The Link Between Hip Pain, Tailbone Pain, Back Pain, and the Pelvic Floor

Pain in your back, hip, or tailbone is extremely common. Most of us have felt pain in one or more of those areas. There are many causes for pain in these spots, but did you know that pelvic floor dysfunction can be part of the problem?

The pelvic floor is deeply interrelated with your low back, hips, and tailbone. It acts like a sling of muscular support at the bottom of your pelvis, and plays a role in stabilizing your hips and your low back (along with your abdominals, glutes, and deep back muscles). If your pelvic floor isn’t strong enough or coordinated enough to provide the support that it should, your low back and hip joints may take more stress than they need to. They can even get into a feedback loop where poor stabilization at the hips or low back causes the pelvic floor muscles to try even harder to support these regions and end up with trigger points and discomfort. Labral tears in the hip have a particular association with pelvic floor dysfunction.

The tailbone is particularly linked with the pelvic floor muscles, because some of them attach directly to it. Tailbone pain is often related to excessive pelvic floor tension, which pulls on the tailbone and changes how pressure is applied to it when we sit. Working on balancing the pelvic floor muscles is often a key part of solving tailbone pain.

Not every person that has pain in these areas also has dysfunction in the pelvic floor, but it’s worth considering if:

  • You have tried regular orthopedic physical therapy but there are still lingering issues

  • You have coinciding pelvic floor issues like leaking urine, painful sex, excessive urinary urgency/frequency, or pelvic organ prolapse

  • You are also pregnant or postpartum and have likely had more stress to your pelvic floor than the average person

As both an orthopedic specialist and pelvic floor physical therapist I think it’s so important to recognize how different regions of the body interact, and treat the body as an integrated system. We get the best results when we can zoom out and look at the bigger picture for each individual!

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