Online massage booking        Find us on Facebook    Google+    twitter RSS

Sciatica and Massage

Many people claim to suffer from sciatica but what is sciatica?

Put simply, sciatica is a pain, usually in the back of the leg caused by compression, irritation, or inflammation of the sciatic nerve. The sciatic nerves are the longest and largest nerves in the body, running down the back of each leg and are about the diameter of your thumb.

The sciatic nerve is actually composed of four or five smaller nerves that leave the spinal cord from the lower spinal column, join together and then travel down each leg. It then divides into numerous smaller nerves that travel to the thigh, knee, calf, ankle, foot and toes. When these nerves are irritated or affected by the inflammation of nearby soft tissues, then this is referred to as sciatica.

There are several reasons why the sciatic nerve could become compressed, entrapped, or irritated. In “true” sciatica, the nerve roots can be compressed by herniated, degenerated or displaced lumbar spinal disc(s). This can be exacerbated by tight muscles and soft tissues in the lower back, buttocks or leg.

sciaticaThere are also other conditions which can mimic sciatic symptoms such as Piriformis Syndrome where the sciatic nerve is entrapped by the piriformis muscle in the buttocks. Piriformis Syndrome is sometime referred to as “back pocket sciatica” as pressure on the piriformis muscle and sciatic nerve can be caused by sitting on a wallet in the back pocket of a person’s pants. Another problem that can imitate sciatic pain is trigger points in the Gluteus Minimus muscle. The trigger points in this muscle can refer pain sensations down the back of the leg along the path of the sciatic nerve and also on the outside of the leg.

People with sciatica suffer from a wide range of symptoms. The pain may come and go at different times, it may be a constant problem and then it may subside for hours or days for no apparent reason. Some people may feel only a dull ache travelling down the back into the upper leg. For others, it may be intense sharp shooting pains all the way down the leg into the foot and toes.

Many factors can influence the pain of sciatica. If the sufferer sits in one position for long periods of time then the pain can increase. Long distance drivers and computer operators are particularly susceptible. Exercising, or even simple things like walking, bending, twisting or standing up may be difficult and painful. For some, the pain may change from side to side or be present in both legs. For others, back pain may appear before the sciatica emerges. In some severe cases, sciatica can impair reflexes, or result in the wasting of the calf muscles.

Treatments for Sciatica
The medical approach to dealing with sciatica is to treat the symptoms. This may include using painkillers, muscle relaxers or anti-inflammatory drugs such as NSAIDs . Traction, physical therapy or injections directly into the nerve roots may also be used. In severe cases, Surgery (such as microdiscectomy or lumbar laminectomy) is used to help relieve both pressure and inflammation.

  
Massage Therapy
Massage Therapy and Bodywork can help Sciatica, Sciatic Nerve Pain, in particular the conditions which mimic sciatica such as Piriformis Sydrome. Massage therapy can relaxes muscles, releases trigger points and abnormal tissue adhesions, and improve posture to relieve the pressure on nerve roots and other sensitive structures.

Other Manual treatments (including physical therapy, osteopathic, or chiropractic treatments) can help relieve the pressure. Chiropractic and Osteopathic techniques are often used in conjunction with treatment by a Massage Therapist.

Use a Tennis Ball
The knots in the muscles of the hip and buttock can be effectively treated with a tennis ball. Simply lie on a tennis ball such that it presses on deep, sore points and just wait for the feeling to fade. However please be aware that the piriformis muscle is so unusually reactive and the use of a tennis ball to massage the piriformis needs to be gentle and conservative.

Jump in the Spa to Relax the Area with Heat
Whether the pain is caused by the crushed sciatic nerve itself, or just by tight muscles, the muscles need to relax. Hot tubs, with jets, are ideal for sciatica.

Check Your Posture
The types of sciatica that are related by excessive sitting may be influenced by the ergonomic design of work station and/or chair. It may be worth experimenting with your chair and the layout of your work station. A simple option is to use a timer to remind yourself to get our of your chair at regular intervals such as every fifteen-twenty minutes.

By Richard Lane

The Benefits of Abdominal Massage

Many massage therapists will spend the vast majority of session working on the back of the client. They will give great bodywork to the back, shoulders, neck and the back of the legs but then only give cursory attention to the front of the body. Now it is true that most of us have significant issues with the back of our bodies but to neglect the muscles and soft tissues at the front of the body is to provide an incomplete session. Only a few therapists would routinely incorporate an abdominal massage within a full body massage, yet there is little doubt that bodywork through the stomach area can offer many health benefits.

