Clinical:Case Study: Massage Modalities for Common Women's Health Concerns

Original materials created in January 2001 by Lynne Firpo, MT

Back Pain in Late Pregnancy

AB is a 32 year old G3 P2 at 33 weeks gestation who notes much dull, aching pain in her lower back, worsening at the end of the day. She occasionally takes Tylenol for this, and has sought massage for more relief.

For alleviation of low back and sciatic pain I suggested the purchase of a body-length pillow. They can be found at a department store, or any bed and bath specialty store. A kingsized pillow, while not preferred, may be used. The mother lies on her side with her standard pillow under her head. The body-size pillow is placed along the anterior aspect of her body. Her lower leg, the one in contact with the mattress, remains extended, in alignment with her body. Her upper leg is bent at the knee and rests on the pillow. This posture allows the gluteal muscles to rest in a relaxed position, decreasing pressure on the sciatic nerve. Gentle circular motions can be applied to the area between the greater trochanter and the sacrum. This can provide tremendous relief for hip aches, low back pain, and sciatic pain. For maximum comfort and to ease turning over in the middle of the night, a body pillow can be placed on both sides of the mother. Thus, she only has to turn her own body, and the other pillow is there ready for her. This does work better in a large bed, and/or with an understanding/accommodating bed partner.

Massage for Mastitis

CD is a 29 year old G1 P1 at four weeks post-partum who has been breastfeeding successfully since her baby’s birth. One day, unexpectedly, she develops a low grade fever, and then notices a small area of redness and warmth on her left breast, about the size of a quarter. She describes the area as hard, like a knot, and wants to know what she can do for it. Engorgement and mastitis can occur within the first week after birth, at the time of weaning, or during periods of time when the nursing mother is away from her baby. It can also occur without any apparent cause, but when the motherbaby dyad is separated it is time to be aware of measures to prevent the infection. Using the flat surface of the finger tips make circular motions to loosen the skin from the breast tissue. Secondly, support the breast underneath with one hand, and stroke from the areola out toward the torso. Use as much steady pressure as possible without causing discomfort. I also suggested applying lotion to the skin. Finally, use the fingertips to apply pressure in small circular strokes superiorly and laterally toward the area where lymph drains. Throughout the childbearing years there may be many times when the woman can feel the early signs of a breast infection. If these massage techniques are begun immediately and repeated as often as possible, it can help considerably to prevent recurrence.

Massage and Dysmenorrhea

EF is a 36 year old G1 P0 who has had mild to moderately painful menses on and off during most of her reproductive years. She treats this often with typical doses of NSAIDs (non-steroidal anti-inflammatory drugs) but is looking for something more natural for aid. She has been found to have simple dysmenorrhea; more serious etiologies for menstrual pain have been ruled out.

These next techniques give relief for the back ache and lower abdominal pain that often occur with menstruation. Using duct tape, or wide masking tape, completely wrap two tennis balls so they are attached. Lying down supine (face up), place the tennis balls beneath the lower back. With the balls on either side of L5 relax the back and let the body weight take the pressure of the balls into the paravertebral muscles. After about a minute, move the balls up to L4 and repeat the relaxation. I also taught that if the pressure feels too great, try lying on a bed for this technique. A warm pack can be placed over the anterior lower abdominal/pelvic area during this procedure. A warm water bottle, a hand towel soaked in warm water, or a heat pack which can be warmed in the microwave all serve as good sources for moist relaxing heat.

A Tip for Women Working on Weight Loss

GH is a 42 year old G1P1 who is 6 months post-partum and has been dedicated in her efforts to lose the extra weight gained during pregnancy. She has accomplished a loss of about half of what she had gained. She notes at a check-up that she “wishes the skin on her thighs were more smooth”. She doesn’t want to seek specialist techniques immediately, but wonders if “anything can be done?”

This final technique works most effectively for women who have lost some weight, but did not decrease the appearance of ‘cellulite’. This stroke is called “skin rolling.” In theory when connective tissue layers are lifted from the adipose tissue, dimples and lines will become more shallow and can disappear. Begin at the hip and use both hands. Pinch about an inch of skin between the thumbs and forefingers. Slide the hands down the thigh by using a walking motion with the forefingers, keeping the thumbs steadily in contact with the skin. (I demonstrate that the motion is akin to rolling down a leg of panty hose) A roll of skin will remain pinched in between the fingers and the thumbs as you travel down the thigh. Repeat this stroke enough times to cover the entire thigh. Perform this stroke regularly two to three times a day. Look for results after a few weeks. Some people find that they need to do maintenance strokes a couple times a week to keep the desired results. The same stroke can be used across the forehead to diminish horizontal wrinkles. Try it on frown lines or deep, dimpled scars. This technique can have notable satisfactory results.

References

1. Curties, Debra. Breast Massage. Overzet Publications, Moncton, New Brunswick, Canada. 1999.
2. Stillerman E. Mother Massage: touch for happier, healthier pregnancies. Massage Magazine; #87 Sept-Oct 2000: pp82-94.
3. Nichols, Frank. Theory and Practice of Body Massage. Milady Publishing Company,Bronx, NY, 1987.