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Pregnancy Massage: Considerations and Techniques for Successful Treatments

by Lisa Rose November 06, 2016

Pregnancy Massage: Considerations and Techniques for Successful Treatments


Many pregnant women seek relief in the form of massage and who can blame them? Pregnant women have a lot to deal with – the aches and pains can be endless, the extra weight can put strains on parts they didn’t even know were there until the pregnancy developed; overall, the bodily changes can mean big challenges for many pregnant women. So you the therapist will occasionally find your phone ringing with a tired, expecting mother on the line looking to you for a bit of relief.

For those therapists that are familiar with pregnancy massage, there may be no surprises. But for therapists who are less familiar with pregnancy massage, the first few times can be a little daunting. First there is the obvious – the client may be unable to lie on her stomach, and this alone can mean confusion because your standard massage techniques are going to have to be adapted. There are pregnancy massage tables on the market with holes cut out so that women can lay on their fronts, but if you don’t have a table designed for this, it doesn’t matter too much – there are ways around it.

Women in the early stages of pregnancy may not present too many difficulties for you as a therapist, except that you need to be aware of the effects of your massage on her body and how much pressure to apply. This kind of massage will be a little different to the usual Swedish style though, and as the stages progress, the more adaptations you will need to make to your routine.

Physical symptoms can be reduced, so annoying and unsightly issues like fluid retention (edema) are alleviated when massage stimulates the soft tissues holding the water. Due to pressure on the pelvic floor and lower back, painful conditions like Sciatica often arise, causing pregnant ladies a lot of pain; it isn’t just the sciatic nerve that is affected, as the leg muscles can swell too, pressurizing surrounding nerves. Regular massage relieves this inflammation and tension.

It isn’t just the physical pain that is a problem for pregnant women either; their moods can be hugely affected by fluctuating hormones. Stress hormones can cause adverse conditions for the baby, resulting in the child being underweight. Depressed mothers-to-be are often perked up by a relaxing massage, so they may well come to you regularly for a pick me up during their pregnancy.

How to ensure you give the best possible massage

If you haven’t done a course, even just a one day or week-end course as an extra after your main qualification, then it would be wise to do some research and watch some videos demonstrating good techniques. It is always important to find out from the client how far into the pregnancy she is and ask her what her particular issues are – take as many specific details as you can about where she may be feeling physical discomfort, when it’s at it’s worst etc., so that you can decide whether the areas should be massaged or avoided. Check that she has consulted her doctor about the suitability of massage at her stage of pregnancy. This way she will feel confident that you are concerned with her condition and are going to take a lot of care during the massage itself.

Prone positioning is simply not going to work for a pregnant woman and can be quite detrimental to her pregnancy, compression or exerting strain on the pelvic and lumbar regions as well as the joints and ligaments. Back discomfort, which is likely to be what they came to you for relief from, will be aggravated greatly. Equally, supine position can cause a few problems with some women reporting dizziness and difficulty breathing. Others may be totally ok with this, so you can ask them how they feel but it may be better to err on the side of caution, especially with heavily pregnant women.

It is much better to position the client on her side and ensure that she is fully supported using pillows and/or bolsters. If you think you will be doing regular massages it could be wise to invest in a body cushion, otherwise known as a prenatal cushion; these are designed for pregnant women and can take the pressure off all round. Lying on the side is the most comfortable and is generally accepted as the safest position for a pregnant woman to receive a massage. Regardless, care must be taken not to exert too much pressure so that the woman is not moved onto her abdomen.

Swedish massage is the generally accepted massage treatment for pregnant women due to its efficacy in reducing the many discomforts pregnant women are going through. Most massage therapists started with Swedish so you are likely to be familiar with the necessary techniques and the benefits this type of massage produces. Pregnant women benefit from relief from muscular tension, lymphatic drainage and improved circulation more than most clients. Effluerage, petrissage and tapotement are the main strokes required.

How do you feel about pregnancy massage as a therapist? Do you find it easy and feel comfortable treating heavily pregnant women? Do you have any tips for successful pregnancy massage, and what props do you use for comfort? Please share your ideas with us!

Lisa Rose
Lisa Rose


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Massage Table Size Guide

Massage tables comes in many different shapes and size. It can be confusing for you, the customer, to choose the right one but we are here to help!

A lot of customers call us up after they have bought the wrong size massage table elsewhere and we would like to help you avoid this mistake. It normally goes something like this; they like the look of a picture of a massage table on a website, they like the low price and then they check the carrying weight is ok. If the carrying weight fits their needs they click add to cart and the new massage table turns up at their doorstep in a few days. They unfortunately assume all massage tables are pretty much the same width and size.

The standard size of a massage table is 28 inches wide (71cms) and 73 inches (185cms) long. One of the reasons many "lightweight" budget massage tables are so cheap is because

  1.  They are smaller in size (normally around 61cms wide) and as such have less materials
  2. They are sold by specialist retailers who also sell anything else they can import and turn a profit on. As such they just buy the cheapest massage tables they can find in China. They go for smaller sizes as they are cheaper.

