daily basis

[00:05:14] [SPEAKER_01]: to make sure we're getting in enough water, but also replenishing

[00:05:17] [SPEAKER_01]: those little electrolytes.

[00:05:18] [SPEAKER_01]: So if you want to go try the grapefruit flavor or make sure you get element

[00:05:21] [SPEAKER_01]: into your daily routine, go down to the link in the show notes.

[00:05:24] [SPEAKER_01]: It's just drinkelement.com backslashoptimal.

[00:05:27] [SPEAKER_01]: That's drinkelementlikelmnt.com backslashoptimal.

[00:05:32] [SPEAKER_01]: And with every single order, you get a free sample pack

[00:05:35] [SPEAKER_01]: so you can try out all their flavors and know which one you want

[00:05:38] [SPEAKER_01]: to try next.

[00:05:39] [SPEAKER_01]: Go get some element and keep yourself hydrated.

[00:05:43] [SPEAKER_00]: And you had something that we're going to talk about.

[00:05:46] [SPEAKER_00]: You were sitting on something to help relieve your pressure.

[00:05:51] [SPEAKER_00]: I was.

[00:05:51] [SPEAKER_01]: What are you talking like that?

[00:05:54] [SPEAKER_01]: Sitting on something to help relieve your pressure.

[00:05:58] [SPEAKER_01]: I was using a cordous ball, which is one of our favorite

[00:06:02] [SPEAKER_01]: like all purpose tools for tissue,

[00:06:06] [SPEAKER_01]: myofascial type release for breath work.

[00:06:09] [SPEAKER_01]: And now I guess we can add relieving tailbone pain or tailbone pressure

[00:06:13] [SPEAKER_01]: to that list.

[00:06:14] [SPEAKER_01]: But it just when I was sitting in the car specifically,

[00:06:16] [SPEAKER_01]: it helped lift my bottom and it helped me putting my pressure

[00:06:20] [SPEAKER_01]: through both my sit bones and just in generally like my upper thighs

[00:06:25] [SPEAKER_01]: and lower buttock and then keep my tailbone off of the seat

[00:06:30] [SPEAKER_01]: where I was having a lot of discomfort,

[00:06:32] [SPEAKER_00]: which is one of the things they say to help with.

[00:06:35] [SPEAKER_00]: So grab yourself a cordous ball because what's also great

[00:06:38] [SPEAKER_00]: about the cordous ball, you can deflate it to what you need it to.

[00:06:42] [SPEAKER_00]: And so you have that ability to make it a little bit smaller.

[00:06:47] [SPEAKER_00]: So it's not so like firm and big.

[00:06:49] [SPEAKER_00]: Yeah.

[00:06:49] [SPEAKER_00]: And so you could have that bigger surface area

[00:06:52] [SPEAKER_00]: across the sit bones, your ischial tubes to be able to sit on.

[00:06:56] [SPEAKER_00]: So that again, it takes that pressure off the tailbone area,

[00:06:58] [SPEAKER_00]: which where's the tailbone, the coccyx?

[00:07:01] [SPEAKER_01]: The coccyx, which means cuckoo birds beak.

[00:07:05] [SPEAKER_00]: Well, it's the Greek word for beak of the cuckoo bird because

[00:07:12] [SPEAKER_00]: of the cuckoo bird, I guess that's what if you're looking at from it

[00:07:16] [SPEAKER_00]: at it from the side, the beak apparently.

[00:07:19] [SPEAKER_00]: That's what the coccyx looks like, which is hilarious.

[00:07:23] [SPEAKER_00]: But anyways, bottom of the start to the episode.

[00:07:26] [SPEAKER_01]: I know this is crazy.

[00:07:27] [SPEAKER_00]: Sorry guys.

[00:07:28] [SPEAKER_00]: This is what it looks like is parents with no sleep

[00:07:30] [SPEAKER_00]: after the third episode in a row.

[00:07:32] [SPEAKER_01]: Yeah, third one we're recording today.

[00:07:34] [SPEAKER_01]: So lucky you.

[00:07:36] [SPEAKER_00]: So if we're looking at the sacrum, which is the bottom portion of our spine.

[00:07:43] [SPEAKER_00]: Yeah, that's the thing.

[00:07:43] [SPEAKER_00]: We're going into our pelvis or your pelvis.

[00:07:46] [SPEAKER_00]: Yeah.