Abdominal massageMost people who do request an abdominal massage would likely do so because of digestive issues although there is also significant musculature in the area that may require release to assist with physical problems. For example, a tight and contracted rectus abdominis muscle will impact on the stability and movement of the lower part of the body or lead to us slouching forward setting up postural imperfection through the lower back.

In total there are at least four layers of muscles in the abdomen and these can impact on your core strength (both your physical and emotional core). Trigger points are not uncommon in the abdominal muscles and the pain referral patterns can include the lower back. Simons and Travell (1) observed that

An active trigger point high in the rectus abdominis muscle on either side can refer to the mid-back bilaterally, which is described by the patient as running horizontally across the back on both sides at the thoracolumbar level … In the lowest part of the rectus abdominis, trigger points may refer pain bilaterally to the sacroiliac and low back regions.

Regardless of the requirement for remedial massage and trigger point techniques for hypertonic muscles in the abdomen, the vast majority of abdominal massage will be for digestive issues. Most therapists consider that massage to the stomach areas will improve the capability of the digestive system and will potentially benefit some of the organs that are contained within the abdominal cavity (such as liver, pancreas, gall bladder, small intestine and colon). A recent review of research has confirmed that there are likely to be benefits for performing abdominal massage to treat chronic constipation. Sinclair (2) concluded “studies have demonstrated that abdominal massage can stimulate peristalsis, decrease colonic transit time, increase the frequency of bowel movements in constipated patients, and decrease the feelings of discomfort and pain that accompany it. There is also good evidence that massage can stimulate peristalsis in patients with post-surgical ileus.”

Routine for Abdominal Massage
In order to give an abdominal massage then the stomach needs to be exposed and it is usually recommended that there be some bolstering under the knees to slightly relax the abdominal region. Normal massage lubricatants are fine to use.

– Place your hands gently on the stomach and palpate. The stomach should feel soft and relaxed

– Always be aware of the breathing of the client and work with the breathe, not against it.

– Sink in through the diaphragm region with the breathe of the client

– Lightly work along the lower border of the rib-cage with fingers and thumbs.

– Gently effleurage the area with light circular strokes. Always work in the direction of the digestive system which means working clockwise around the stomach.

– Place your hands over the rectus abdominis and gently palpate for areas of tenderness and restriction. Work the edges of the muscles with static compression (asking the client to tense the muscle by have them start to sit up) with sufficient pressure to be therapeutic but not too much that it causes pain. Release attachments at the xyphoid process (obviously without ever putting direct pressure on the vulnerable process itself). Release the attachments at the upper border of the pubic bone (mindful of the sensitive nature of this area – if client has any concerns then you can get them to use their own hand to achieve this release or alternatively work through a drape).

– Work deeper under the ribcage on both sides of the body (be aware of working too deeply directly into the liver which is on the right side of the body). Cross friction at any tender points.

– Pull through the sides of the body with relaxed hands, reaching around the body as far as possible, working and stretching the fascia.

– Work the ascending colon (right side) and descending colon (left). Make sure you connect with sufficient pressure through colon although not too much so that it causes pain. Some therapists recommended clearing the descending colon first too “make room”.

– Finish with a calming connective touch to the abdomen.

  
Normal massage contraindications would apply for abdominal bodywork and if the massage is to be performed for a specific health objective then it is recommended that it be discussed with suitable doctor prior to treatment. Also be aware that many people may have emotional sensitivity and instinctively be highly protective of this so any bodywork needs to be mindful and respectful

1. Simons DG, Travell JG. Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 1, Upper Half of Body, 2nd Edition. Lippincott, Williams and Wilkins, 1999:943.
2. Sinclair M. The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther 2011; 15:436-445.

============
Update – a 2011 review of the effect of abdominal massage in chronic constipation found that abdominal massage can stimulate peristalsis, decrease colonic transit time, increase the frequency of bowel movements in constipated patients, and decrease the feelings of discomfort and pain that accompany it.

“The use of abdominal massage to treat chronic constipation.” Sinclair M.
J Bodyw Mov Ther. 2011 Oct;15(4):436-45. doi: 10.1016/j.jbmt.2010.07.007. Epub 2010 Aug 25.
============

By Richard Lane

PNF Stretching

PNF stretching is considered to be the most effective way to increase static flexibility and is a combination of static passive stretching and isometric stretching. PNF stands for Proprioceptive Neuromuscular Facilitation and was first developed as a treatment for paralysis patients.

