14 massage & fitness magazine
Pregnancy is a normal physiological event. People are built to survive, and pregnant women are no different. Pregnancy is a presentation that massage therapists ought to recognize as having specific needs. Consider that this population is as expected as pediatrics and geriatrics to go through all normal stages of life, pregnancy does not inherently imply pathology.
Physiological accommodations to recognize & consider:
1. Hormonal response: There is an increase of progesterone and estrogen contribute to laxity of ligaments and cartilage. It is important for such accommodation for fetal growth and increased joint flexibility for delivery.1 Precautions would to be consider the outcomes of modalities that may affect the stability of joints such as joint mobilizations or underlying connective tissue disorders. A good practice would be encouraging muscle resetting prior to getting up after a treatment. This will allow for neurological input for self-awareness in time and space.
2. Uterine response: The uterus has a hypertrophy of uterine fibers and hyperplasia (increase in numbers) of uterine fibers.2
3. Cardiovascular response: There is a 50 percent increase in blood volume by the 34-week gestation as well as increase in blood clotting factors.3 This is important because it causes a change in vascularity, blood volume, and clotting. Consideration for modality, tissue response, and patient tolerance will allow for a more effective treatment.
Assessments
Assessments prior to treatment provide foundation for a safe, effective treatment. Consider the following:
1. History: Understanding the clients’ pregnancy experience and how they are feeling. Are they experiencing biomechanical discomforts or emotional stressors? Have they required medical intervention? What is the age and constitution of the client? What is their gestational age? What prenatal care are they receiving? What is their level of confidence in their prenatal care? Who is their prime source of information?
2. Observations and Palpation: Are there any overt signs of discomfort? What is the quality of movement? Are there any signs or symptoms of concerns such as edema, circulatory issues, inflammation? What is the size and shape of the belly? How are they carrying (high, low, anterior, posterior, one sided)?
Photo: Fineart