The Hooked Coccyx and Spinal Dysfunction

Erik Dalton, Ph.D.

Two of the most devastating and often overlooked spinal dysfunctions are the hooked and side bent coccyx. When this tiny group of bones flexes anteriorly or bends to one side (typically the left), the dural tube tightens. In reported cases, a hooked coccyx has actually shut down central nervous system functioning by changing the shape of the brain and spinal cord’s piezoelectric gel, thus, hindering cerebrospinal fluid flow.

A hooked coccyx.

  • Idiopathic head and low back pain syndromes frequently manifest when a distorted coccyx tugs on the dural tube, causing reverberating tensional forces to travel all the way up to the occiput.
  • Recurrent, persistent headaches may develop when a hooked or side-bent coccyx reciprocally alters the position of the sphenoid bone.
  • Difficulty sitting for any length of time, problems with sex, urination, PMS, bed wetting, digestion and extreme sensitivity to light also raise red warning flags of possible coccyx dysfunction.

Ida Rolf, Ph.D. referred to the coccyx as the “seat of the soul,” and insisted on correcting coccyx disorders during her famous session six of the Rolfing® series. A hooked coccyx can lead to loss of psychological integrity. Reported cases cite severe emotional disturbances in people whose coccyx has been removed or broken off, leaving no anchor for the dura mater. The coccyx has been implicated in clients presenting with functional and structural scoliotic patterns. Through its intimate connection with the sphenoid, excessive dural tension stresses the 11th cranial accessory nerve, which, in turn, shortens specific neck and shoulder muscles, including upper trapezius and sternocleidomastoid. Protective muscle spasm from bilateral dural irritation can cause these neck muscles to compress the C7-T1 area, resulting in Dowager’s humps and osteoarthritic bone degeneration, while one-sided dural torsioning “buckles” the cervicothora! cic vertebrae into a functional scoliotic curve.

A modified version of Rolf’s coccyx technique is demonstrated below.

Sacrotuberous/sacrospinous/lateral sacrococcygeal ligament release.

  • Therapist releases tight right pelvic ligaments by reaching across the body and contacting the left ischial tuberosity with his dominant thumb and sliding up and under attachments at the inferior-lateral sacral border.
  • The therapist’s other thumb braces on top, maintaining sustained superior pressure to release ligaments and gently lift the coccyx from its hooked position. Perform on both sides and recheck for symmetry. Sidebent Coccyx
  • Check the position of the coccyx. If left sidebent, repeat this procedure to short ligaments on the left to restore symmetry
  • Two minutes of light-to-moderate, fast-paced fibroblast-frictioning help promote collagen formation in weak, overstretched ligaments on opposite side.

An important note to therapists treating coccyx dysfunction: always ask the client’s permission to perform this technique due to possible physical and emotional hypersensitivity in the area. Before performing any type of coccyx work, take time to clearly explain what you’re doing and the desired outcome. Addressing a misaligned coccyx can cause a client to become very emotional, due to the vertebra’s direct attachment to the dural membrane through the filum terminale—a long slender connective tissue strand that terminates at the end of the spinal cord. Connective tissues called the filum durae spinalis enclose the end of the spinal cord and attach it to the deep dorsal sacrococcygeal ligament. Low-back, hip and head pain can manifest as the sacrococcygeal ligament anteriorly flexes the coccyx, compressing the sensitive filum terminale. Perform this ligament release work through underwear or draping.

The neck and coccyx are not the only structures affected by adverse dural tension. Therapists regularly deal with clients complaining of chronic generalized low back or sciatic type pain. Myofascial therapy offers only temporary relief for those clients whose dural tube has been distorted by sacroiliac dysfunctions. This condition is easily recognized due to chronic, sympathetic muscle spasm that stubbornly refuses to release. Future upcoming sacroiliac articles will discuss these pain/spasm/pain cycles.

Learn more about the coccyx, spinal dysfunctions and Pain Management at

NEW- Dalton’s Advanced Myoskeletal Techniques textbook. The Freedom From Pain Institute offers therapist continuing education through national seminars, state of the art videos and manuals, and certified home study programs.