Category Archives: CAMTC Certified

Postpartum Massage

Recently I massaged a woman who was only two weeks postpartum

My first thought was about her comfort and I offered her a breast cushion, my next thought was about precautions post pregnancy…

In my last post I wrote about prenatal massage and the changes experienced in pregnancy. Following child birth some of those same conditions still apply.  Relaxin, the hormone that loosens ligaments is still present and can remain present in the body up to four months after discontinuing breast feeding, so her joints, especially the SI joints may still be causing her discomfort. The coagulating hormones that poses a risk for deep vein thrombosis during pregnancy may still be present for up to four weeks or more following child birth so deep tissue work is not advised during that time and specifically to be avoided on the back of her legs.

The client may be positioned prone (face down) at this time but if she has had a cesarean section it is advisable for her to wait until after the scars have healed and to speak with her physician before getting massage and to seek her doctors approval before having any abdominal massage work.

The following article by the American Pregnancy Association highlights the Many Benefits of postnatal massage

Postpartum Massage

The Benefits Of Postpartum Massage

Postpartum massage has been shown to be effective for a quicker recovery and better health. Integration of maternal bodywork may add welcome value to your healing journey and transition to motherhood.

Relaxation and Stress Reduction

Massage relaxes muscles, increases circulation and lowers stress hormones, bringing relaxation and stress relief. All body systems appreciate treatment after nine months of change, culminating with the delivery of the greatest miracle in life.

Some women prefer lighter pampering massage while others enjoy deeper techniques to work out the knots. Adding myofascial release and craniosacral therapy reaches deeper into the body for more complete healing. Any of these massage styles will bring relaxation and stress reduction.

Anxiety and depression respond very well to skilled therapy. About two-thirds of new moms experience temporary postpartum blues related to hormonal changes, new responsibilities and adjustment frustrations. Emotional support and the other benefits of massage can help during this transition.

Postpartum depression is a more serious, longer-lasting condition that affects 10-15% of mothers. Studies show massage to be beneficial for treating postpartum depression. Don’t hesitate to consult healthcare providers for assistance, including a postpartum body worker.

Pain Relief

Residual body aches from pregnancy are normal. Adding breastfeeding and childcare can intensify arm, shoulder and back pain. Massage is an effective holistic approach that relaxes muscles and relieves pain without medication. A skilled therapist may also resolve even associated numbness and tingling. Chronic or severe pain may require multiple sessions for resolution.

Hormone Regulation

Massage greatly improves postpartum hormone balance. Estrogen and progesterone hormone levels are very high during pregnancy and decrease after delivery. Prolactin and oxytocin hormone levels rise to facilitate breastfeeding. Studies indicate that massage reduces the stress hormone cortisol. Certain essential oils may also bring hormone and mood balance.

Massage also reduces naturally occurring biochemicals associated with depression (dopamine and serotonin) and cardiovascular problems (norepinephrine), supporting Mom with the challenges of motherhood.

Decreased Swelling

Body fluids need to find balance after pregnancy, in which there was an increase of about 50% in fluid volume. Massage increases circulation and lymphatic drainage to facilitate elimination of excess fluids and waste products. Tissue stimulation assists your body to shift water to the right places.

Swelling is also affected by hormones, which go through major changes after delivery. Massage helps hormone regulation, which also decreases swelling (see Hormone Regulation). Continue your high fluid intake for healing and lactation, even though you may still have swelling.

Better Sleep

Most new moms feel exhausted after labor and delivery, complicated with around-the-clock baby care. Massage will ease the fatigue, promote relaxation and assist with sleep. Studies have shown an increase in delta brain waves (those that accompany deep sleep) with massage therapy.

That is why it is very common to fall asleep during a massage. Getting enough sleep is key to postpartum recovery. Everything improves when you feel rested! Arrange some help and get regular massages for better rest and sleep. One study correlated better sleep with losing the baby fat on the tummy!

Improved Breastfeeding

Breastfeeding is a beautiful gift to your newborn, but can also be a challenge for some moms. Massage therapy relaxes the body, increases circulation and increases milk production. Studies show that massage increases prolactin levels, a lactation hormone.

Relaxation in the chest muscles opens the shoulders and improves lactation. New research indicates that breast massage helps relieve breast pain, decreases breast milk sodium and improves newborn suckling. Consult with your therapist about this service as work directly on the breasts may not be legal in some areas.

Her level of comfort and tolerance are as much a concern post pregnancy as they were when she was pregnant.

If at any time she feels uncomfortable with the position, pressure, or duration of the massage be prepared to make accommodations for her.

Her breasts may be tender, swollen, or engorged with milk and it is possible that she may experience a let down of her milk (leaking) during the massage. There is no risk associated with contact with breast milk.

She may be exhausted and sleep soundly through the massage, allow her to fully relax and enjoy the experience.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist

 

Facebooktwittergoogle_pluspinteresttumblr

Prenatal Massage

Last night I had two back to back prenatal massages, one only a week until her due date followed by one only 16 weeks pregnant.

The first one, oh so beautiful in her last trimester but so ready to finally go into labor soon. She had never had a prenatal massage before, she loved it and she wished that she had been getting massages throughout her entire pregnancy.

The second, so very happy to be pregnant following a partial hysterectomy and just coming into the discomforts of her changing body.

Both of these women are first time mommies and it is such a joy to have the opportunity to give these women the benefit of a relaxing and therapeutic massage.

Her Changing Body:

When a woman is pregnant her body is in a constant state of change in preparation for the birth process. A hormone called Relaxin loosens ligaments and the SI joints to help widen the pelvis. This can sometimes lead to low back and SI discomfort.

