Massage Therapy

A term heard a lot in this industry, but what does it mean? There are 5 different styles of long, flowing strokes used in traditional Swedish massage: Effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber) and vibration, rocking & shaking. This type of massage is usually used when someone is experiencing pain, joint stiffness, poor circulation, hypertension or tight muscles.

There is no extra Charge for Pregnancy Massage.

Pregnancy Massage Therapy Foundations Course completed

Updated the knowledge and experience with pregnancy massage has improved and new information regarding safe and effective massage techniques for moms-to-be. The new pregnancy system of side lying is now in effect.

So your pregnant; now what?

What’s happening to a pregnant woman’s body?

Blood volume increases 45-50%. This is needed for extra blood flow, perfusion to kidneys and other organs to compensate for blood loss during delivery.

Increased cardiac output by 40% about halfway through gestation. The heart increases in size by 12%.

Blood pressure typically declines slightly; Diastolic decreases after 12 wks and continues to 26 wks, and then increases after the

2nd trimester.

Body temp is 100.6 fahrenheit/38 Celsius.

Full ventilation of lungs diminishes during late pregnancy (pressure of the uterus and displacement of other organs into the area lungs.)

Joints and ligaments become lax due to the hormone Relaxin.

Skeletal muscle has to adapt to the changes in weight, gait and loosening of the joints.

Nipple and areola enlarge and darken, and become more sensitive.

Breast tissue becomes enlarged and tender.

In the first trimester, there may be nausea and vomiting because of the hormonal influx.

Often called “morning sickness” but can occur at various times of day.

In severe cases: Diclectin is administered (vitamin B12 combined with a low dose of Gravol).

More fluid in body increases by 50% which makes the kidneys have to filter more fluid.

Increased urination occurs in the 1st trimester due to hormonal changes and in the 3rd trimester because of pressure on the bladder.

1st TRIMESTER: 1-13 weeks gestation

What’s happening to your body:

Your body is going through changes and a lot of it is because of hormonal changes often leading to fatigue/exhaustion; hormonal changes can cause an increase of urination, and nausea and vomiting are common. In some cases you may experience a dull ache above pubic bone, breast tenderness is typical emotional (mood) fluctuations, constipation, headaches and heartburn.

What to expect in a massage therapy session?

It is important to be reminded that with all the changes that are going on in the body with pregnancy, we need to remember there is a fetus that is developing and growing inside. The uterus is getting bigger which means that the ligaments keeping it supported are being stretched more and more, the increase of fluid including blood flow is occurring, and the word “intrauterine pressure” is now becoming a concern.

Prone Positioning Restrictions: While stomach sleeping may be a safe, comfortable resting position for the early pregnant woman, the pressure necessary for massage in this position creates an unreliably safe situation.

Side-lying positioning: When supported sufficiently with firm pillows, bolsters, and/or a Contoured body Cushion, side-lying position is the safest, most postural neutral, and most comfortable position for most women to receive prenatal massage therapy.

2nd TRIMESTER: 14-27 weeks gestation.

What’s happening to your body:

You will notice that Fatigue/nausea should dissipate (however there are some women who have been known to have nausea throughout their entire pregnancy). You will feel more energetic, weight increase will shift the center of gravity, you will feel the baby move “quickening” for the first time, the uterus reaches umbilicus, baby grows to 1.5lbs, increased strain/fascial restrictions on abdominal muscles and lumbar vertebrae (low back), referred pain from uterine ligaments, frequent urination (due to pressure on bladder), spider veins/varicosities and enlarged uterus can cause changes to blood flow to legs, you will notice you walk different and weight changes will influence your posture in the spine especially cervical (neck), thoracic (mid back) as well as lumbar (low back) spine. Anterior pelvic tilt (your pelvis is tilted forward), you get heartburn (worsens as pressure in abdomen increases), and may experience Braxton Hicks (involuntary contractions of uterus preparing for labour – or false labour).

What to expect from massage therapy session

Positioning:

Prone is contraindicated because it puts strain on ligaments and creates intrauterine pressure, which can put the fetus at risk.

