Can Tailbone Pain Contribute to Stress Incontinence During Pregnancy?
Pregnancy is a time of incredible change — your body is adapting, stretching, and shifting to support your growing baby. But sometimes, those changes can lead to symptoms that don’t always seem related at first glance. One of those surprising connections is tailbone pain and stress incontinence — leaking urine with activities like coughing, sneezing, jumping, or laughing.
Let’s unpack how these two symptoms can be linked, and what you can do to start feeling better.
A Real Example: Tailbone Pain and Leaking During Pregnancy
A pregnant client came to see me with tailbone pain and leaking when she coughed, sneezed, jumped, or skipped rope. She had a history of tailbone injury, and since becoming pregnant, her symptoms had gradually worsened.
She noticed that sitting felt uncomfortable, and she carried a lot of tension in her glutes. Like many active women, she was doing so many things right — Pilates, meditation, relaxation techniques, and strength training. But something still wasn’t clicking.
During our assessment, we discovered a few key patterns that explained her symptoms and guided our plan forward.
How Tailbone Pain Affects the Pelvic Floor
Her posture showed that her pelvis tilted forward, and her low back was arched. This position often lengthens the abdominal wall and makes it harder for the front part of the pelvic floor to activate. Without that balanced engagement, the back of the pelvic floor starts to do too much — creating tension around the tailbone.
Because she stopped doing abdominal exercises during pregnancy, her glutes and pelvic floor were working overtime to stabilize her body. The result? A tight, overactive pelvic floor and tension pulling through the tailbone — both of which can make leaking worse.
We also found tightness in the inward hip rotators, especially on the left. When these small but powerful muscles get tight, they can limit pelvic mobility and contribute to uneven tension across the pelvic floor.
Our Approach: Restoring Balance and Mobility
The goal of treatment was to restore balance — helping the front abdominal wall and inward hip rotators join the conversation again so the pelvic floor could stop overworking.
Here’s what we worked on together:
1. Inward Hip Mobility
We added gentle hip sway movements, 90-90 hip rotations, and back leg lifts to improve hip rotation mobility and activate the inward rotators. These movements helped her hips move more freely, releasing unnecessary tension from the back of the pelvis and tailbone.
2. Core Engagement in Pilates
We refined her Pilates practice to bring awareness back to her deep core muscles. Using the cue:
“Ribs to hips — hug baby to spine as you breathe out.”
This imagery helps engage the transverse abdominis, your deep core stabilizer, and supports a gentle front pelvic floor lift without clenching or bearing down.
3. Abdominal Activation
We progressed her Pilates routine to challenge all abdominal muscle groups, integrating breath and alignment so that the front body could share the load again — taking pressure off the tailbone and pelvic floor.
4. Position Changes
To reduce tailbone pressure, we shifted her meditation and relaxation time from sitting to lying down or side-lying. This simple change can make a big difference in allowing the tailbone muscles to release and recover.
5. Muscle Release
We introduced tennis ball release techniques for the pelvic floor and glutes to improve blood flow and ease muscle tension. This helps create more flexibility and balance across the pelvic floor.
Why This Approach Works
By combining mobility, core alignment, and relaxation, we addressed the root causes of her symptoms — not just the surface tension or leaking.
When the pelvic floor is balanced, the tailbone can relax, and the core can support movement efficiently. This creates a ripple effect throughout the body — less discomfort, more confidence, and better bladder control.
Takeaway for Expecting Moms
If you’re pregnant and experiencing tailbone pain or stress incontinence, know that you’re not alone — and you don’t have to just live with it. These symptoms are often connected through posture, muscle tension, and core balance, and with the right guidance, you can find relief.
A few key reminders:
Avoid sitting for long periods on hard surfaces.
Try gentle hip mobility exercises like hip sways and 90-90 rotations.
Reconnect to your breath and deep core using cues like “ribs to hips” or “hug baby to spine.”
Use a tennis ball release for glutes or pelvic floor muscles if you feel tension
If symptoms persist, working with a pelvic floor physiotherapist can help you personalize your plan and feel confident in your movement again.
Ready to Feel Relief?
If you’re experiencing tailbone pain, tension, or leaking during pregnancy, it’s a sign your body is asking for a bit more support.
I’m Maria Tyumkin, a pelvic floor physiotherapist and health coach, and I help women feel strong, comfortable, and in control throughout pregnancy and beyond. Together, we’ll take a whole-body approach to restore balance, reduce pain, and help you move with confidence.
✨ Let’s create a plan that fits your body and your stage of pregnancy.
📍 Based in Vancouver, BC — available for in-home and online physiotherapy and health coaching sessions.
