Aches, pains, swelling, fatigue are just some of the complaints I hear from pregnant friends and family yet with many of my pregnancy clients looking for a massage as their burgeoning bump starts to overwhelm their daily life it’s the chance to switch off for a couple of hours and some time to relax that draws them in the door. Whatever the reason, these women are choosing to look after THEM selves and this is where our job is to help these women keep their bodies in check during this time and to give them the tools to support their bodies during this time. Let us get them to a place of restorative relaxation but let’s couple this with amazing, targeted treatment that will have a much broader impact on these individuals than relaxation will alone.
Treat your pregnancy client with same skill and attention you given an injured client. Don’t fall into the trap of rolling out a prescribed thoughtless, routine. Assess, plan and target your treatment as even if there is no ‘injury’ there is a myriad of things going on in the body during this time. Targeted soft tissue work is critical to minimising future injury, or dysfunction resulting from postural changes that can bed down during this period. Take a look at the example below of a growing bump and some of the changes that come with it to help this blog come to life and hopefully help you upgrade your pregnancy treatments.
As you can see above, along with a growing bump and a hugely modified centre of gravity the posture is clearly changing. A clear shift from a neutral to an anteriorly tilted pelvis, the head moving every constantly forward, shoulders rounding out and to top it all off a large bump pushing, stretching and locking out the tissues of the body, in particular imagine how tight that frontal plane has become to envelope the bump. Where there is restriction, there is discomfort and sometimes even pain so we have our work cut out. We need to identify the big ticket items, release them and give the client the best ‘great feeling’ value we can in the time we have with them so forget giving an all over ‘glaze’, and rather zone in on the areas that matter to make your treatments truly game changing.
Once you have assessed your client take what you see and translate it into what is going on in the body so you can get stuck in. Your hands are your best assessment tool and as you absorb the information they receive you can hone your treatment plan as you go doing what you do best.
Head Forward – Shortened Levator Scapulae, Upper Traps with straining Scalenes and Neck Flexors.
Shoulders Rounding – Look for tight pectorals along with the upper traps and Levator Scapulae. Are the scapulae winging and the tissues in between straining and weakening? Think homecare not just release strategies. In addition are the shoulders rotating inwards? Think sideline access for wonderful release strategies of Latissimus Dorsi, Subscapularis, Teresa Major and Deltoids.
Ribs Flaring – Straining intercostals, a diaphragm that is being pushed up and outward by the growing baby affecting the breathing pattern. As the ribs lift up and out to help increase the thoracic cavity for the lungs they add to the pressure on an already straining abdomen potentially adding to the risk or the very real issue of Diastasis in your client. An area often ignored in hands on work it is one not to be missed in your pregnant client.
Anterior Tilted Pelvis – Hip flexors shortening, Quadriceps overloaded, the Quadratus Lumborum shortening the lower back to help support the bump. Hamstrings and calves being pulled long and taut. Glutes on vacation perhaps? Again make those mental notes for homecare.
Hips Laterally Rotated – Lateral hip rotators over worked and locked short with little support from these holidaying glutes.
Widened Stance – The TFL, IT Band and adductors are working hard to counter act the pressure of the bump on the hips forcing the wide gait/stance in the latter stages of pregnancy.
Pronated Feet – With the hips rotating out and the increased load pushing down and through the pelvis the feet can sometimes give. They pronate to remain grounded coupled with all that lovely relaxin hormone which can leave the client flat footed during this time. The sling of Peroneals and Tibialis Anterior straining under the pressure. The feet, ankles and supporting structures need attention too so ensure to give some time to these hardworking friends.
In summary, as with all things soft tissue don’t forget to assess. It might be as simple as asking your client what hurts? Look at them standing, look at them in movement and tailor your massage to their needs. Pregnancy is no different from our other areas of work in that the homecare factor is critical and should not be overlooked. What it should be and always be is considered and appropriate. Gentle strengthening not just releasing is vital in pain management and minimising the long term postural legacy left behind when the baby arrives.