PNF stretching is usually carried out with a partner who provides the resistance for the isometric contraction although it can be done without a partner (but generally will be less effective). If using a partner, then it is important that the partner be attentive and focused.

Pnf StretchingThe most commonly used PNF technique is the “Hold-Relax” which is sometimes referred to as the “Contract-Relax”. The muscle is stretched passively towards the limit of its range of motion and then the muscle being stretched is isometrically contracted for 5-15 seconds after which the muscle is relaxed for a couple of seconds before being subjected to a passive stretch which should be greater than the initial passive stretch. This stretch is held for around 10-15 seconds before repeating the PNF stretch one or two more times.

PNF Stretching Examples: Hamstring Stretch
For an example of a PNF stretch, then the person being stretched lies flat on their back with one leg bent at 45 degrees and the other leg extended straight. The partner lifts the straight leg until a comfortable stretch is felt through the hamstring (nb partner just supports the stretched leg and does not push). This stretch is held for 15 seconds.

The stretchee should then isometrically contract the hamstring against partner’s resistance for 5-15 seconds, relaxes and the partner gently guides the hamstring to a deeper stretch. This is repeated a few more times until there is no further increase in range of motion.

Brief PNF Physiology of Stretching
Muscles spindles cells located within the muscles, protect the muscle from injury. They sense how far and fast a muscle is being stretched and when activated produce a stretch reflex. This reflex causes the muscles to contract to prevent overstretching the muscle.

Located within the muscle tendon is another sensor called the golgi tendon which senses how much tension is being put upon the tendon. When the golgi tendon is activated then it relaxes the muscles (unlike the muscle spindle).

A voluntary contraction during a stretch increases the tension on the muscle, activating the golgi tendon organs more than the stretch alone. So when the voluntary contraction is stopped the muscle is inhibited from contracting against a subsequent stretch. PNF stretches uses this to take advantage of the sudden vulnerability of the muscle and its increased range of motion by using the period immediately following the isometric contraction to train the stretch receptors to get used to this new, increased, muscle length. This is accomplished by the final passive stretch.

Some General Recommendations for PNF Stretching

•Leave 48 hours between PNF stretching routines
•For each muscle group complete 2-5 sets of the chosen exercise
•Each set should consist of one stretch held for 10-15 seconds after the contracting and relaxing phases
•PNF is not recommended for anyone under 18 years old
•A 5-10 minute thorough warm up is recommended before performing PNF stretching as a separate exercise session.

While most of us could obtain benefit from the improvement in flexbility that PNF stretching can bring, there is some conjecture amongst sports professionals about the effective of stretching in general to reduce the risk of injuries and to improve performance. Although there is some conflicting evidence reported, on balance research literature reviews such as reported by Thacker et al (1) support the hypothesis that routine stretching has little impact on reducing total injuries amongst competitive or recreational athletes.

  
However, research has also found that pnf stretching may lead to improvements in running mechanics. Caplan et al (2) concluded from studying rubgy league players that stretch training at the end of regular training is effective in improving running mechanics during high velocity running.

As with all stretches, only take a PNF to the limit of what feels comfortable. Pain is an indication that you are overstretching.

In addition, there are advantages and disadvantages of PNF stretching and it may be worthwhile discussing these with a suitably qualified sports therapist.

(1) Thacker SB, Gilchrist J, Stroup DF, Kimsey CD., Jr. “The impact of stretching on sports injury risk: a systematic review of the literature”. Med Sci Sports Exerc. 2004;36:371-378
(2) Caplan N, Roggers R, Parr MK, Hayes PR. “The effect of proprioceptive neuromuscular facilitation and static stretch training on running mechanics.” J Strength Cond Res, 2009, 23: 1175-1180

By Richard Lane

Do you cheat when you stretch your quads?

Many people “cheat” when they stretch their quads. The standard stretch for the quads that you will see many people doing is to stand on one leg and bring their foot to your butt.

However, the chances are that their alignment is such that they are not actually stretching the quads at all, but merely compensating by hip or trunk rotation.

(If you can cope with the sound of young children) The following video explains how best to perform a genuine quad stretch.

