FLEXIBILITY PROTOCOLS DURING PREGNANCY…ANOTHER WAY!
Actually, the title should be Flexibility Protocols During Pregnancy and the Post Natal period…..another way! But that’s a bit long….:-)
Full disclosure, I don’t like the term ‘stretching’…..it bores me….it feels so limited and such an underplay of the possibilities when aiming to mobilize, free and help our clients move well in their amazing bodies, I’ve written about why, here before so I won’t go on again but instead give you some more insight into my rationale and the education I offer regarding flexibility protocols during Pregnancy and into the Post Natal period for those serving this very special population.
Bear with me on this but………there was a time in Pregnancy exercise education when students were being told that “Pregnant women are, under the influence of the hormone Relaxin, inherently stable and you should be hypervigilant when administering stretching protocols and never perform ‘developmental’ stretches” YIKES! Look away yoga people….. This, is general got further mis-translated by many to “be very afraid of stretching Pregnant and Post Natal women who are FULL of destabilizing, wicked Relaxin“…….hmmm……fear + programming = poor programming. This reminds me of the Supine Hypotensive Syndrome argument and working with the Pregnant woman in the supine position………again fear + programming = poor programming. Here’s an update on the role of Relaxin if you need it…….
So, are Pregnant women inherently unstable? Should ‘stretching’ be avoided or only applied with extreme caution? My answer……….a resounding NO! As professionals serving this client population, we need to ‘rule the tool’ as they say. It’s not the activity but the application of the activity…….. As I said in the intro to this blog, ‘stretching‘ has moved on, and instead of being limited to the golden oldies (shown in pic below) basically adaptations of standard stretching protocols carried out until the bump gets in the way, let’s go wider and think about using a variety of modalities to aid the ‘releasing‘ the client from the discomfort caused by the musculoskeletal and biomechanical changes that occur during and post Pregnancy. Let’s go wider and think about the application of the Biotensegrity theory and dynamic ‘mobilization’ along the Myofascial Lines and muscular sling systems in multiple planes with multiple height and depth of reach. Let’s go wider and think about the ‘releasing‘ part of our sessions turning into the STAR TURNS of our sessions and something that our client positively anticipates instead of something that feels like penance! Let’s go wider and apply strategies while the client is standing and moving rhythmically. Let’s go wider and help the client to move away from ‘stretching so they are not stiff’ to the gifting themselves the ultimate self-care present. Ultimately, there is beauty and deliciousness to be had in this part of programming and I’d love to share what I do and teach with you…..
1. Ante/PN Soft Tissue ‘Hotspots’ – I’m thankful for the 15 years of both clients and students who I have been honored to serve that have helped me hone my ‘Aaaaaah’ skills…..it’s not a scientific term but if ever there was a part of your practice that was truly experiential, this is it….soothing and salving the client’s on both a physical and psychological level is paramount and paying attention to what they ‘feel‘ is simply of upmost but often neglected importance. How your client ‘feels‘ after you’ve helped them with their ‘hotspots’ is the MOST IMPORTANT indicator of your success. What the client ‘feels‘ afterwards is what will keep them returning as a raving fan, what the client ‘feels‘ will have them refer you to the hills….that unscientific Aaaaaah is GOLD! That unscientific Aaaaaah is an essential indicator that your hard earned clinical/soft-tissue skills have hit the mark, relieved pain and discomfort, up-regulated the client’s Parasympathetic Nervous System and helped restore the precious but elusive reconnection to the pain-free ‘self’. Every Pregnancy is unique but without fail (ish) there are areas of ‘universal soft tissue stuckness’ (illustrated by the stars on the diagram below) that you will find on most Pregnant women, especially past the second Trimester and for sure still making their presence felt in the Post Natal period……In my personal experience……..get a Pregnant or Post Natal woman out of pain in these areas and you have a one-woman referral machine for life! The key ‘Hotspots’ are global and you’ll need to be a detective going nose to toes including…..the scalp fascia, Upper and Lower Crossed Syndrome Tissues, the hip complex in all planes, the pubic mound (especially for those who have birthed via C-Section), the Diaphragm border, the intercostals, the pectorals into the myofascial ‘arm lines’…..etc., it’s deep work but your client will adore you for your thoroughness. So, after a mix of questioning, client-self-reporting, intuition, and palpation, I get to work and teach you to get to work to erradicate pain and discomfort using the strategies below….
2. Instrument Assisted Massage – I’ve been having a minor love affair with this small but powerful mode of myofascial release/soft tissue mobilization for some years now after my 9 month stuck abdominal hysterectomy scar was released in under 5 mins by a lovely man I met while cruising a fitness convention trade show….another story, another blog :-). The instruments (there are many styles) effectively break down fascial restrictions and scar tissue. The ergonomic design of these instruments provides the clinician with the ability to work on small locations or conversely on larger areas that can be challenging for the hands alone and, assisted by palpation, locate restrictions and allows the clinician to treat the affected area to create ‘controlled microtrauma’. This stimulates a local inflammatory response that has the potential to initiate the reabsorption of fibroses and excessive scar tissue and facilitates the innate cascade of healing activities resulting in the remodelling of targeted soft tissue and fibroblast proliferation. Adhesions within the soft tissue which may have developed as a result of surgery, immobilization, repeated strain/overuse or other mechanisms, are broken down to allow full functional restoration to occur. Studies have shown IAM performs impressively in the area of pain perception and speed of transformation….always a good thing for the time-pressed therapist.
3. Traditional Massage alongside Soft Tissue Release (STR) and Post Isometric Relaxation (PIR) – Muscle Energy Techniques (MET’s) are often omitted from the arsenal of those serving the Pregnant client…..why? Worries about ‘breath-holding’, increasing blood pressure and again….the client being too unstable to withstand contract/relax techniques are easy to overcome through simple modification and when these strategies are incorporated into your practice, they turn you into a trouble-shooting, pain relieving assassin as opposed to a nice but sometime ineffective non-targeted treatment. Not familiar with them? Take a look at the video below. And as for ‘traditional massage’ strategies – there is not a Pregnant or Post Natal woman on this planet who will not willingly lay themselves down even for 30 mins and accept the transforming power of a skilled pair of hands. At a life phase when the adrenal system can be under duress and new moms present with chronically elevated Cortisol that can create a detrimental hormonal cascade affecting mental health, gut health, Post Natal fat loss, sleep patterns, the soft tissue healing mechanism……………. taking ones-self off for a massage isn’t a luxury, it’s becomes an ESSENTIAL! Are you a massage therapist in the UK? You can join me for my 2 day bodywork spectacular where we go deep into the art of Pregnancy & Post Natal Massage/Remedial Therapy in London……