Why Sit-Ups Hurt Your Tailbone (and What to Do Instead)

Tailbone Pain From Sitting or Sit-Ups? Why Your Coccyx Hurts — and What to Do Instead

Have you felt sharp tailbone pain during or after sit-ups?

Have you ever said, “my tailbone hurts” after a workout or after prolonged sitting?

That pain is not normal.

And you don’t have to push through it.

In this blog you’ll learn:

• What is happening at your coccyx

• Why doing sit-ups hurt your tailbone

• Why prolonged sitting can irritate this area

• What safer, more effective core work looks like

• Exercises to relieve tailbone pain

If you want support now, read more about our pelvic floor physical therapy services in Oakland:

What Is Tailbone (Coccyx) Pain?

Your “tailbone” is technically called the coccyx.

The coccyx is a small bone at the base of your sacrum — the very end of your spine inside your pelvis.

It’s unique because it is one of the only bones in the body that is essentially suspended within soft tissue — specifically the pelvic floor muscles.

Because of that, pelvic floor tone and coordination often dictate whether this area becomes painful.

If your pelvic floor is:

• Overactive

• Guarded

• Poorly coordinated

• Or strained

You are more likely to develop tailbone pain from sitting, exercise, or repetitive spinal flexion.

Why Doing Sit-Ups Hurt Your Tailbone

When you perform repetitive spinal flexion (rounding your spine) like traditional crunches or sit-ups, you increase pressure at the base of the pelvis — including the coccyx.

That compression can lead to:

• Tailbone pain during exercise

• Tailbone pain after workouts

• Irritation with prolonged sitting afterward

• Pelvic floor over-recruitment or weakness

Sit-ups can also increase downward pressure into the pelvic floor. If that system is already tight or dysfunctional, the coccyx becomes more sensitive.

If you already have:

• Bowel or bladder dysfunction

• Pain with intercourse

• History of pelvic trauma

• Falls directly onto your tailbone

• Chronic low back pain
  
  

You may be predisposed to coccyx pain.

If doing sit ups hurt your tailbone, it is a signal — not a weakness.

Why Prolonged Sitting Can Cause Tailbone Pain

If you notice tailbone pain while sitting, especially after long workdays, this may be why:

When you sit:

• Your pelvis often “tucks under”

• Your lumbar spine flexes

• Direct pressure loads the coccyx

• The pelvic floor may stiffen and experience decreased blood flow

Over time, prolonged sitting tailbone pain can develop from repetitive compression and reduced movement variability.

Often the issue is not just “tight hamstrings” or “weak abs.”

It may include intra-abdominal pressure and pelvic floor coordination issues.

Core Is More Than Your Abs

Most people think the core is just the “six pack abs” (rectus abdominis).

Functionally, that muscle mostly creates spinal flexion — which explains why crunches became popular.

But your true core is deeper.

It includes:

• The respiratory diaphragm (top)

• The pelvic floor (bottom)

• The transverse abdominis (sides)

Together, these muscles create a three-dimensional pressure canister.

The primary job of this system is to:

• Manage intra-abdominal pressure (the contents inside your abdominal walls)

• Absorb load when you bend forward, squat, rotate, reach, jump, etc.

• Stabilize the spine by maintaining its elongation

• Stabilize the pelvis so the hips can move well and get strong

Think about your abdominal cylinder as a pressurized soda can. If you are constantly flexing your spine without coordinated abdominal pressure management, including breathing practices, you essentially “kink the can” and strain your spine and pelvic floor.

Before strengthening aggressively, you need coordination.

At Bodyful, both of us are students of Dynamic Neuromuscular Stabilization (DNS), a developmental kinesiology approach to exercise training that treats the core as a pressure system that prioritizes optimal breathing patterns.

Exercise to Relieve Tailbone Pain (Without Compressing Your Low Back)

If your tailbone hurts, here are more functional core options that reduce direct coccyx pressure:

1. Crawling Patterns

Crawling integrates:

• Breath

• Thoracic rotation

• Hip and pelvic stability

• Deep core activation

All without loading the tailbone before it is ready for load.

2. Quadruped Hovers

From all fours, lift your knees slightly while maintaining neutral spine.
This activates deep core musculature and decompresses your coccyx.

3. Bird Dogs

Extend opposite arm and leg from hands-and-knees.
This challenges coordination and stability without spinal flexion.

4. Side Planks

Strengthens obliques and glutes in neutral spine and gently loads your tailbone if you are breathing properly. May be performed on your hand or elbow.

5. Dead Bugs

On your back, stabilize in neutral and alternate arm/leg extension.
This promotes coordination without direct coccyx loading.

With every core exercise, you must still breathe into the canister.

If you are unsure what that means, a pelvic floor PT can clarify quickly.

4 Modifications for Immediate Tailbone Pain Relief

If your tailbone hurts right now:

1. Modify Activity

Do not stop moving — adjust how many repetitions you practice, go slower, reduce resistance, or make it a smaller movement.
Pain often reflects reduced movement options and is your body’s request for something different. Small variations can reduce nervous system sensitization.

2. Cross Train

Too much repetition or sudden increases in volume that you are not conditioned for may increase sensitivity, strain, and discomfort.
Swimming and walking are often excellent options for tailbone pain from sitting.

3. Find Neutral Pelvis

Align your ribs over pelvis so they are parallel to each other. Breathe in this position and let your breath move all the way to your tailbone. You may need to try this while lying down, feet up, and pelvis elevated slightly by a pillow.
Avoid excessive tucking or gripping of the glutes, abdominal muscles, or pelvic floor.
Full breathing improves pressure distribution and appropriately “loads” the muscles at your tailbone so that they are ready to support your pelvic organs and spine when you are upright.

4. Heat & Gentle Self Massage

Heat over the glutes (10-30 minutes at a time) can relax pelvic floor tension.
Gentle massage ball work is fine — but avoid intense pain and breath holding.

When to See a Pelvic Floor Physical Therapist

If:

• Tailbone pain lasts longer than 4–6 weeks, or you have experienced it before and now it returned

• Sitting is consistently painful

• Exercise triggers coccyx pain

If your symptoms also come with numbness, tingling, and bowel/bladder changes speak with a pelvic health PT or your MD immediately.

Pelvic floor physical therapists are uniquely trained in:

• Integrating your pelvic floor, the muscles that attach to your tailbone, with the body mechanics of your whole movement system

• Abdominal pressure management

• Manual therapy

• Internal pelvic assessment (optional, never required)

Because the coccyx is directly connected to the pelvic floor, internal assessment can sometimes clarify what external treatment cannot. If you have myofascial trigger points in your levator ani, internal pelvic floor PT can help.

At Bodyful Physical Therapy and Wellness in Oakland, CA, you can expect:

• Thorough history taking

• Orthopedic and pelvic PT assessments

• Movement analysis

• A personalized home practice starting day one

• Somatic movement therapy

You Don’t Have to Live With Tailbone Pain

If you’re thinking:

• “My tailbone hurts every time I sit.”

• “Prolonged sitting causes tailbone pain.”

• “Doing sit ups hurt my tailbone.”

• “I need exercise to relieve tailbone pain.”

There is a reason.

And it is treatable.

If you haven’t yet tried comprehensive and holistic pelvic floor physical therapy for tailbone pain, book a free discovery call or schedule an initial evaluation with one of our pelvic health physical therapists in Oakland today!

We’re here to help your body organize differently — not just push through pain.