Free Massages – How Not to Give Them

When you are a student massage therapist then providing a free massage for Sydney family members and friends is considered part of the training. In return for you giving them a massage then you get the chance to practice strokes and techniques that you may have learnt in class. In addition, you can solicit feedback from the recipient of the free massage.

It is a win-win situation.

However, once you have qualified and start working as a massage therapist then this synergistic situation changes. You are confident of your skills and how your bodywork is received by clients and client feedback is less important for you.

If you have been working hard at a clinic, doing mobile massage or at a spa then the last thing you want to be doing when you get home is to give away a freebie.

free massage in SydneyUnfortunately from the therapists point of view though friends and family don’t necessarily see it this way and many therapists are frequently asked to give them a few minutes of time to massage their stiff neck or sore shoulder.

A question that is often posed is how can I, as a therapist, politely decline to work on them?

On a recent Facebook posting, therapists gave suggestions on how to deal with this issue. The most common response was along the lines of handing the person your business card and asking them to call to make a booking.

Here of some of the other answers.

I say in a funny sarcastic yet friendly way, “I have all my free massages when I was in school for two years. I have to pay off my student loans before giving anymore free massages.”

I’m just honest. I tell them that I don’t have the stamina on my days off and they always understand. If I can tell someone is just trying to get a freebie, I tell them they can have a business card. They laugh and say, “Smart answer”.

Tell them you’ll trade if they work on you first

When family and friends come crying to me about what is hurting on them (hinting about wanting me to work on them) I always reply by telling them what is hurting on me. They usually get the hint

It seems that people think that because we are MT’s, that we never hurt. Typically don’t like it when I say… Yeah, my neck and back are killing me too!

Sometimes if my friends say “Oh, my back hurts so badly!” I answer with, “I’m sorry, I wish I knew someone who could help”

Make an appointment, today’s my day off.

“Sure! I’ll trade you. I can always use a massage! 5 minutes for 5 minutes?” “Uhh.. uhh… uhh… “

  
But probably my favourite is

If you know someone who is a mechanic, and says “My back hurts, can you help me?” answer: My car needs brakes, can you help me later tonight?
If you know someone who does daycare and they ask for free massage, ask them in turn to babysit your kids for free when they get off work.
You get the point. If they wouldn’t work for free, why should you?

By Richard Lane

Pain Between Shoulders

Although there are any number of reasons that people call for remedial massage, probably one of the more common is for pain between the shoulder blades. This can be an isolated pain or it can be in conjunction with neck pain and stiffness or headaches. The pain can be persistent and chronic or it can appear acutely after a particular activity or movement.

Many people will believe that the root cause of the problem lies in the muscles between the shoulders blades, namely the rhomboids. If they book in for a massage then they will expect that the therapist pays particular attention to these muscles and the muscles around the area to reduce the tightness and tension.

MHowever, often the problem is not associated with tightness in the area but weakness. Tightness in other muscles is causing the muscles such as the rhomboids to become irritated because they are over-stretched not because they are overly tight. A massage therapist that tries to eliminate the tightness by stretching and adding length to the muscles may even be adding to the problem.

Often postural professionals will refer this condition with terms such as forward head posture or upper cross syndrome. The pain between the shoulders actually results from the complex interaction of the muscles around the shoulder girdle. It comes about from an increase in tightness in the muscles at the front of the neck and upper chest and weakness with the upper back and back of the neck (technically muscles such as the levator scapula, pectoralis major, suboccipitals, SCM and upper trapezius tend to be tight whereas the lower trapezius and rhomboid muscles tend to be weak).

Typically when you have your posture checked, a therapist would notice that the shoulder blades (the scapulae) are depressed lower than they should be and they are spread apart towards the sides of the body. When the shoulder blades are in this position, the traps and the rhomboids are stretched to their maximum and they struggle to hold the weight of the arms. The force of gravity leads to a constant pulling on the muscles and nerves in the area. The results is pain in and around the neck, between the shoulder blades and even down the arms.

Postural awareness is the first starting point for reducing the impact of upper crossed syndrome or forward head posture. Left untreated it can lead to degenerative changes in the upper back and result in constant neck pain, back pain and contributes to the formation of the Dowager’s Hump and be implicated in TMJ dysfunction.

  
Being mindful of when you are performing repeated tasks with you arms extended in front of you (such as typing on computers or driving) is a good starting point. However, restoring the balance between the muscles of the shoulder girdle is of prime importance and this can often be quite a challenge as normal movement patterns may have been compromised by persistant pain.

