by Gary Vitti
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On January 8th Rotoworld has listed Los Angeles Lakers center-forward Anthony Davis with an injury to the tailbone. I have no direct knowledge of his injury but I will tell you what I know about tailbone injuries ( coccydynia or coccygodinia ).

The tailbone in anatomy is called the coccyx from the Greek word cuckcoo, because it resembles the beak of a cuckoo bird. It is a triangular structure made up of the three to five bones at the end of the spine. These bones fuse together to form one bone ( sometimes the first bone does not fuse ) to establish a joint with the sacrum. There is only slight movement at this joint known as an amphiarthrodial joint. The coccyx serves as an attachment point for ligaments, the gluteus maximus and several pelvic floor muscles which help with balance in the sitting position.

Women are five times more likely to have coccyx pain because the female pelvis is broader for childbearing leaving the coccyx more exposed. There are also cases of coccyx injury associated with childbirth. In sports, coccyx injuries occur most often to a fall in the seated position or a direct blow to the coccyx. The injury is usually classified as a contusion but dislocation and fracture should be ruled out with imaging in both the standing and seated position.

There is significant acute pain described as anywhere from a deep ache to the sensation of sitting on a knife. There are four categories of coccyx curvature and because the coccyx curves under and forward the pain may worsen with prolonged sitting. A coccygeal cushion that supports the buttocks but has a cutout to take the pressure off of the coccyx will help. There may also be pain in the lower extremity or back.

In my experience, all of the coccydinia episodes got better with conservative therapies but there are cases that require manual manipulation or surgery.

Manual manipulation is generally done through the rectum to adjust the joint between the coccyx and the sacrum to reduce pain caused by inadequate coccyx mobility.

Surgery is generally required if there is hyper-mobility of one or more of the coccyx bones or there is a sharp-pointed new bone growth ( spicule ) on the coccyx that must be removed
( coccygectomy ).

Physical therapy will include flexibility and strengthening exercises. Stretching the piriformis, iliopsoas and the glutes will help manage and prevent tailbone pain. The therapist will also include Kegals and other resistance exercises to increase core strength to provide pelvic stability.

A relatively mild bruise should resolve itself in just a few days. An athlete with a severely contused pelvis should avoid high impact exercises and prolonged sitting with resolution in four weeks or less. The average time for coccyx fracture requiring surgery is approximately twelve weeks.

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izzi April 1, 2020 - 11:43 am

Very good info. Lucky me I discovered your site by accident (stumbleupon). I have saved it for later!


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