*This is something that is extremely important, especially if considered high risk (increase in intrauterine pressure puts added stress on the pelvic floor); therefore side lying is indicated. Both sides are safe in a healthy pregnancy; left side lying position creates optimal blood flow to fetus. Most woman who hear “side lying only during pregnancy massage” tend to be turned off by this. After hearing the words “increased intrauterine pressure in the prone position” the most important concern is fetal health.

Contraindications and Modifications for 2nd trimester:

(in addition to applicable CI’s from 1st trimester list):

Do not use prone position (reason indicated in positioning). If on bed rest, be cautious in some cases blood clots in legs can occur and consider exhaustion and fatigue.

3rd TRIMESTER: 28-40wks gestation.

This is when fatigue can often return, nausea may return, dramatic weight gain, Symphysis Pubis Separation (SPS) and women often experience sharp, shooting pain, especially when standing from sitting or lying. The pubis can separate, yet does heal postpartum; the bladder is compromised and a shortness of breath is felt (let’s face it, baby is taking a lot of space and your organs have little room anymore). During this trimester the baby will “drop” or lower into position for birth; frequent Braxton hicks’ contractions are likely to occur.

What to expect from massage therapy session

Side lying mainly. The beautiful thing about side lying is the different angles the massage therapist can access, like those the tight muscles in your torso and breast area. Breast massage may be an option,
which both therapists are trained to do, due to increased edema (swelling), massage therapists can help reduce this using lighter pressure, which also feels wonderful for calf cramps due to calcium/magnesium imbalances so massaging the tight muscles in all areas of the body can help relieve the pressure.

Contraindications and Modifications for 3rd trimester:

(in addition to applicable CI’s from 1st and 2nd trimester list):

Do not use prone position (Reason indicated in positioning). If on bed rest, be cautious in some cases as blood clots in legs can occur and consider exhaustion and fatigue.

*The Aortic artery supplies your lower body with blood; the aortic vein brings the blood back to your heart.

** Videos from Body support website**

Contraindications (CI) ^

-Abdominal and sacral massage is compromised of only light strokes or should be avoided, if the risk of miscarriage is present during the 1st trimester.

-Deep massage and facial techniques are CI over the low back during the first trimester.

-Avoid deep massage over varicose veins.

-Massage is CI if a change in blood pressure is noted and if it is combined with other symptoms of preeclampsia.

-If the client has diabetes, a snack or juice should be eaten prior to treatment to maintain blood sugar levels

– In the 2nd and 3rd trimesters, the client must be carefully positioned in a slight incline on her back to avoid compression of the aorta and inferior vena cava. If nausea or discomfort is experienced, despite appropriate modifications, the position is changed to side lying or seated, or the treatment is discontinued.
Resources:

Clinical Massage Therapy; understanding, assessing and treating over 70 conditions, by Rattray and Ludwig

Perinatal Massage Therapy Education; by Michelle Francis-Smit B.A., RMT & Nicole Nifo RMT

Online resource: http://www.massagetherapycanada.com/finance/positioning-concerns-1298
Oakworks inc

There are a lot of clients who enjoy deep tissue massage. Deep tissue doesn’t necessary mean we’re going to show you how strong we are! The basis of this technique is to address the deeper muscles, not to feel pain with massage. Deep pressure should be applied within a person’s pain tolerance. If this technique is too deep, you will react by guarding and contracting your muscles, so you won’t get the benefits of this technique. Trigger point therapy (ischemic compression) and muscle stripping are some
of the techniques our therapists use to reach those deeper structures. Ulnar border kneading (using the forearms instead of hands or thumbs), helps breakdown the tight connective tissue and is a firmer form of deep tissue massage. There are certain situations that heavy deep pressure will be used, consent will be asked before this will take place. Communication is key, if you don’t let your therapist know it hurts, we may not realize the pressure is too much!

There are intra-oral and working muscles of mastication (chewing muscles). Intra-oral can be used however our patients find it a little too invasive. Working externally on the face muscles, especially around the joint itself and jawbone as well as the sub occipitals (tiny muscles located on either side of base of the skull), is where most of our treatment occurs. It is imperative to release the muscles that are playing “tug-a-war” with your jaw.

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