So during our prenatal massage session, we have released mum’s shoulders. We have released her back. We have worked with the uterus. We have introduced ourselves to the baby, and we have released her sacrum and done some work with the hip flexor muscles and the hip rotator muscles. Obviously a prenatal massage session is much different than just a regular relaxation spa massage. The goal for the prenatal massage session is to make changes to mom’s body so that she feels more comfortable and so that her body is able to take better care of the baby. Another really important thing to address during the prenatal massage session is the hips mobility. Now there is a joint between the sacrum and the ilium that is called the [inaudible] joint, the sacred ILIAC joint, and this joint has to be moveable. In order for the sacrum to move and order for the ilium to move this, both of those are going to need to move.

When the baby comes out, the sacrum moves back and out of the way and the ilium spread a little bit wider in order to make room for the baby’s head and for the baby’s shoulders. So now that we have released all of the ligaments and muscles around this joint, it’s important to mobilize the joint itself. Now this is very, very comfortable work for mom and she when we have her laying on her side, we’ll have one leg hanging down just a little bit and this helps to open up that joint a little bit more. Then the prenatal massage therapist will take his hands using a little bit of force but not uncomfortably. He will mobilize the hip and help the hip to move. Once we have some good movement in the hip, then we will turn over and repeat the same thing on the other side.

Now this is actually an area where the prenatal massage therapist can go a little bit too far. In some cases during pregnancy, mom’s body is producing a hormone called relaxing and the job of relaxing is just like the name implies to relax the ligaments. And so that the body can move and adapt to the extra person that is living inside of it. Now all of the muscles and ligaments that we have been releasing have been augmented by the relax and that is in her body and her is usually quite willing to release all the things that we are asking it to release. Many times during pregnancy, a woman will complain about pain in the s I joint and if there is pain there during pregnancy, very often the problem is not so much that the joint is stuck but that the joint is too mobile. What can happen is for example, the left side say SEI joint is stuck and then the right side has to move twice as much in order to compensate for it. Well, with the right side moving twice as much, it doesn’t like that and it begins to complain and it begins to hurt, but the problem isn’t on the right. The problem is on the left. So when doing this work, it’s important for the prenatal massage therapist to understand that there does need to be movement in the [inaudible] joint, but not too much movement.

Of course, as mom gets closer and closer to her labor, her body will be producing more and more of these hormones and her joints will be getting looser and looser. We want mum to be as comfortable as possible, but we don’t want to loosen these ligaments too much. We want to keep her stability so that she can still walk and squat and move about comfortably. So during the prenatal massage session, it’s important for the therapist to not only release the ligaments and the muscles, but also to know when is the right time to stop the releasing.

Another very important part of the prenatal massage therapy session is to work with the pelvic floor. Now during these sessions, the woman will always be fully clothed and she is always free to refuse any services that she just does not feel comfortable with. For any reason. This work will take place while the woman is on her side with one knee bent. Wearing something that is comfortable and stretchy and athletic is very helpful. During this work. Something like yoga pants are often preferred during this time.

The external pelvic floor work, well first of all involve releasing muscles called the add doctors. These ad doctors are found on the inside of the leg when there is tension inside the pelvis. That tension almost always travels down the inside of the leg and pulls on those muscles. The Fatia tenses up and hardens and will not let the muscles release. This causes the knees to actually draw in a little bit and can create knee issues. So it is important that the prenatal massage therapists do some work with these muscles in order to stabilize mom so that she can walk more comfortable and feel more comfortable in her body.

Now these adductor muscles are also connecting right by the pubic bone and much of the time the biggest part of the tension is going to be where the muscles actually attached to the bones, so it’s important for the prenatal massage therapist to pay special attention to where the muscles are attaching and to have a good understanding of anatomy so that the work is both appropriate and effective. We’re doing the pelvic floor work. The prenatal massage therapist also has access to the hip capsule itself. This can be another area that can help mom to feel much better. After he is released the adductor muscles and the hip capsule, he will next pay attention to a bone called the pubic Ramus, and this is a bone that is right on the bottom of the pelvic floor. It is important to take tension out of this bone. When you take tension out of the bone, you’re also taking tension out of the surrounding tissues. So if we are going to free the muscles of the pelvic floor, then it’s important to release the muscles or drawer to release the bones that those muscles are attaching to.

Once the adductors have been released and the pelvic floor or the hip capsule haven’t been released and the bones have been released, then we can go straight to the pelvic floor work. Now this work is often somewhat uncomfortable, but it is very, very productive and it’s work period. If the pelvic floor muscles can move and relax and stretch, then mom is going to have a much more comfortable labor and a much less chance of tearing and complications from her from, uh, resulting from a tight pelvic floor. Now tight pelvic floor is very much evidenced when we are doing the squat test. So at the beginning of the prenatal massage session, we do a squat test to determine if there is tension in the lumbars or in the top of the sacrum, in the bottom of the sacrum or in the pelvic floor. And very often we will find that there is a little bit more attention in the pelvic floor, and this is evidenced when the woman can’t get all the way down to the floor. She stops just shy of a full squat, not after we have done the releases to the pelvic floor along with the other releases in the pelvis. She is often able to do that squat more fully and with a lot more comfort. Interestingly, this squat can also be done at home with her husband as a helper. It’s something that will help to open up the pelvis and to keep her open up so that when it comes time for the baby to come out or hell, her pelvis has not tightened itself back up again.