[00:07:46] [SPEAKER_00]: So it's connecting our pelvic bones together and it's

[00:07:49] [SPEAKER_00]: it's this triangle shape in the back with kind of like those,

[00:07:54] [SPEAKER_00]: you know, low back bones now fused together.

[00:07:57] [SPEAKER_00]: And then if we go to the very bottom, we see this little,

[00:08:01] [SPEAKER_00]: this tiny little triangle at the bottom, but it's not necessarily connected.

[00:08:06] [SPEAKER_00]: So it can move forward and backward.

[00:08:07] [SPEAKER_00]: It has that freedom of movement.

[00:08:09] [SPEAKER_00]: It has ligaments that are in and muscles that are connected into it.

[00:08:12] [SPEAKER_00]: And that's called your coccyx.

[00:08:13] [SPEAKER_00]: And so that's why especially sitting for prolonged periods

[00:08:17] [SPEAKER_00]: when you're slumped, you're putting a lot of pressure right into that area.

[00:08:21] [SPEAKER_01]: It is the caboose of the spine brings up the rear.

[00:08:27] [SPEAKER_01]: And yeah, like you said, why do people get coccyx pain or coccidinia?

[00:08:33] [SPEAKER_01]: Direct trauma, like a lot of times gymnasts I know,

[00:08:37] [SPEAKER_01]: or people ice skating or roller-plating.

[00:08:40] [SPEAKER_01]: If you've ever just had your feet go out from under you, land on your buttock.

[00:08:45] [SPEAKER_01]: That's two times using buttock in this episode so early on.

[00:08:49] [SPEAKER_01]: This happened in Minnesota often when people would just first ice over of the winter.

[00:08:55] [SPEAKER_01]: People walk outside and feet go out, land on your butt right on that tailbone.

[00:09:00] [SPEAKER_01]: That can be like a direct acute trauma.

[00:09:02] [SPEAKER_01]: Otherwise direct pressure, like you said, just from sitting,

[00:09:05] [SPEAKER_01]: especially if you sit kind of in slumped back with your pelvis tucked under

[00:09:09] [SPEAKER_01]: and more of a posterior pelvic tilt, you're putting a lot of direct pressure

[00:09:12] [SPEAKER_01]: on your tailbone, which is not where we should really put pressure while we're sitting.

[00:09:16] [SPEAKER_01]: And then there are different internal factors.

[00:09:19] [SPEAKER_00]: I mean, those who have a lot of hypermobility can be prone to getting a lot

[00:09:24] [SPEAKER_00]: of increased pressure back into the tailbone area.

[00:09:27] [SPEAKER_00]: If you have any childbirth trauma when you went through birthing,

[00:09:32] [SPEAKER_00]: that can cause some trauma to the area.

[00:09:34] [SPEAKER_00]: And then there's different like, I know women or females are five times more

[00:09:39] [SPEAKER_00]: likely to have this tailbone pain than men, which I think is interesting.

[00:09:44] [SPEAKER_01]: That's interesting and I wonder if that has to do with pelvic shape

[00:09:47] [SPEAKER_01]: or has something to do with female anatomy.

[00:09:51] [SPEAKER_01]: Childbirth, I'm sure plays into that or just like menstrual cycles

[00:09:55] [SPEAKER_01]: or I wonder if there's anything that really.

[00:09:59] [SPEAKER_00]: But I also look at like a lot of the exercises that women tend to do

[00:10:03] [SPEAKER_00]: a little bit more than men and a lot of it has to do with sitting.

[00:10:07] [SPEAKER_00]: Like I remember even when I was teaching Pilates and a lot of women

[00:10:10] [SPEAKER_00]: might complain about sitting or doing any reclined positioned exercise.

[00:10:17] [SPEAKER_00]: And then there's a lot of exercises where you're kind of putting

[00:10:18] [SPEAKER_00]: a little bit more pressure into that coccyx area during Pilates.

[00:10:23] [SPEAKER_00]: So yoga, Pilates, things that are sitting or maybe putting a little bit

[00:10:27] [SPEAKER_00]: more pressure that could happen.

[00:10:29] [SPEAKER_00]: And then if you have like a suddenly rapid reduced weight loss,

[00:10:34] [SPEAKER_00]: well, you just rapidly lost some ad post tissue within your buttocks as well.

[00:10:39] [SPEAKER_00]: And so now when you're sitting doing exercise, you might be putting

[00:10:44] [SPEAKER_00]: a little more pressure than you're used to in that area.

