Can You Walk with a Fractured Tailbone? (+ Physio’Tips)

How to know if you’ve really broken your tailbone (coccyx)?

The tailbone is the bone at the very bottom of your spine. It’s a small bone composed of 3 to 5 fused vertebrae, located just below the sacrum.

Like any bone, it can break. In this case, it’s referred to as a coccyx fracture (broken tailbone) or more generally, a fracture in the pelvic region or pelvic fracture.

This can include fractures of the pelvis, sacrum, ilio-pubic or ischio-pubic branches, and more.

What are the common causes of a tailbone fracture?

In the vast majority of cases, the tailbone is broken due to a fall on the buttocks, for example:

• Slipping on ice (living in French Alps❄️, as a physical therapist, I saw people of all ages experiencing this every year);
• Engaging in sports, particularly snowboarding, skating, or cycling (again, in Savoie, we are familiar with these activities 🏂🏻🚴‍♀️⛸️!);
• Car accidents, where there are often other associated fractures in the pelvis, back, legs, arms, or rib fractures;
• During childbirth.

Tailbone fractures occur almost three times more often in women than in men, especially after menopause, mainly because bones are more fragile due to osteoporosis. In men, they occur more often during puberty, as there is more risky activity at that age.

However, falling on the buttocks and experiencing pain in the coccyx area are not sufficient to diagnose a coccyx fracture.

Source: Won 2020

What are the symptoms of a tailbone fracture?

Here are the most common signs of a broken tailbone:

• Pain: You may experience intense pain in the lower back region, just above the tailbone. The pain can increase when you move, sit, or when pressure is applied to the tailbone. It can also be significant when you sit for a while and then stand up.
• Disturbed sensitivity: You may feel tingling sensations in the area. Or when you touch this area, it can trigger different sensations than usual, either diminished or, on the contrary, hypersensitive in that area.

How is the diagnosis of a tailbone fracture made?

If you consult for your tailbone pain, your doctor will ask you questions and conduct an examination. They may prescribe an X-ray (physical therapists cannot prescribe X-rays) if there is doubt about the presence of a tailbone or sacrum fracture or crack.

However, an X-ray is not always prescribed, for at least these 3 reasons:

1. Fractures of the tailbone are not always visible on an X-ray.
2. Even if a fracture is visible, in the vast majority of cases, it will not change anything in the treatment and what you can do afterward.
3. X-rays are not without risk, and if they can be avoided, it’s better.

You may sometimes be frustrated about not having had an X-ray and not knowing exactly what you have. In such cases, don’t hesitate to discuss it with your doctor so that they can reassure you and explain why, in your case, the X-ray was really not suitable and would not have changed anything.

MRIs, ultrasounds, and CT scans are even less frequently prescribed because most of the time, they do not provide additional treatment insights.

What type of tailbone fracture are we talking about here?

There are different types of tailbone fractures based on the direction of deformation (flexion, extension, compression, lateral deviation, dislocation, etc.) or whether there is displacement:

1. A tailbone fracture with displacement means that there is a gap of several millimeters (or even centimeters) between the different broken bone ends. These fractures may take longer to heal, especially if they are unstable, meaning that bone fragments move when you move.
2. Tailbone fractures without displacement generally heal faster because the bone fragments are hardly separated.
3. Tailbone cracks generally heal even faster because the bone fragments are not separated at all. There is simply a small crack in the bone, often not across its entire width.

Normally, you will find precise information about the type of fracture you have by looking at your X-ray report. However, this does not change much in terms of what you can do and how long it will take for you to recover.

In this article, I discuss tailbone fractures and cracks in general, with or without displacement.

Source: Maine 2020

How to know if you can walk and how to do it according to the type of fracture?

Even if you have a displaced and unstable coccyx fracture (which is the most “serious” type of fracture), you can, in the vast majority of cases, still walk with a coccyx fracture without the risk of aggravating the fracture.

Why? The coccyx is located at the lower end of the spine, and the body’s weight is mainly distributed on the other pelvic bones rather than directly on the coccyx. The amount of weight supported by the coccyx is relatively low compared to other parts of the body, such as the ankle.

If you have a displaced and unstable fracture, whether operated on or not (which is very rare for a coccyx fracture), your medical team may sometimes recommend not walking for a few weeks, or walking only with crutches to put less weight on the coccyx. But this is very rare.

In most cases, after a coccyx fracture, the only hindrance to walking is the pain, not the risk of delaying consolidation and healing.

Source: Mabrouk 2023

Is it better to walk with or without crutches with broken tailbone?

If you have been given the green light, crutches are only there to relieve your walking pains. If you feel that using them does not help you walk more easily or with less pain, you can certainly do without them.

However, often, putting a little less weight on the legs and a little more on the arms with the help of crutches can alleviate coccyx pain during walking.

Walking is generally recommended after a fracture because it helps:

• Limit the risk of complications related to being largely in a lying or sitting position: thrombosis, constipation, skin problems, muscle wasting, etc.
• Resume your daily activities more quickly.
• Distract yourself.
• Indirectly, potentially relieve pain by changing positions and secreting hormones that promote relaxation.

There is no right or wrong way to walk with crutches in the case of a coccyx fracture: find the one that relieves your pain the most. If needed, ask your physiotherapist to show you different ways to walk with crutches or to go up and down stairs.

How long does it take to walk normally after a fractured tailbone?

It is difficult to predict how long it will take for you to walk perfectly again after fracturing the coccyx.

Since there are no data from clinical studies following the recovery of individuals who have broken their coccyx, I am providing indications based on my experience as a physiotherapist.

Stage	Timeframe
You can walk, but you often experience pain that increases while walking, especially when changing positions. You may need crutches, and you will likely limp.	The same day and in the following days
Pain begins to decrease while walking. You may still feel some discomfort, but you probably won’t need crutches anymore. You can gradually walk outside for longer periods without limping.	Within 1 to 2 weeks
Pain will be even more relieved or absent. If you still feel any discomfort or pain, it’s occasional, not continuous. You can gradually resume activities like running and other more impactful physical or sports activities. You no longer limp.	Within a few weeks to a few months

How to Sit with a Broken Tailbone?

Sitting is often very painful when you have a broken coccyx, similar to walking. However, like walking, it is rare for sitting to be completely restricted.

Here are some tips to alleviate the sitting position:

• Find a more comfortable seat height. Sometimes very high, sometimes very low. This varies from person to person, but depending on the seat height, the pelvic angle is different, and it’s more or less comfortable.
• Make sure both feet are resting on the ground. This helps distribute some weight on the feet so that everything is not concentrated on the buttocks.
• Place several cushions under your buttocks or get cushions with a central opening (= with a hole; available on Amazon) or memory foam cushions without an opening. A donut cushion can also work if you don’t want to buy anything, and these cushions can also be found on second-hand product websites like Leboncoin, in pharmacies, etc.
• Feel free to spend more time lying on your side or in a semi-seated position than usual. Alternating between sitting and walking throughout the day will still engage your muscles and cardiovascular system.

What Is the Total Healing Time for a Tailbone Fracture?

In general, tailbone fractures can take several weeks to several months to fully heal.

Like any bone, the coccyx takes an average of 1.5 to 2 months to begin healing. However, it is possible to gradually resume daily activities long before complete healing occurs!