Yesterday, I received a phone call from a woman in her third trimester. Her back was throbbing and had been desperately looking for somebody to do deep tissue massage in pregnancy.
She asked, “Can I get deep tissue massage while pregnant? Because everybody is refusing!”
My answer was: “Yes! Of course, you can!”
This issue never ceases to be a problem for women trying to find massage while they are pregnant. But you may need to hunt around before you find it. A lot of establishments have a “house policy” to avoid deep tissue work on pregnant women.
Periodically I will call some of my favorite spas in San Diego to find out about their prenatal massage services. How much they charge, positioning, duration, special limitations (for example, no massage during first trimester). Overall I was quite impressed with the way the spa staff answered my questions, but one thing really stood out as the spas kept emphasizing it: light to medium pressure!!
Their policy is a safe, conservative move that has absolutely no basis in fact or science. HOWEVER, it also a smart move on their part — if their therapists performing prenatal massages are minimally trained and have limited experience, perhaps it is prudent for them to set limits on the type of bodywork they offer pregnant women.
Here at Equilibrio, we do make bold claims that pregnant women deserve and can safely receive deep tissue massage. Deep tissue work is actually indicated given the many structural changes happening to a pregnant woman’s body over a short period of time.
But here’s the catch: a pregnancy massage — deep tissue or not — is always going to be RESPONSIVE, SMART and RESPECTFUL of the changes happening to woman’s body.
When we talk about “deep tissue massage” in pregnancy, we always have to address two prevailing ideas:
- Common ideas about pregnancy as fragile and delicate
- Popular ideas about “deep tissue massage” that perceive it as painful, overwhelming and aggressive
Deep pressure is responsive pressure.
We like to think that we are very thoughtful about how deep tissue work is done in preparation for birth and labor. But how deep is ok? Massage should not hurt. Intense is ok. But you should still be able to breathe comfortably through even deeper work.
Deep tissue should not make you jump off the table! (see funny photo)
While this image depicts a popular understanding of deep tissue massage (and, well the expectations on the part of a few clients) — this is NOT what deep tissue massage should be doing (particularly, the MT smiling as you wince!). We do not want to create a pain response in our moms (or any of our clients).
In prenatal massage, we are trying to give an experience in which she can gently surrender to our touch, not suffer through it. We are trying to move her from a state of “doing” to “being.” Sweet, gentle, surrender. Our hands are patient with her tissue, waiting for it to release. We apply pressure inspired by birthing women managing contractions in labor — surrender to her body and let it pass through, as opposed to tensing up and forcing our way through.
Deep tissue massage is not necessarily hard and sharp
At Equilibrio, the bulk of our deep tissue work is slow and rhythmic. We have learned that working harder, faster and sharper elicits pain, but not results. In fact, pressure that is too intense can be counter productive — your muscles can react and tighten up against the pressure AND you get a mild stress reaction (there goes that relaxation part to the massage).
We apply pressure slowly to a muscle to the level of that tissue’s resistance. Then we wait for the muscle to release and then allow our “tool” to sink more deeply. And, sometimes the muscle doesn’t release. Or won’t release that day or for minutes. What is key here is we are trying not to “do” to the muscle, but rather allow the muscle to open. There is real subtlety here.
And it can be an important shift for a woman as she prepares for birth. We helping her experience manageable intensity in her muscles that she can breath through and easily surrender to. We are not aiming to conquer her muscles.
Deep tissue massage respects all the safety precautions for all prenatal massage.
Earlier this year, a client came to me who had been on modified bed rest for preterm labor for 10 weeks already, and she was still only about 32 weeks along. Her doctor cleared her for massage, but told her not to make sure the MT avoided abdominal massage and did no deep tissue work. As MTs, we care for you, but are NOT your caregiver and we always respect you and your pregnancy by respect
ing any restrictions that your MD or midwife establishes (and secretly, we are thrilled they are being thoughtful about massage!!). However for this mama, after working on her neck and shoulders for a few minutes (after 10weeks of bed rest!), I was
thinking: “These muscles are screaming for deep tissue work!” We were able to get mom some relief from gentle Swedish-style massage. And then we talked with her doctor. We were able to clarify for her doctor, that abdominal massage always contraindicated for a woman who was on bed rest. And that localized, slow, gentle deep tissue massage might actually be beneficial. The doctor was completely on board with the idea of tension-relieving deeper work that was restricted to mom’s back and neck and that mom experienced as pleasurable, and did not overwhelm mom or trigger a stress response in her body.
Deep tissue massage is not necessarily deep tissue full body massage
On the flip side of the frustrating prenatal massages is the reality in which a nonpregnant client will pay extra for a “deep tissue” massage. Then an enthusiastic massage therapist will attempt to deliver “deep tissue” on every part of their body, over delivering non responsive, no yielding pressure with sharp thumbs and elbows. The client is overwhelmed with pain sensation, most likely bruised and left with the impression that “deep tissue” is not for them.
- Not all parts of the body need the same type of pressure. Some people really enjoy a deeper-style pressure on their shoulders, but not their hips.
- Deep tissue massage takes time if it is going to work — you can’t really force a muscle to release.
- Deep tissue work is subjective. I can apply the same amount of pressure to two different people on two different days and they will both define it differently. It will feel like deep tissue massage to one, but perhaps not the other.
Is deep tissue massage in pregnancy for you?
What’s the conclusion here for YOU as you are trying to schedule deep tissue massage during your pregnancy? If you are experiencing a healthy pregnancy that is progressing normally, there is probably no overarching contraindication to some deeper work. However, ask yourself what feels right in your own body. And find a therapist who can speak smartly to you about any deeper work you want. What type of training do they have? How experienced are they? And ask them what limitations they would use with you. Talk to the therapist!