Make sure the massage table is the right size for you and your clients as the narrow massage tables at 61cms can be very uncomfortable for anyone who isn't petite and many clients cannot relax with their shoulders and arms unsupported.


The Width of the Massage Table:

Almost all therapists choose the standard 28 inch wide massage table. All our massage tables are the same length so it is only the width and shape our customers need to decide on.

Your massage table should be wide enough to cater for the wide variety of shapes and sizes of your clients. It needs to be wide enough to comfortably accommodate your treatment style, while being narrow enough to ensure you don’t have to strain your own back during treatments.

Each therapist's postural training and ability is different, so only you will know what massage table width you can handle. We have spoken to therapists who are five feet tall and get the wider 30 inch massage tables, and we speak to six foot therapists who have back problems and go for a 25 inch wide massage table. Everyone is different.

Generally speaking, if you are of smaller stature, you may do better with one of the narrower 25-inch massage tables. If you're quite tall, or are particularly keen to offer your clients a very spacious experience, a 30-inch massage table might be more suitable.

If you are in doubt, see if you can go into your local training college and see whether the massage tables there suit you. However, there is another way to get a feel for what will work of you don’t have access to a couch when you are deciding:

Cut out a piece of cardboard to the dimensions of both sizes you are deciding between. Put it on top of the kitchen table and lean over it. Visualise a client lying there, and see which width will suit you and your client best.

measuring the width of a massage table

Make sure you can get close enough to the table that you can pivot at the waist and have your shoulders squared to the clients hips, with your hands parallel to the clients' spine. Working in this position will ensure an injury-free career, so it's an important factor in your decision.

The most popular massage table widths are 28 and 30 inches. We sell 25-inch massage tables but you should really only choose this width if you are shorter in height and having a wider massage table might put your own back at risk over the course of your career.

You can also choose the 25-inch if you want to have the lightest massage table possible. By reducing the width of the massage table, the weight is also reduced. Now, this can mean a trade-off of some client comfort, but this trade is often worthwhile if you are a fully mobile therapist and use public transport frequently, where saving a kilogram or two will make a difference to you over time.


The Height Of the Massage Table

Nowadays, almost all portable massage tables come with height adjustable legs. Whichever massage table you choose should come with a large height range to accommodate you, and to cater for a broad range of therapies.

A common height range of massage tables is between 60 to 80cm, and this height range should cater for everyone. To check which height you need your massage table to be at follow this rule of thumb:

1. Stand up straight with your hands by your sides. Clench your fists.
2. Measure the distance between the floor and your knuckles
3. This distance should equal the height of your massage table.
4. Add a few inches in height to allow for the body of the patient on the massage table.

The height of a massage table is usually only adjusted when different therapists are using the same massage table, or if you have a client that is outside the average size you normally treat. So for example, if someone with a lot of body depth comes for a treatment after an average size person, you may need to adjust the height a notch or two.

You should be able to adjust the height of a massage table in just 2-3 minutes. Even though you mightn't adjust the height very often, the faster the better when you do have to!

There are 2 types of height adjustment mechanisms found on modern massage tables.

1) Twisting knobs (found only on wooden massage tables):

If you are working with a wooden massage table, it is better to have two knobs on each of the four legs for greater strength and reliability. When buying online, make sure to check how many knobs are on the legs. Cheap massage tables often only have one knob, and when you raise the legs to the highest heights they are less stable and have been known to snap.

2) Telescopic push-buttons (found only on aluminium massage tables):

The mechanism to adjust the height of an aluminium massage table is much the same as the push-button method on aluminium crutches. It only takes a few seconds to adjust each leg, and the mechanism is very reliable. Check out the video to see how it’s done.


Massage Table Shape:

The following are the different shapes of massage tables on the market.

1. Rectangle shaped with square corners 

This is the traditional shape of a massage table and the one you are probably familiar with seeing. Our Combi-lite 3 in 1 and Affinity Portaflex are shaped like this.

2. Rectangle shaped with rounded corners

Same as no 1 above in every way except the corners are rounded. Does not affect function in any way, just a different design/look.


3. Hour glass shaped with gradual gradient 

A fabulous massage table innovation in recent years, which solves a lot of the problems around choosing the correct width is the hourglass shaped massage table.

This style of massage table is wider at the ends, and tapers somewhat at the middle. This provide a spacious and comfortable experience for your client (as the shoulder and feet area are 30 inches wide) without compromising your own posture and health, as the middle of the couch where you lean over is a much narrower 26 inches wide.Having recently upgraded to one of these hourglass massage tables myself, I can vouch that my working days are much more comfortable, and many of my clients have commented on the extra comfort from the wider shoulder area.


4. Hour glass shaped with sharp gradient
Same as point above but instead of the it gradually going from wide to narrow, the massage table changes quickly from normal width to narrow width so people of very short stature can get in close.
5. Oval Shaped

 The name says it all! There are no corners on the massage table. Therapists normally choose this for one of two reasons. They simply like the look of this massage table and it is aesthetically more pleasing in their treatment room and/or they find it easier to move around the massage table during the treatment without having to side step the corners. This is particularly handy when space is limited in your treatment room.

oval massage table


Have any questions or comments about anything above? Please let us know in the comments below!