Before any massage can be administered it may be advisable for pregnant clients to obtain a doctors clearance for any therapy received. Massage can increase circulation flow which may cause dizziness and add to any existing morning sickness or other health conditions. If the client is still in the first trimester it would be important to obtain medical clearance before commencing any treatment so her doctor is aware of the treatment she will be receiving.
If the client is still very early in her pregnancy it is allowable to have her lay prone however if she doesn't find this comfortable then she may choose to lay on her side with one or two pillows positioned between her knees to keep her pelvis in proper alignment. During the second and third trimesters she will not be able to lay prone so she will need to be positioned on her side with one or two pillows between her knees to keep her pelvis in proper alignment.
Some common symptoms of pregnancy which can be treated with massage are sacroiliac pain, sciatica and fluid retention. Treatment will only be able to address these problems assuming the doctor has given the all clear to proceed and no other contraindications present themselves.
The symptoms of sacroiliac pain are often caused by traumatic injuries, biomechanical injuries, hormonal changes and inflammatory joint disease. Provided the cause of pain isn't the result of a traumatic injury or inflammatory disease then the symptoms can be treated with massage.
Before massage is applied a heat pack can be applied to the sacral area to increase circulation, relax muscle tissue and alleviate some of the sacroiliac pain. Massage can be applied to the rest of the back while the heat pack warms the area. Before using any heat the client should always be asked if they want a heat pack to be used as part of the treatment.
Massaging the shoulders and between the shoulder blades can release any muscular tension the client may be carrying due to the increase stress and tension of pregnancy. When the heat pack has been applied for around 15 to 20 minutes it can be removed and a gentle yet firm massage consisting of effleurage, petrissage and friction can be applied to the sacrum and lumber region.
Massage to the abdominal region is strictly contraindicated in the first trimester and so this area will be avoided.
Massaging the upper back, sacrum and lumber region can help alleviate sacroiliac pains, pains in the lumbar region, assist with circulation and help to relax the client. Treatment for sciatica is still required and will follow upper body treatment. Fluid retention will be alleviated during all massage so it is not entirely necessary to target that problem specifically unless it presents itself in a key area. If the fluid retention is too severe then massage is contraindicated and it is best the client speaks to her doctor about it before continuing with treatment. If severe fluid retention is isolated to one location then contraindication is specified to that area alone or as recommended by her doctor.
Treatment for sciatica involves manipulating trigger points in the quadratus lumborum, gluteus medius and the gluteus minimus. Massage to the rest of the legs can also correct any muscle imbalances that may be present which can affect the alignment of the pelvis and lumbar region. In addition to the musculo-skeletal benefits provided by leg massage; circulation will be improved in the legs and throughout the rest of the body.
While the client is receiving treatment Aromatherapy can be utilised to help her relax by using essential oils in an evaporative burner and with her permission, through a massage oil.
In the evaporative burner the ideal blend would be a combination of lavender and lemon essential oils to help with relaxation and relieve any nausea. These oils can also be used in the massage carrier oil at low concentration of around 1%. Lavender and lemon essential oils used in a carrier oil can help with fluid retention by improving circulation, can help relieve muscular aches and pains and help to create a relaxing environment.
To support the massage treatment, the client can be instructed in ways to help her while at home, at work or simply while she is out and about. This would constitute proper posture while sitting, laying and performing day to day duties. Sleeping with a pillow between her knees can also help to reduce symptoms of pain in the pelvic and lumbar regions while laying on her side.
Home massage is possible from with the help of the partner, family member or close friend. Simple effleurage and petrissage motions can be demonstrated to the individual whom will be performing the treatment to help alleviate pain and discomfort which the pregnant client might be experiencing; in the case of two partners exchanging massage, this will also create a stronger bond between the two adults and their baby.
If a pregnant client has problems with morning sickness and fatigue then she can be advised to purchase an evaporative burner and use a single essential oil or blend from the following to help with nauseous feelings: Ginger, Lemon, Nutmeg, Rosewood and Sandalwood. In addition to these oils she can also use Lavender, Tea Tree oil and/or Ylang Ylang to help her relax.
This treatment was originally designed to assist with symptoms that have presented themselves at the time of therapy during the first trimester. Future treatments will require new assessments as human physiology changes throughout a pregnancy and new symptoms may present themselves. Therefore this treatment should be adjusted accordingly when unforeseeable circumstances arise.
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