[00:10:47] [SPEAKER_01]: Yeah.

[00:10:48] [SPEAKER_01]: So I mean, all this to be said, any rapid change in any of these things

[00:10:52] [SPEAKER_01]: that we just mentioned, the amount that you're sitting, the amount

[00:10:55] [SPEAKER_01]: that you're standing in extreme range of emotion, like you said,

[00:10:58] [SPEAKER_01]: with people with hypermobility, that happens because sometimes

[00:11:01] [SPEAKER_01]: and this is a generalization, those people will like stand

[00:11:05] [SPEAKER_01]: in extreme positions, whether it's extreme anterior pelvic tilt

[00:11:08] [SPEAKER_01]: with their hips kind of locked forward or something.

[00:11:11] [SPEAKER_01]: And that causes the tendons to be pulling at that coccyx

[00:11:16] [SPEAKER_01]: that come from the low back and come from the hips and the pelvic floor.

[00:11:21] [SPEAKER_01]: So because of that, you know, you'll have a lot of different pressure

[00:11:25] [SPEAKER_01]: on the pelvic or on the on the tailbone on that coccyx.

[00:11:28] [SPEAKER_01]: The good news is it's 90 percent of people who have tailbone pain

[00:11:33] [SPEAKER_01]: respond really well to conservative treatment

[00:11:36] [SPEAKER_01]: and don't need anything beyond that like injections or,

[00:11:39] [SPEAKER_01]: you know, there are surgeries even for tailbone pain, which

[00:11:43] [SPEAKER_01]: I shouldn't be surprised, but I was kind of surprised.

[00:11:46] [SPEAKER_01]: Like really a coccyctomy.

[00:11:47] [SPEAKER_00]: Hey, depending on the direct trauma that you might have,

[00:11:50] [SPEAKER_00]: I suppose it landed really hard and I spoke.

[00:11:54] [SPEAKER_01]: Yeah, I guess I was just thinking about sitting.

[00:11:56] [SPEAKER_01]: Yeah.

[00:11:56] [SPEAKER_01]: How would a surgery help to then go back to sitting?

[00:11:59] [SPEAKER_01]: Right.

[00:12:00] [SPEAKER_00]: Yeah.

[00:12:00] [SPEAKER_00]: So if you have it not because of, you know, you fell suddenly

[00:12:04] [SPEAKER_00]: or recently, you know, then we want to be looking at the other things

[00:12:08] [SPEAKER_00]: that can help. And this is where pelvic floor physical therapy

[00:12:11] [SPEAKER_00]: actually becomes really powerful as a tool to be able to help

[00:12:16] [SPEAKER_00]: because there are actually mobilizations that you can do to the coccyx

[00:12:21] [SPEAKER_00]: bone and it is a little bit more intimate with your therapist,

[00:12:25] [SPEAKER_00]: but can really help in relieving that immediate pressure

[00:12:30] [SPEAKER_00]: as we're working toward improving mobility around the area

[00:12:34] [SPEAKER_00]: and movement, changing your posture, all that kind of stuff.

[00:12:36] [SPEAKER_01]: Yeah. And it was interesting when we looked at research,

[00:12:38] [SPEAKER_01]: because a lot of the research that surrounded tailbone pain

[00:12:42] [SPEAKER_01]: had to do with these manual therapies because that's one of the providers

[00:12:46] [SPEAKER_01]: main tools to help somebody feel a more immediate change in that pain

[00:12:51] [SPEAKER_01]: is doing either a levator, an eye massage,

[00:12:55] [SPEAKER_01]: which is levator and is one of the muscles in our pelvic floor

[00:12:58] [SPEAKER_01]: doing a coccygeal like manual therapy or manipulation or mobilization,

[00:13:03] [SPEAKER_01]: you know, and it would be kind of comparing these different manual techniques,

[00:13:07] [SPEAKER_01]: which like, OK, that's great.

[00:13:09] [SPEAKER_01]: Again, if somebody rubs your tailbone a little bit and it's in pain,

[00:13:13] [SPEAKER_01]: like we might feel a change and there might be like some minor differences

[00:13:16] [SPEAKER_01]: between those different manual therapies.

[00:13:18] [SPEAKER_01]: But there was also a really cool study that looked at what we were talking about

[00:13:22] [SPEAKER_01]: the pressures that come from the tendons and the muscles that are attached

[00:13:26] [SPEAKER_01]: to the coccyx and if doing mobility or other therapies

[00:13:31] [SPEAKER_01]: like stretches to those areas could help with the tailbone pain.

