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Carpal tunnel, pregnancy and massage

Carpal tunnel can be an extremely painful and uncomfortable condition that can affect anyone. However, during pregnancy the chances of suffering from carpal tunnel syndrome are greatly increased, particularly in the latter stages of pregnancy. The reason for the greater incidence of carpal tunnel syndrome during pregnancy is that there is greater retention of fluid (due to varying hormones during pregnancy) and that relaxin can soften the ligaments that form part of the carpal tunnel.

Carpal tunnel and pregnancy massageCarpal tunnel syndrome will normally manifest in the form of pain, numbness and/or tingling in the outside three fingers of either hand. In more extreme cases, the compression on the nerve through the carpal tunnel can lead to the forearm feeling numb. The fingers and the hands will feel weak and have poor grip strength and pain may radiate up the arm as far as the shoulder.

For pregnancy induced carpal tunnel syndrome the symptoms will be worse either during the night or first thing in the morning due to greater fluid retention as the arm is relatively inactive.

There are a number of steps to you can take to reduce the impact of the condition. These include:

  • Avoiding any task or action that causes pain
  • Elevate the affected arm to attempt to reduce the amount of oedema and swelling
  • Be aware of your posture. There is a tendency amongst pregnant women (+ office workers + people who drive a lot etc) to have their neck protracted ie their chin juts out. Even a little can add compression to the lower cervical vertertae so try to keep your chin back in a more neutral position.
  • Try to keep your wrist in as neutral a position as possible (some physiotherapists recommend the use of splints to maintain a neutral wrist while you sleep. If you are suffering from carpal tunnel from breast feeding then remember to bring the baby to the breast rather than move the breast to the baby and again be aware of your wrist position.
  • Some professionals may suggest modifying your diet (and/or lifestyle) to reduce your body’s general propensity for swelling

Massage for Carpal Tunnel Syndrome During Pregnancy
An effective massage for carpal tunnel syndrome is primarily aimed at reducing the amount of swelling in the arm through lymphatic drainage techniques and, when performed by a therapist who has a good understanding of the condition, it can be a highly effective treatment.

Routine for Carpal Tunnel Pregnancy Massage
This routine can be considered as being relevant for during pregnancy and also post-partum when the new mum can have wrist problems when breast feeding.

Start at neck with little or no lubrication and work very and gently. The movement of lymph at the level of the skin is the objective for the routine. Always proximal to distal with the order of the strokes but work each individual stroke in a distal to proximal direction. Stretch the skin and work down the arm all the way down to the hand. Again need to reiterate that the pressure should be very light as working deeply can be ineffective.
Repeat this series of strokes a few times.

  
Perform a lymphatic compression on the arm – scooping up and then hold each compression for a count of about 10. Pressure is still very light.

Compressive tissue release – keep wrists neutral and stroke down the forearm (both top and botton of the forearm) using thumb and fingers whilst applying traction to the wrist. This stroke can free up the nerve sheaves through the carpal tunnel.

If you feel that you need to stretch the fascia of the palm make sure that you keep the wrist in neutral. Work the joints of adjacent fingers in opposite directions.

By Richard Lane

Pregnancy Massage in the First Trimester

Massage for pregnancy

If you ring to book for a pregnancy massage and mention that you are in the first trimester then there are many therapists who will refuse to accept your booking. Day spas often will include on brochures and promotional materials that you should not come in for a massage if you are in the early stages of pregnancy.

So it appears as though the massage industry supports the view that massage during the first trimester is not safe.

However, for many women this is just not the case and there are no scientific reasons for healthy women not to get a massage during the first trimester. Indeed often women will receive bodywork without even knowing that they are pregnant.

The reasons for the varying positions on first trimester pregnancy massage stem from a misconception that massage can, in some cases, lead to miscarriage. This view is inaccurate and there is no causal link between massage and miscarriage. Whilst the prevalence of miscarriage is greatest in the few months of pregnancy, in general, the actions and the activities of the women will have no bearing on the likelihood of her suffering from an unfortunate miscarriage. Basically if it is going to happen then it will happen as the miscarrying embryo is typically chromosomally abnormal and not viable. Infections and diseases may be other causal factors. Exercising, stretching or having a massage, however, does not contribute any risk towards a miscarriage.

If a miscarriage does happen within a short period of having a massage, assuming that the massage therapist has not acted outside of their scope of training, then it is fair and reasonable to declare that having the massage was not the reason for the miscarriage. Whilst a woman may very well question what she did and didn’t do in the days before the miscarriage, in the long run hopefully she will be able to understand that what happened was going to happen regardless and she should not assign any blame to her (or others) actions.

Most massage therapists do understand this point, yet a significant proportion are still reluctant to perform a first trimester pregnancy massage. Their position is that they do not wish to be put into a position of the woman associating a miscarriage with any massage. This is very much a personal choice of an individual therapist and no therapist should ever be put into a position of providing massage services when they are not entirely comfortable to do so. Some clinics may make a similar decision on behalf of all therapists, more out of a misguided fear of litigation.

  
Whether a woman actually feels like having a massage during the first trimester though is a separate question. Nausea, morning sickness lethargy, breast tenderness, etc may act as negative influences and make her not want to get a massage anyway. However, this is a separate issue to whether she can get a massage or not.

Before booking in for a massage with a suitably trained therapist, we would also suggest that you discuss your intentions with your doctor just to ensure that there are no issues which may mean that pregnancy massage (at any stage of the pregnancy) is contraindicated.

By Richard Lane


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