Massage can help to address some of the issues associated with these problems, in particular by releasing those muscles that are pulling the shoulders blades forward and down. Your therapist can also suggest stretching exercises for the upper chest and strengthening exercises for the upper back.

Massage and Back Pain
– Research Findings

There are many reasons why people book in for a mobile massage in Sydney with us. It can be purely to de-stress and wind down. It can be as a reward for working hard. It can be part of a sportsman training regime to include a regular sports massage. However, the majority of people that we see are suffering from physical discomfort and they are looking for remedial therapy to help them reduce the pain and tightness they are experiencing.

Massage for back pain reliefNeck /shoulder pain and headaches are probably the top of the list for the reason why people book in for a remedial massage and many people know that massage is a great way to deal with these problems. The next most popular reason for getting a remedial or deep tissue massage is for lower back pain and there is some good news that recent research has found that massage may very help is dealing with the pain and suffering that lower back pain can cause.

When suffering from lower back pain many people seek out medications from their doctor to treat the pain. Others try exercise regimes from physiotherapist. However, a significant proportion of experiencing and secondly as a form of preventative maintenance once they are relatively pain-free. Researchers set out to ascertain whether massage compared favourably against usual medical intervention for treating lower back pain.

In the study (1), carried out by researchers from the Group Health Research Institute, Seattle, Washington, the study participants were randomly assigned to receive either a relaxation massage, a structural (remedial/deep tissue) massage or usual medical care without massage. Their symptoms had been assessed and also recorded was the impact of the back pain on their daily life.

Those in the massage groups had a one hour session weekly for 10 weeks.

The symptoms of those in the study were recorded after completing the massage program, at six months and finally a year after they initially began the massage.

The results obtained were encouraging for the massage industry. After the 10 week assessment, the researchers found that those who had received massage had lower levels of pain and they were able to perform daily tasks better than those who had only received the usual medical care. These results were similar regardless of which type of massage they received, be it relaxation or structural.

Whilst the benefits did not remain after one year, there was still a significant difference with the results obtained after 6 months and so it may be reasonable to conclude that massage can be an effective treatment for those who are suffering from lower back pain.

(1) Cherkin DC, Sherman KJ, Kahn J, Wellman R, Cook AJ, Johnson E, Erro J, Delaney K, Deyo RA. “A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial.” Ann Intern Med. 2011 Jul 5;155(1):1-9.

By Richard Lane

Positional Release

Most people who have regular remedial or therapeutic massage in Sydney would probably prefer to have the therapist to get stuck into the muscles and the soft tissues. Certainly with our Sydney mobile massage business, deep tissue and deep pressure massage are more popular than Swedish or relaxation massage.
However, not all clients necessarily respond best to a stronger massage and recently I’ve some good results with incorporating positional release techniques within a session (particularly when the deep tissue techniques have not yielded the benefits that I would like to have seen).

Therapeutic relief through positional release techniquesPositional release is a gentle and relatively non-invasive technique that allows for pain relief effectively by the body healing itself. It relies on the use of placing the body or painful part of the body in a comfortable position so that myofascial trigger points can release.

Positional release can be incorporated into a remedial massage bodywork session to assist with reducing the pain for particularly stubborn area or it can be considered as a standalone session. In addition, once you have experienced pain relief from using positional release then it is possible to perform some level of self-positional release.
In order to perform positional release, then a therapist will locate the areas of dysfunction (most often affected by trigger points) and then they will manoeuvre the client’s body into such a position that the pain experienced from the trigger point is eliminated (or at least minimised). The client will stay in this position for up to 2-3 minutes (which may be assisted by the therapist supporting an arm, a leg or the head for example).

The philosophy behind of positional release is that painful muscles when put into such a position that they are shortened (without contraction) then the pain sensors within the muscle can in effect be “switched off”. The muscle may then be in a more relaxed state when the passive support is removed and the level of pain and discomfort can be decreased.

Self-Positional Release
If you are having problems with soreness in your neck then lie on your side on a pillow and using your fingers or thumb find a spot that is particularly tender. Often these points are just below the occiput (ie just under the bone of the skull at the back of the neck). Now very slowly and very easily move your head in different directions whilst monitoring the pain you are experiencing. You may need to tilt your head backwards, forwards or to the side or even rotate it in one direction. Hopefully you will move into such positions that the pain will be reducing – if you find that it is actually increasing then move in the opposite direction.

