Do you avoid basic 'belly-work'...even with pregnant clients?

Comment

Comment by Erik Dalton on September 14, 2009 at 12:55pm

Question for all you "mother-massage" therapists out there..."What techniques do you find most effective during the 3rd trimester to help foster a healthy happy delivery"?

Comment by Erik Dalton on September 13, 2009 at 10:58am

Hey Geo:

Thanks for reminding me that I never addressed my initial question: "Should these techniques be performed on our pregnant moms?" Of all people requiring belly work, this population is probably at the top of the list.

Trained therapists must begin restoring balance and function to all core and global structures as early as possible and continue with regular treatments to maintain front-to-back and side-to-side myoskeletal balance.

We all know that overstretching of the rectus abdominis and poor "Lower Crossed Syndrome" alignment has the ability to create tears in the tough linea alba ligament causing a condition termed recti diastasis.

Manual therapists must incorporate sidelying extended finger (scooping) techniques as demonstrated in the article listed above so that the recti can be repositioned back toward the mid-line. This will help restore trunk extension and reduce strain in the lumbar facets, intervertebral discs and associated structures burried in the osteoligamentous canal. Although this is a good treatment plan, what about prevention?

Many cases of recti diastasis has roots in fetal lie during momma's 3rd trimester. Left fetal lie is the optimum embryologic positioning during most of the final trimester, but today, many babies seem to be presenting in an awkward delivery position termed "sunny side up".

Many believe this presentation, where the baby's head clips the pubic bone during the restitution and expulsion phases of delivery, causes head-on-neck hyperextension through the O-A joint. Resultant compression of the fragile neurovascular structures hidden beneath the posterior-occipital atlantal membrane seems to have a direct link to our society's addiction to sitting, sleeping, driving, etc. in flexed positions. Let's face it...we're a flexion-addicted population and this grave problem is commonly reflected in the birthing process and the health of the child.

Because the infant's skull is highly vulnerable to forces of labor, when compressive forces of the uteurus are carried via the spine to the base of the skull, cranial distortions often occur that plague the child throughout his/her lifetime.

Comment by Geoffrey Bishop on September 13, 2009 at 9:51am

I am happy to say that I studied with Jon Hart at East West College of Healing Arts in Portland. We performed a great section of work in his Deep Tissue/M.E.T. Class dedicated to webbing the diaphragm, maual manipulation to the rib attachments of the breathing diaphragm, rib techniques (PIR and RI) and pelvic floor work. The Myoskeletal work I've studied enhances these techniques I'll have to say. These are such important topics to address when looking at overall client health!

Comment by Erik Dalton on September 13, 2009 at 8:09am

One of the best ways I've found to get around the vanity, vulnerability issue is by talking to my client (as I work)about the importance of 'belly-work' from a postural standpoint. Almost everyone desires better posture and by using the simple techniques shown on my You Tube video @ http://erikdalton.com/NewslettersOnline/Sept_09_Newsletter.htm , it'll give you a place to begin a dialogue about the benefits of abdominal work.

Also, it's important to discuss how lymphatic toxitity develops from alterations and imbalances in the neuromyoskeletal breathing apparatus. Optimun diaphragmatic breathing is often hampered by facilitation or inhibition not only in the respiratory and pelvic diaphragms, but also in core stabilizing structures. Commonly in clients suffering constant congestion, when one soft hand is placed on the ribcage (supine) and another on the belly, you'll find the client's chest and belly rise and fall opposite each other. This is called paradoxical breathing (as opposed to diaphragmatic breathing) and can create major health issues via alterations in the body's PH levels. Tight scalenes and a weak respiratory diaphragm are common culprits. Joint and rib dysfunction can inhibit diaphragmatic function...so can prolonged computer work...OK I'm off this computer...going to the gym.

Comment by Gerry Bunnell on September 12, 2009 at 3:32pm

I don't incorporate abdominals as part of my regular routine. I agree that that typical massage therapy education does not spend enough time on this area. It is treated as an "optional" area to address. I confess that is the main reason I also treat it as such. I do not shy away from it though. If a patient indicates to me they have issues with digestion, cramping, monthly cycle and/or pregnancy, I strongly recommend to them abdominal work.

I feel the reasons abdominal work is avoided are:
The technique doesn't have the same feel good comfort that a lot of other areas of the body offer,
Proper draping can be tedious to perform,
Therapists may be concerned about patient/client response to the technique. (No one likes to obviously "pass wind" in a closed space which usually happens during obdominals.

Irregardless, abdominals are extremely therapeutic and should be encouraged.

Peace

Comment by Erik Dalton on September 12, 2009 at 2:18pm

Exactly Marissa!

There are many areas people just don't want exposed. Typically, I'll ask if I can work through the sheet until they get comfortable and as they begin to trust my non-judgemental touch, they'll allow me to work the tissues....with proper draping.

Actually, I prefer sheet-work (sounds funny) and/or underwear in many cases, i.e., hooked coccyx techniques, levator ani releases and most pelvic floor routines.

Lots of emotion stored in that solar plexus. Recall the 'startle-reflex'? Pin-prick a baby and she immediately curls back up into a fetal position. The first muscles to contract are those of the belly.

In the very early 1970s I attended a lecture with Dr. Rolf and my idol at the time, Fritz Pearls, (founder of gestalt psychology.) Fascinating discussion of how memmory is stored in cells and what happens during solar plexus hypercontraction due to fear, anxiety, phobia, physical harm etc. In the absense of good manual therapy...sometimes combined with counseling...that emotional junk collects in the abdominal tissues. And then we wonder why drug companies make a fortune selling Tums and Nexium.

Comment by Marissa on September 12, 2009 at 1:37pm

I believe that it may have something to do with the fact that we, as a nation, are very worried about our "image". I have had many clients who would benefit from abdominal work immediately turn down the treatment and shy away due to the fact that I would see their belly. I have explained that some treatments could be done directly over the draping. Some clients decide to try the treatment, others are still firm on not seeing or touching the stomach area. To each their own. And yes, I believe that it is under-emphasized and under-utilized.

Comment by Erik Dalton on September 12, 2009 at 1:21pm

Funny story Amy...thanks for the interesting post.

Comment by Erik Dalton on September 12, 2009 at 1:19pm

Darcy:
I attended massage college in the 'dark ages' and we weren't even allowed to perform belly techniques and, therefore, weren't taught proper draping techniques. That presented a problem when I attended the Rolf Institute since we were required to perform diaphragm and anterior rib work in the first session. I get some of the best structural alignment results on the anterior (yin) side of the body...thx.

Comment by Amy Quartermaine on September 12, 2009 at 1:01pm

I received no training in belly work at the massage schools I attended. But through the Japanese American Acupuncture Foundation I took a class in Ampuku-Abdominal massage. It was taught by a Dr. Goi, who has a school and clinic, doing exclusively abdominal massage. I have used his techniques ever since. The only difficulty of the class was Dr. Goi spoke only Japanese, and required a translator. The translator felt he should not only translate the words, but the touch as well. This was not good as the translator had a much heavier touch. I was asked "Does this hurt?" I said "It didn't hurt in Japanese, but it hurts in English". True story.

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