Anatomy Review: Pregnancy Massage and the Migration of Fascia

Did you know it is basically a law of structure that under compression fascia will “migrate” laterally? Think of pressing down on a beach ball. The more you press, the further out each of its color segments would get.

This is exactly what happens to the pregnant woman under the compression of the extra weight carried during pregnancy. The muscles and fascia under compression particularly in the abdomen and waist migrate laterally.

This means, particularly with back work with this special population, you may need to change the directions of some of your strokes. Particularly many therapists have the habit, which ordinarily feels good, of taking their thumbs and, starting medially near the spinous processes pushing out laterally stretching and spreading the back muscles out.

Ordinarily this can feel quite good. But in the case of pregnancy where these muscles often are already stretched beyond their normal limits and, migrating laterally, the last thing you want to do is make their lives harder.

Instead concentrate on gently pushing the muscles on the lower and mid-back in toward the center.  We have a technique in Deep Massage that we teach here that is really effective with these lower back muscles.

Nine Points: Erector Spinae, Multifidus, Quadratus Lumborum

With the client side-lying with pillows supporting the “upper arm” and comfortably between the legs, and the massage therapist along client’s right side, facing head (reverse direction for other side).

Gently encourage client to breathe and bring their awareness to the lumbar region.  Then place your hand alongside the lateral margin of the lumbar muscles on the side of the body. It is useful to start gently focusing first into the lateral margin of iliocostalis (the lateral-most of the erector spinae muscles).

With the finger pads of your middle finger supported by the first and ring fingers (or with the middle phalange of the first finger supported by the thumb), gently melt down into the lateral margins of the lumbar muscles at three levels in the side: just under the 12th rib, halfway between the 12th rib and the iliac crest, and just above the iliac crest. Your pressure is medial-ward, toward the spine.

First work into the erector spinae, then the multifidus, and finally, the quadratus lumborum. Where you find tension, work  gently into it and spend more time melting into these areas with gently curved fingers (or supported middle phalange of first  finger).

Regularly check in with client regarding appropriate pressure and movement. Always err on the side of conservativeness, using too little pressure rather than too much. Less is more!

Repeat on the opposite side.

Kate Jordan’s 4-day pregnancy massage certification course Bodywork for the Childbearing Year begins in October.