[00:13:35] [SPEAKER_00]: Yeah. I mean, and going back to that first study, I mean, yes,

[00:13:38] [SPEAKER_00]: it's like it's kind of weak for us, right?

[00:13:40] [SPEAKER_00]: Just looking at massage and mobilization

[00:13:43] [SPEAKER_00]: because it doesn't really include as much movement.

[00:13:46] [SPEAKER_00]: But I think what was cool with that, at least, is that we can see

[00:13:49] [SPEAKER_00]: if we are combining both levator and eye,

[00:13:53] [SPEAKER_00]: which is one of the pelvic floor muscles that connect around into our

[00:13:56] [SPEAKER_00]: coccyx bone, so more of that posterior pelvic floor

[00:14:00] [SPEAKER_00]: in the back.

[00:14:01] [SPEAKER_00]: And if we are doing massage and stretching to that area

[00:14:06] [SPEAKER_00]: that had a greater effect than joint mobilization, which joint mobilization

[00:14:10] [SPEAKER_00]: you have to use a provider massage and stretching, you don't have to use a provider.

[00:14:15] [SPEAKER_00]: You could you can do that on your own.

[00:14:17] [SPEAKER_00]: And we have we usually show this with different tools that we have.

[00:14:21] [SPEAKER_00]: You can use a pelvic wand as well.

[00:14:24] [SPEAKER_00]: You can use one of the therapy balls from Tune Up Fitness,

[00:14:27] [SPEAKER_00]: you know, to kind of get that into that pressure.

[00:14:29] [SPEAKER_00]: And then you could do some specific stretches that will kind of show a little

[00:14:33] [SPEAKER_00]: bit on YouTube as well.

[00:14:34] [SPEAKER_00]: So if you're watching, you can see some of these things.

[00:14:37] [SPEAKER_00]: But those can really help to to take off that pressure from that

[00:14:43] [SPEAKER_00]: tailbone area. And that was actually shown to be a greater effect than joint mobilization.

[00:14:48] [SPEAKER_00]: So I mean, I think that's pretty cool.

[00:14:50] [SPEAKER_01]: Yeah, that's actually a great point that the one that you can do on yourself

[00:14:55] [SPEAKER_01]: had had a better effect than the one that requires a provider.

[00:14:58] [SPEAKER_01]: And that's what we're all about, especially in this podcast,

[00:15:00] [SPEAKER_01]: we want to give you the tools that you can go and have actionable takeaways

[00:15:05] [SPEAKER_01]: for yourself. The other study that talked about doing stretches

[00:15:08] [SPEAKER_01]: and they specifically looked at hip flexor stretches and also thoracic

[00:15:14] [SPEAKER_01]: opening and piriformis stretches, which I think is pretty cool

[00:15:18] [SPEAKER_01]: because piriformis kind of attaches right in on the sacrum

[00:15:21] [SPEAKER_01]: down to the lower part of the sacrum, which is right above that coccyx.

[00:15:25] [SPEAKER_01]: Hip flexor, the thought was that if the hip flexors are,

[00:15:28] [SPEAKER_01]: you know, contributing to more standing and anterior pelvic tilt,

[00:15:33] [SPEAKER_01]: same with the thoracic opening, they thought if we aren't

[00:15:37] [SPEAKER_01]: standing with good posture, is that causing us to put more pressure

[00:15:40] [SPEAKER_01]: in the tailbone area? And they actually found that doing

[00:15:44] [SPEAKER_01]: stretches and exercises for these areas resulted in better posturing

[00:15:49] [SPEAKER_01]: and sitting in standing position, so they weren't putting as much pressure

[00:15:53] [SPEAKER_00]: on the tailbone area. Yeah, some more pain-free sitting.

[00:15:56] [SPEAKER_00]: I mean, that's the goal, right?

[00:15:58] [SPEAKER_00]: It ultimately is what someone wants to feel.

[00:16:00] [SPEAKER_00]: So and I think that just cool study in terms of like, let's not look

[00:16:04] [SPEAKER_00]: directly at the area, but let's look at what if we make changes around

[00:16:08] [SPEAKER_00]: the area and how that can actually cause an effect.