It is also not uncommon for women to experience sciatica in later stages of pregnancy as her changing body and the pressure of her baby can irritate the sciatic nerve.

A woman’s body also produces hormones that effects the clotting factor to prevent her from losing too much blood when giving birth. Because of that we do not use deep tissue on the back of a pregnant woman’s legs as she is more prone to blood clots at this time.

In later stages of pregnancy she may experience swelling of the feet and legs, but if that swelling is mostly on one side that can be an indication that there may be some problems and that should be addressed with her doctor.

She may become more off balance as her body is changing and she may also experience some dizziness when getting up from a resting position, so it is important for her to be careful when getting off of the massage table or out of bed.

How Massage Can Help:

  • Reduces muscle and joint discomfort
  • Provids needed relaxation
  • Improve sleep
  • Help minimize foot and leg swelling
  • Improves circulation
  • Help move lymphatic fluids
  • Minimizes anxiety and stress

Contraindications and Precautions:

Hot stone therapy and aroma therapies are often avoided at this time as they can effect blood pressure and in some cases can effect hormone levels.

Some use of aromatherapy have been shown to be safe during pregnancy  (such as lavender oil) but due to the highly concentrated nature of essential oils it is often suggested that aromatherapy should be avoided at this time and avoided all together in the first trimester.

High risk pregnancies such as preeclampsia or a history of blood clots should avoid getting massage until after delivery.

Many therapists may refuse to massage a woman in her first trimester because that is a time in which miscarriages are most common and it is always best to be cautious.

In the second trimester it is not uncommon to do some of the massage supine (face up) as long as the client is still comfortable laying on her back, but by the third trimester the massage needs to be done in the side lying position.

Pregnancy massage cushioning systems are sometimes used by some therapists and spas in the second and part of the third trimester, but if at any time the client feels uncomfortable it is always best to perform the massage side lying.

Always remember that if at any time you or your client feel uncomfortable in any way about the massage it is always better to err on the side of caution.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist

 

Facebooktwittergoogle_pluspinteresttumblr

When NOT to Massage

The following are examples of times in which we should NOT massage or at the very least modify the massage and inform the client as to why…

Client has not seen a doctor but believes he or she may have “torn” a muscle or “thrown out” their back lifting something:

As you begin to massage the area in question the pain becomes intolerable.  At this point STOP working on that area, we do not want to do anything that may make the condition worse.

We unfortunately do not have x-ray eyes and cannot see if a muscle is torn or a disc has been herniated or if there may be a bone spur pressing on a nerve or any of the many things that could possibly be going on.

This is when we really need to tell the client to see their doctor just to be sure that the injury is not worse than what the client believes it to be.

Many people are hesitant to see their doctors for a variety of reasons, I will admit that I seldom go to the doctor unless I am absolutely sure that I cannot manage whatever is wrong with me on my own so I understand this. Many people are more inclined to schedule a massage or stop by their local chiropractor before ever seeing a physician.

You are giving a massage and come across an area that is red, swollen, and hot to the touch:

Avoid that area, not only for their safety but for yours as well, there could be a staph infection or other condition that not only could you make worse but could contract and or spread to other clients.

I had this situation happen with a walk-in client, the first part of the massage, neck, shoulders, and back was uneventful, but when I exposed one leg to work on it that was when I saw the problem. I did not touch the area in question, I held my hand slightly above it and could feel the heat coming off of it, everything in me was telling me this man needs to see a doctor ASAP.

I told him that based on what I was seeing I cannot massage his legs and I strongly urged him to have it looked at by a doctor, his leg looked so bad that I added that he should not wait to have it checked out. I honestly hope that he did, because what I was seeing was very concerning.

Prenatal client states to avoid one of her legs:

As I was massaging her I noticed that the leg in question was more swollen than the other, she later tells me that she had recently had a blood clot in that leg but that it was gone now. She went on to tell me that in the past she had a blood clot that had gone to her lung when she was not pregnant. Later she tells me that she is on blood thinners.

I documented this in her chart and told the receptionist that she is very high risk and we cannot continue to massage her during this pregnancy for her safety and the safety of her baby.

Client Comes in Requesting a Deep Tissue but has a lot of bruises:

When you see a lot of bruises on a client that should caution you that deep tissue techniques should be avoid.

The client may be on blood thinners or an aspirin regimen to reduce potential blood clots. Often times the client will fail to disclose daily use of aspirin  because they do not consider over the counter medicines as being medications that we should be aware of.

When I see a lot of bruises on a client I ask them if they are on blood thinners or an aspirin regimen, if they are not on either of these things the bruising may be caused by anemia or a vitamin deficiency, but regardless of the cause of the busing  we need to avoid causing further damage.

Avoid suspicious skin rashes:

There are many skin conditions that are not contagious such as eczema, psoriasis, vitiligo, and ichthyosis. Such areas we can massage without concern, however, suspicious rashes, especially if red or itching should be avoided.

If you see redness or marks from fingernail scratching this should alert you that the area may be contagious. Any strange lesions or open sores should be avoided.

If a rash or other skin condition seems questionable you can choose to use gloves for the massage but make sure that the client does not have a latex allergy.

Do not be afraid to refer a client to their doctor:

Your clients trust you, if you see something that is concerning please don’t hesitate to suggest to the client that they may want to have their doctor take a look at something. It is better to be cautious than to let a potential condition worsen or go untreated.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
Facebooktwittergoogle_pluspinteresttumblr