Recently I have been asked about lying pregnant clients in Prone for massage. Besides the obvious reason that it might prove a bit difficult with the belly bump there are other more structural and functional reasons not too. Even with the use of the massage tables with belly holes or the pregnancy pillow system, lying prone is not considered best practice in the massage industry.
I am lucky because I do have the opportunity in some of the therapy centres I work to lay my clients in prone however as a therapist I am obliged to follow best practice. This is part of my code of ethics as a registered therapist. If a client does specifically come in to the clinic to lie in the belly hole because “it’s been months since I (she) laid on my tummy” I will inform her of what is best practice and give her the reasons she may chose a side lying position for massage. Of course we discuss the reasons specifically for her but ultimately she can chose the treatment plan that she believes is best for her. If that happens to be lying in prone with her belly in the hole than that is the position I will massage her in.
To help you understand why it is considered best practice to massage in a side lying position I developed a top ten list. I thought I would share with you all:
1. Increase and changes to intra-abdominal pressure which can contribute or acerbate Rectus Distastes (abdominal separation)
2. Can acerbate shortening of lumbar extensors which may already be shortened due to increase in lumbar lordosis
3. Can acerbate shortening of the psoas muscle. Side lying provides an opportunity for ease of psoas release.
4. Hip / gluteal muscles are ineffective in treatment for prone lying, side lying provides ease of releasing certain muscles in the hip / gluteal and sciatica
5. Clients can feel nauseous in prone lying
6. Increased headaches due to hormonal changes
7. Increase in nasal congestion making prone lying very uncomfortable for some clients
8 Lying prone may contribute to shortness of breath and rib pain due to pressure placed on the thoracic (chest) area
9. Breast tenderness is a natural occurrence in Pregnancy and lying prone may cause discomfort
10. Increased pressure in the bladder
References / Further Reading
Kendal, F etal 2005 Muscles Testing and Function with Posture and Pain, Lippincott Williams & Wilkins, United States of America
Koch, L 2012 Core Awareness North Atlantic Books, Berkely California
Hanlon, P 2014 Position Matters in Pregnancy, Massage Magazine viewed online https://www.massagemag.com/position-matters-in-pregnancy-massage-13602/
Hobbs, V 2014 Pregnancy Massage – Is it Safe? Vikki Hobbs Pregnancy, Birth & Post Partum Coach, viewed online http://vickihobbs.com/pregnancy-massage-is-it-safe/
MCInerney, C 2015 Practitioner of Pregnancy Massage Notes, Nurture Life Melbourne
Osborne, C 2011 Pre and Perinatal Massage Therapy, Lippincott Williams & Wiliams, United States of America
Osborne, C 2013 The Benefits of Using Side Lying Position, AMTA, viewed online https://www.amtamassage.org/articles/3/MTJ/detail/2850
Yates, S 2010 Pregnancy and Childbirth, Churchill Livingston Elsevier United States of America
I am lucky because I do have the opportunity in some of the therapy centres I work to lay my clients in prone however as a therapist I am obliged to follow best practice. This is part of my code of ethics as a registered therapist. If a client does specifically come in to the clinic to lie in the belly hole because “it’s been months since I (she) laid on my tummy” I will inform her of what is best practice and give her the reasons she may chose a side lying position for massage. Of course we discuss the reasons specifically for her but ultimately she can chose the treatment plan that she believes is best for her. If that happens to be lying in prone with her belly in the hole than that is the position I will massage her in.
To help you understand why it is considered best practice to massage in a side lying position I developed a top ten list. I thought I would share with you all:
1. Increase and changes to intra-abdominal pressure which can contribute or acerbate Rectus Distastes (abdominal separation)
2. Can acerbate shortening of lumbar extensors which may already be shortened due to increase in lumbar lordosis
3. Can acerbate shortening of the psoas muscle. Side lying provides an opportunity for ease of psoas release.
4. Hip / gluteal muscles are ineffective in treatment for prone lying, side lying provides ease of releasing certain muscles in the hip / gluteal and sciatica
5. Clients can feel nauseous in prone lying
6. Increased headaches due to hormonal changes
7. Increase in nasal congestion making prone lying very uncomfortable for some clients
8 Lying prone may contribute to shortness of breath and rib pain due to pressure placed on the thoracic (chest) area
9. Breast tenderness is a natural occurrence in Pregnancy and lying prone may cause discomfort
10. Increased pressure in the bladder
References / Further Reading
Kendal, F etal 2005 Muscles Testing and Function with Posture and Pain, Lippincott Williams & Wilkins, United States of America
Koch, L 2012 Core Awareness North Atlantic Books, Berkely California
Hanlon, P 2014 Position Matters in Pregnancy, Massage Magazine viewed online https://www.massagemag.com/position-matters-in-pregnancy-massage-13602/
Hobbs, V 2014 Pregnancy Massage – Is it Safe? Vikki Hobbs Pregnancy, Birth & Post Partum Coach, viewed online http://vickihobbs.com/pregnancy-massage-is-it-safe/
MCInerney, C 2015 Practitioner of Pregnancy Massage Notes, Nurture Life Melbourne
Osborne, C 2011 Pre and Perinatal Massage Therapy, Lippincott Williams & Wiliams, United States of America
Osborne, C 2013 The Benefits of Using Side Lying Position, AMTA, viewed online https://www.amtamassage.org/articles/3/MTJ/detail/2850
Yates, S 2010 Pregnancy and Childbirth, Churchill Livingston Elsevier United States of America
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