[00:16:12] [SPEAKER_00]: And again, especially if we're looking at static stretches,

[00:16:15] [SPEAKER_00]: they did this for two minutes on each side.

[00:16:19] [SPEAKER_00]: So think of a hip flexor stretch, two minutes on each side,

[00:16:21] [SPEAKER_00]: and they did that five times a week.

[00:16:23] [SPEAKER_00]: So it has to be something long-term.

[00:16:26] [SPEAKER_00]: It has to be sustained for a long period of time.

[00:16:29] [SPEAKER_00]: They have to do it repetitively over and over again

[00:16:32] [SPEAKER_00]: in order to start to see any kind of benefited result.

[00:16:36] [SPEAKER_00]: But in doing that, they did see a result.

[00:16:38] [SPEAKER_00]: So I think that's really cool to just keep in mind.

[00:16:40] [SPEAKER_00]: And this comes back to our own recommendations of, you know,

[00:16:43] [SPEAKER_00]: kind of assessing our posture.

[00:16:46] [SPEAKER_00]: We have to look at the upper back and the thoracic spine, the rib cage,

[00:16:50] [SPEAKER_00]: because how my rib cage is resting really is going to dictate

[00:16:55] [SPEAKER_00]: where my pelvis is underneath it.

[00:16:58] [SPEAKER_00]: Then, you know, it kind of just like plays off of one another.

[00:17:01] [SPEAKER_01]: I love the post that was it Katie?

[00:17:03] [SPEAKER_01]: Yeah, Katie's and Katie had one where she had a rib cage

[00:17:05] [SPEAKER_01]: and a pelvis and like put glasses on them and was doing

[00:17:08] [SPEAKER_01]: like this little skit where everyone blames the pelvis.

[00:17:10] [SPEAKER_01]: Oh, air-tiered pelvic tilt.

[00:17:11] [SPEAKER_01]: Oh, posterior pelvic tilt.

[00:17:13] [SPEAKER_01]: Pelvis is fault.

[00:17:13] [SPEAKER_01]: Why are you doing everything wrong, pelvis?

[00:17:15] [SPEAKER_01]: And the rib cage is hanging out over here like

[00:17:18] [SPEAKER_01]: people aren't blaming me.

[00:17:20] [SPEAKER_01]: But like you said, if we're not paying attention to our rib cage,

[00:17:22] [SPEAKER_01]: it's hard to complete that equation

[00:17:24] [SPEAKER_01]: because they work so much in tandem with each other.

[00:17:27] [SPEAKER_00]: Exactly.

[00:17:28] [SPEAKER_00]: So a lot of times when people do find themselves

[00:17:31] [SPEAKER_00]: standing in a little bit more anterior pelvic tilt,

[00:17:34] [SPEAKER_00]: well, let's look again at the rib cage.

[00:17:36] [SPEAKER_00]: Typically sometimes it's then flared and it's forward.

[00:17:40] [SPEAKER_00]: And when we're trying to correct our posture

[00:17:43] [SPEAKER_00]: and pull our shoulder blades back,

[00:17:44] [SPEAKER_00]: but we're actually flaring that rib cage.

[00:17:46] [SPEAKER_00]: So when we flare that rib cage,

[00:17:47] [SPEAKER_00]: then the pelvis is gonna respond by tipping forward as well.

[00:17:51] [SPEAKER_00]: So, you know, we have to then say,

[00:17:54] [SPEAKER_00]: okay, how can I get that better rib cage mobility

[00:17:56] [SPEAKER_00]: out to the sides, which we talk about a lot?

[00:17:59] [SPEAKER_00]: Grabbing the sides of your rib cage,

[00:18:01] [SPEAKER_00]: doing some intentional breaths to kind of open it up

[00:18:04] [SPEAKER_00]: and allow it.

[00:18:05] [SPEAKER_00]: And when you do those intentional breaths

[00:18:07] [SPEAKER_00]: into the side of your rib cage,

[00:18:08] [SPEAKER_00]: you naturally start to stack over your pelvis.

[00:18:11] [SPEAKER_00]: Like your pelvis, you're going to do this in standing,

[00:18:14] [SPEAKER_00]: do it in standing right now.

[00:18:15] [SPEAKER_00]: I don't care where you are, I'm just kidding.

[00:18:17] [SPEAKER_00]: When you get a chance,

[00:18:19] [SPEAKER_00]: stand, grab your hands around your rib cage,

[00:18:22] [SPEAKER_00]: do some really big breaths into the size of your hands

[00:18:25] [SPEAKER_00]: and you're gonna feel what happens on your pelvis.