  
Once you have found a position such that the pain is minimised then support your head as much as possible in that position and just stay there for a couple of minutes (no need to keep monitoring the pain with your fingers at this time). Gradually ease yourself back into a normal position and hopefully your pain will be less. If you need to work on the opposite side then simply turn over and repeat.

Obviously never force your head into uncomfortable or strained positions whilst you are attempting to perform self-positional release and if you have any concerns regarding the pain and discomfort you are feeling, always consult a health care professional.

By Richard Lane

Pregnancy Massage Tables

Pregnancy massage is an important part of our Sydney mobile massage business. Although we believe that for many people there are great reasons for choosing a home massage over a clinic, these advantages are magnified for pregnant women – particularly in the latter stages of their pregnancy. It just makes sense for a woman to have a therapist visit her at home so that she can truly relax post massage rather than having to traipse to and from a clinic.

Whilst there is a fair amount of discussion about massage in the first trimester of pregnancy (check out http://www.innerwestmassage.com.au/first-trimester.php for more information) there is no debate that after the first trimester then massage can be considered effect therapy for a pregnant woman (assume that there are no pregnancy massage contraindications). However, as the pregnancy progresses then it reaches the stage that the woman is no longer able to lie prone (or on her stomach) for the massage on a normal massage table.

Often we get calls from women who are aware that there are massage tables with holes that have been cut out for the stomach (and occasionally the breasts) looking to have a massage lying on their stomach on one of these tables. Click here for an example of such a table.

Pregnancy massage in side-lying positionHowever, we only ever massage pregnant women who are too large to lie prone in a side lying position. There are good reasons for this and the vast majority of experienced pregnancy massage therapists would never consider using a table with cut out hole(s). More information about our pregnancy and pre-natal massage service is at http://www.innerwestmassage.com.au/pregnancy_massage_cushion.php

The issue about the merits (or otherwise) of pregnancy tables with holes cut-out was recently conducted and some of the comments have been included below.

===========

Nasal congestion and breast tenderness are some of the issues that a lot of pregnant women deal with and prone position is just going to aggravate that. Pregnancy tables don’t take different bodies into account so I think those specific tables are a waste of money but there are plenty of body cushioning systems out there so you can adjust to each woman. However, side-lying position is a widely under-used position and that is a shame because of the ability to move the shoulder and hip through it’s full range of motion and the fact of how nurturing and relaxing this position actually is. There is always a possibilty of increasing lumbar lordosis or uterine ligament pressure in prone especially if you are not monitoring her and as long as she is very good at communicating with you when she becomes uncomfortable. Oakworks also has a great side-lying bolstering system that eliminates pressure on the shoulder and hip that is being laid on. Ultimately, you are going to make your decision on what you will feel comfortable doing. I am very confident and comfortable with my side-lying routine and I know my clients leave very happy because they come back and they send their pregnant friends to me. I am comfortable with side-lying position and that is what I offer. I won’t spend my money on a body cushion system that will allow them to lay prone. I am ok with that. If I lose a client because of that, that is fine. There will be another to take her place.

I received massage throughout my two pregnancies and was side line. I went to the beach one summer and dug a hole in the sand to fit around my big belly so I could lay on my stomach. That was the best nap I’d had in a long time. There is no problem with lying on your stomach if you are supported correctly. Where I work we have a water table and so they start out on the left side to get the back and then face up for legs, arms, head and neck. The water table is wonderful.
=========
As I just had a baby and had several massages during my pregnancy as long as there is a sling in the belly cutout that is snug enough to not have the ligaments in a bind and there are breast recesses the prone massage wins HANDS DOWN!!! The sling in the belly recess gives enough support for an hour or 2 of massage. NOT recommended for long term use (to those of us pregnant that have a prenatal table) but I personally LOVE the prenatal table and prone massages (best naps EVER while big and pregnant!)
=========
As a LMT who specializes in prenatal work and had also been pregnant (3 times) before, most mama’s will lay on their belly until its uncomfortable. If their own body weight pressing on the belly is too much then it’s time for side lying. Knowing they are in early pregnancy you should not be pressing deeply on the low back area anyway so if mama is still able to lay prone this should not be an issue. I personally don’t use a cutout table, and I don’t see how one set non adaptable system can accommodate mama’s of all shapes and sizes….just my opinion though so please no negative comments. I prefer my side lying set up with a body pillow and other regular pillows to adjust the comfort of side lying or the incline when supine.
I set my table with pillows at the head and foot so my clients can lay supine in a reclining position. I am able to work on their entire body in this position. Then I will readjust the pillows for them to lie on their side to finish off on their back. My clients are very comfortable in this position
=========
No table with the hole. It puts strain on the lower back. Lying on the stomach, although super comfy, is not an ideal position for anyone. But for the ladies that love being prone, there is an special cushion set for them for our tables. I forgot the name though.
=========
I used to work in a spa that had pregnancy tables and the clients LOVED them. Especially women that normally sleep prone, for them to be able to lie prone again after months of not doing it is a real treat for them.
=========
There are pregnancy pillow set ups that allow pregnant women to lie on their stomach without putting undue stress on the back. Having had 2 children I would have LOVED this option!!! I have used one of the commercial body systems on a preg friend who loved being prone and didn’t feel any undue stress on her back muscles or ligaments (she is also an LMT).
=========
I’ve seen all the support cushions for pregnancy massage, and I too am curious to hear/see information about the benefits and contraindications. I have only been exposed to side-lying and reclining massage.
=========
I don’t do pregnancy massage, but we were taught in school they are not supposed to be prone at all and not to waste our money of a pregnancy table with the cut out that allows you to because it’s still a contraindication.
=========
In my practice I used a pregnancy pillow and my moms loved it. I had a handful of expectant mothers that were too small to be comfortable lying prone so we just adjusted to a side-lying position. Being able to lay in a comfortable prone position many of my clients were able to achieve a deeper state of relaxation. I myself have used it and I am not pregnant. The pillow reduced the tension in my back and allieveated pain due to two bulging disks.
=========

  
I have the Body Cushion system and have done a few pregnancy massages. Being able to lie prone was a relief to them. The cushions can be adjusted so there isn’t stress on the back. Just like any other client, though, you just have to adjust to each one, and each session as they get farther along. My policy is to ask for a new written Dr.’s release every thirty days, since the see the Dr. at least 1 x per month.

If you wish to receive a massage on a pregnancy massage table with holes cut-out then unfortunately we would not be able to help you but we certainly can provide a safe and effective pregnancy massage with you lying on your side.

By Richard Lane

Spondylolisthesis and Massage Therapy

Many people book in for remedial and therapeutic massage because of lower back pain. However, the causes of lower back pain can vary considerably and they are poorly understood. Massage therapy can be appropriate for a significant proportion of those who present with lower back pain due to muscular tightness and/or trigger points. However, massage therapists are not permitted to diagnose conditions and there are some patients for whom massage is contraindicated or for whom massage should only be performed under the direction of a suitable physician.

One such condition for which massage therapists should be extremely cautious is spondylolisthesis. If you think or suspect that a client may be presenting with spondylolisthesis then you should consider that the massage is contraindicated.
Spondylolisthesis arises from a stress fracture in the vertebrae, most typically in the L5-S1 region and occurs when one vertebra actually slides forward relative to another because of the fracture.
Activities that cause repeated flexion and extension of the spine are considered to be risk factors for the development of spondylolisthesis. Gymnasts, butterfly swimmers, weightlifters, for example, are particularly susceptible. In addition excessive lumbar lordosis is often considered to be a contributing factor as the greater curvature of the spine can place increase loads and the tilt angles at various parts of the spine.
Clients who present with spondylolisthesis will likely complain of dull pain in the lower lumbar or upper sacral areas and this pain will normally occur after the person has been performing the repeated flexion/extension activities. If a therapist tries to palpate the area then pain levels can increase if there is anterior forces being applied to the spine that can further contribute to forward slipping. X-rays or MRI scans may be required to confirm the presence of an anterior slipped vertebra.
Treatment for spondylolisthesis will normally begin with rest and refraining from carrying out any activities that flex/extend the spine. Some physical therapists may suggest bracing of the back to prevent further movement. It is likely that some strengthening and flexibility training may be incorporated into a rehab programme and it is at this point that a massage therapist is most likely to become involved. Under direction, the therapist may target muscles that have become hypertonic in response to compensating for pain.
However, a word of caution is that hamstrings will often tighten in those who are suffering from the condition. The reason for this is that they are effectively trying to rotate the pelvis posteriorly and minimise further vertebral slipping. Releasing tight hamstrings in spondylolisthesis patients would generally not be recommended, particularly in the early stages of rehabilitation.

By Richard Lane


Tweet