[00:18:27] [SPEAKER_00]: It's gonna naturally stack underneath your rib cage.

[00:18:30] [SPEAKER_01]: Yeah, it's hard to avoid that.

[00:18:31] [SPEAKER_01]: And when I think about that study

[00:18:32] [SPEAKER_01]: where they talked about doing the stretches

[00:18:34] [SPEAKER_01]: and doing the thoracic opening

[00:18:35] [SPEAKER_01]: and doing the piriformis stretch,

[00:18:37] [SPEAKER_01]: especially if those people were aware

[00:18:39] [SPEAKER_01]: that this was because of tailbone pain

[00:18:42] [SPEAKER_01]: or positioning and stuff,

[00:18:44] [SPEAKER_01]: it's hard for them not to also be thinking about,

[00:18:46] [SPEAKER_01]: okay, this is position related.

[00:18:48] [SPEAKER_01]: So then when they're going to sit or going to stand,

[00:18:51] [SPEAKER_01]: that's also in their mind like,

[00:18:52] [SPEAKER_01]: okay, I've been doing these stretches

[00:18:53] [SPEAKER_01]: for two minutes a day, five days a week.

[00:18:56] [SPEAKER_01]: I have to be a little more aware.

[00:18:58] [SPEAKER_01]: And this is what we're talking about right now.

[00:19:00] [SPEAKER_01]: If you're somebody who sits for long periods

[00:19:02] [SPEAKER_01]: or stands for long periods, especially for work,

[00:19:05] [SPEAKER_01]: you really wanna start tuning into that.

[00:19:08] [SPEAKER_01]: If you have pain in your tailbone or pain anywhere else,

[00:19:11] [SPEAKER_01]: you know, our body's not built to stand

[00:19:13] [SPEAKER_01]: or sit in one sustained position

[00:19:16] [SPEAKER_01]: for a long period of time.

[00:19:18] [SPEAKER_01]: So the rib cage breath is incredible

[00:19:20] [SPEAKER_01]: because even if you come back to that once or twice an hour

[00:19:24] [SPEAKER_01]: if you're working and you can't move a ton

[00:19:26] [SPEAKER_01]: and you come back to that rib cage breath

[00:19:28] [SPEAKER_01]: and you do some pelvic tilts,

[00:19:30] [SPEAKER_01]: the next thing I was gonna say is like

[00:19:31] [SPEAKER_01]: the classic cat cow,

[00:19:33] [SPEAKER_01]: like get down on your hands and knees, do a cat cow.

[00:19:37] [SPEAKER_01]: Get seated in your work chair,

[00:19:38] [SPEAKER_01]: do a seated kind of cat cow or pelvic tilt.

[00:19:42] [SPEAKER_01]: Stand if you stand at a standing desk,

[00:19:44] [SPEAKER_01]: do some pelvic tilts.

[00:19:46] [SPEAKER_01]: And it just helps bring that awareness to,

[00:19:48] [SPEAKER_01]: okay, how am I positioning myself?

[00:19:50] [SPEAKER_01]: Find that pelvic neutral-ish.

[00:19:53] [SPEAKER_01]: It's not super important

[00:19:54] [SPEAKER_01]: that you stand in a perfectly stacked position

[00:19:57] [SPEAKER_01]: but if you bring that awareness,

[00:19:59] [SPEAKER_01]: take one of the rib cage breaths

[00:20:01] [SPEAKER_01]: and then get back to work.

[00:20:02] [SPEAKER_01]: You're gonna be doing your brain

[00:20:04] [SPEAKER_01]: and your pelvis and tailbone a massive help.

[00:20:07] [SPEAKER_00]: Yeah, exactly.

[00:20:08] [SPEAKER_00]: I think that's so incredibly important.

[00:20:10] [SPEAKER_00]: And when we just start to improve our thoracics

[00:20:15] [SPEAKER_00]: or our upper spine mobility in general,

[00:20:17] [SPEAKER_00]: it's gonna help us to not be so slumped,

[00:20:19] [SPEAKER_00]: put so much pressure.

[00:20:21] [SPEAKER_00]: It's gonna take pressure off of our pelvis as well

[00:20:25] [SPEAKER_00]: because we're gonna automatically

[00:20:26] [SPEAKER_00]: be standing up a little bit straighter.

[00:20:27] [SPEAKER_00]: When we improve our hip mobility,

[00:20:29] [SPEAKER_00]: it's gonna take different pressure.

[00:20:31] [SPEAKER_00]: So not only hip flexor,

[00:20:32] [SPEAKER_00]: but in general your entire hip mobility,

[00:20:35] [SPEAKER_00]: you're from your glutes to your pelvic floor

[00:20:37] [SPEAKER_00]: to your rotation of the hips, your joints.

[00:20:40] [SPEAKER_00]: Like all of that, if we help to improve the way

[00:20:44] [SPEAKER_00]: that that moves,

[00:20:45] [SPEAKER_00]: it's just gonna be resting in a state

[00:20:47] [SPEAKER_00]: that feels a little bit more relaxed for your body

[00:20:50] [SPEAKER_00]: and isn't putting as much strain and tension

[00:20:52] [SPEAKER_00]: in different areas like your tailbone.

[00:20:54] [SPEAKER_00]: So I think like all those are so important.

[00:20:56] [SPEAKER_01]: Yeah, and we kind of mentioned already

[00:20:58] [SPEAKER_01]: the pelvic floor, how vital this is to the component.

[00:21:01] [SPEAKER_01]: I realize we've been talking about this

[00:21:03] [SPEAKER_01]: and I'm just sitting here like a slob

[00:21:05] [SPEAKER_01]: resting into my tailbone.

[00:21:08] [SPEAKER_01]: That would be it.

[00:21:09] [SPEAKER_01]: And I'm not.

[00:21:09] [SPEAKER_01]: Okay, there's a gymnast sitting there with like

[00:21:14] [SPEAKER_01]: a robot final setup.

[00:21:16] [SPEAKER_01]: The pelvic floor is so vital

[00:21:17] [SPEAKER_01]: because the levator aint night

[00:21:19] [SPEAKER_01]: and other muscles attach right into that tailbone.

[00:21:24] [SPEAKER_01]: So if we're not breathing effectively,

[00:21:25] [SPEAKER_01]: if we're always holding tension in that pelvic floor,

[00:21:28] [SPEAKER_01]: if we're not allowing it to just relax

[00:21:30] [SPEAKER_01]: and then tighten with our breath throughout the day,

[00:21:33] [SPEAKER_01]: again, we might be putting some unbalanced pressure there.

[00:21:36] [SPEAKER_01]: So like you mentioned,

[00:21:37] [SPEAKER_01]: doing some of the pelvic floor reset slash releases

[00:21:41] [SPEAKER_01]: or awareness exercises

[00:21:42] [SPEAKER_01]: with like the tune up fitness balls

[00:21:45] [SPEAKER_01]: are an amazing place to start

[00:21:46] [SPEAKER_01]: because it brings that awareness.

[00:21:48] [SPEAKER_01]: And then while you're doing some of these other exercises

[00:21:51] [SPEAKER_01]: doing one of those rib cage breaths,

[00:21:53] [SPEAKER_01]: I bet you your pelvic floor will start to kick in

[00:21:56] [SPEAKER_01]: and work for you a little bit more as well.

[00:21:58] [SPEAKER_00]: So important to address the pelvic floor too

[00:22:00] [SPEAKER_00]: because things that people don't like to mention

[00:22:03] [SPEAKER_00]: or talk about is pain with sex and pain with pooping.

[00:22:09] [SPEAKER_00]: These are all very important.

[00:22:11] [SPEAKER_00]: And if you are having any difficulties

[00:22:14] [SPEAKER_00]: with any of that or constipation,

[00:22:17] [SPEAKER_00]: we can't just be looking at the foods we're eating.

[00:22:19] [SPEAKER_00]: We also have to be looking at the pelvic floor tension

[00:22:22] [SPEAKER_00]: and tightness.

[00:22:23] [SPEAKER_00]: And this is where I will say

[00:22:24] [SPEAKER_00]: that going to see a pelvic floor therapist

[00:22:26] [SPEAKER_00]: and just starting to understand what muscles

[00:22:29] [SPEAKER_00]: and where on your pelvic floor you're having a lot of tension

[00:22:32] [SPEAKER_00]: because this is an area that we can't easily touch ourselves

[00:22:36] [SPEAKER_00]: and we're not as familiar.

[00:22:38] [SPEAKER_00]: So getting that feedback from a professional to say,

[00:22:40] [SPEAKER_00]: oh, do you feel that?

[00:22:42] [SPEAKER_00]: Oh yeah, that's super tense.

[00:22:43] [SPEAKER_00]: Here's what you can do for that area, right?

[00:22:45] [SPEAKER_00]: And then you start to have the tools

[00:22:48] [SPEAKER_00]: to implement to cause those better relaxation.

[00:22:51] [SPEAKER_00]: Again, if we're talking on the outer pelvic floor

[00:22:54] [SPEAKER_00]: to touch, that's where we can use our fingers

[00:22:57] [SPEAKER_00]: or we can use the therapy balls from Tune Up Fitness.

[00:23:01] [SPEAKER_00]: And I love doing that to just put that feedback into there.

[00:23:05] [SPEAKER_00]: We could use the pelvic wands depending on again,

[00:23:08] [SPEAKER_00]: how deep you need to go based on what you find

[00:23:11] [SPEAKER_00]: from the pelvic floor therapist

[00:23:13] [SPEAKER_00]: and tensions in the area.

[00:23:14] [SPEAKER_00]: It's just so important.

[00:23:16] [SPEAKER_00]: And then we can work on specific stretches

[00:23:18] [SPEAKER_00]: but you don't have to be in pain in these areas.

[00:23:22] [SPEAKER_00]: You don't always have to be constipated

[00:23:24] [SPEAKER_00]: and dealing with this.

[00:23:25] [SPEAKER_00]: If those are things that you're always dealing with,

[00:23:28] [SPEAKER_00]: I would say go see a pelvic floor therapist.

[00:23:31] [SPEAKER_01]: Yeah, and then really the last thing on our list

[00:23:34] [SPEAKER_01]: is just move more.

[00:23:36] [SPEAKER_01]: You know, generally I'd say for a large number of people,

[00:23:41] [SPEAKER_01]: the tailbone pain is coming from sitting consistently

[00:23:45] [SPEAKER_01]: in one position throughout the day too much

[00:23:47] [SPEAKER_01]: or for too long periods or standing in one position

[00:23:51] [SPEAKER_01]: or just again, those muscles pulling at that tailbone

[00:23:54] [SPEAKER_01]: in a way that is unbalanced

[00:23:57] [SPEAKER_01]: or puts too much pressure in the tailbone area.

[00:24:00] [SPEAKER_01]: So moving more, having more variation

[00:24:02] [SPEAKER_01]: in our movement throughout the day.

[00:24:03] [SPEAKER_01]: If we do work in a standing or sitting position

[00:24:06] [SPEAKER_01]: for long stretches, force yourself to come back

[00:24:09] [SPEAKER_01]: to some of those exercises that we talked about,

[00:24:11] [SPEAKER_01]: whether it's the breath, whether it's pelvic tilts,

[00:24:15] [SPEAKER_01]: doing a chest opener on the wall,

[00:24:17] [SPEAKER_01]: anything to just have a little more variation

[00:24:20] [SPEAKER_01]: in that movement for 30 seconds

[00:24:22] [SPEAKER_01]: and then getting back to work.

[00:24:25] [SPEAKER_01]: Well, there we go, kind of our review

[00:24:27] [SPEAKER_01]: on tailbone pain or coxidinia.

[00:24:30] [SPEAKER_01]: If you enjoyed that, please consider sharing with a friend

[00:24:32] [SPEAKER_01]: or leaving us a rating and review

[00:24:34] [SPEAKER_01]: on your favorite podcasting platform.

[00:24:36] [SPEAKER_01]: And remember we have the role into hip program

[00:24:38] [SPEAKER_01]: that Jen collaborated on with Jill Miller

[00:24:41] [SPEAKER_01]: who is actually one of the co-founders

[00:24:42] [SPEAKER_01]: of Tune Up Fitness, which in this episode

[00:24:45] [SPEAKER_01]: we talked a lot about their balls and tools

[00:24:47] [SPEAKER_01]: which are our favorites to use on our body.

[00:24:49] [SPEAKER_01]: And those tools are gonna be used a lot

[00:24:51] [SPEAKER_01]: in the role into hip program.

[00:24:53] [SPEAKER_01]: So go check out the link in the show notes

[00:24:55] [SPEAKER_01]: to get signed up for the role into hip program.

[00:24:57] [SPEAKER_01]: And of course we'll see you next time

[00:24:58] [SPEAKER_01]: on the Optimal Body Podcast.