Massage during pregnancy and lactation: indications, types, and rules

The article discusses the effects of massage during pregnancy and lactation, common misconceptions, and also the benefits of hardware massage and RSL sculpting procedure.

Introduction

Quality of woman’s life is determined by her pregnancy progress, childbirth, and the puerperium. More often than not, during pregnancy and after giving birth, women have to face the following problems:

• pain in the back, neck, lumbosacral pain, sacro-iliac joint pain, lower limb pain, cramps in leg;
• psychic tension, fatigue, dizziness, insomnia, headache;
• symptoms of mild toxicosis (nausea, excessive salivation, swelling of the lower limbs, slight increase in blood pressure);
• stretch marks (striae) in the breast, abdominal and thigh area ¹.

All of the above stimulate interest in the problem of using various physical factors during pregnancy and the puerperium. The exposure of several physical factors to the receptive fields, functionally active areas, and centers of nervous, endocrine, and immune regulation leads to pronounced anti-inflammatory, decongestant, analgesic, uterotonic, desensitizing, immunomodulatory, and sedation effects ². This triggers natural processes of homeostatic regulation of the body’s functional systems, the adaptive capabilities of the female body are increased, and complications of the postpartum period are prevented ³-⁵.

Advantages of the physical factors include physiological nature, there are no restrictions as far as mother/child contact during the procedure is concerned, possibility of widespread application during lactation due to the absence of a negative effect on the child's body, good compatibility with other therapeutic agents and possibility of using the physical factors in various therapeutic regimens, painlessness, and lack of toxicity and allergic reactions ³-⁵.

However, there are a number of contraindications to the prescription of therapeutic physical methods ⁶-¹⁰:

• severe general condition;
• body temperature above 38 °C;
• sepsis suspected;
• history of malignant tumor or their current presence in patients;
• mental illnesses;
• active tuberculosis;
• use of cardiac pacemaker;
• cardiovascular insufficiency, pulmonary insufficiency, renal failure;
• bleedings;
• thrombophlebitis.

Exposure method selection

Various types of massage are the most common and affordable physical exposure methods. Manual massage is by far less effective than mechanical massage as it cannot guarantee deep tissue treatment, an even and deep pressure and has a demerit related to the “human factor” as people can get tired. RSL sculpting procedure performed using Beautylizer is one of the most advanced, effective, and safe procedures of mechanical massage (fig. 1). It is based on the vibration and compression effect of spheres and high-brightness red light on all skin layers, hypodermis, and also on muscles, due to which the following is achieved:

• activation of blood flow and lymphokinesis;
• reducing the pain syndrome;
• muscle strengthening, increasing the elasticity of muscular-ligamentous apparatus, joint mobility retention;
• improving the metabolism;
• improving the psychoemotional state.

Contraindications to RSL sculpting procedure during pregnancy are general contraindications to prescribing therapeutic physical methods ⁶-¹⁰. However, in some cases, even if there are contradictions, methods of point impact can be used. In case of uncomplicated history at the beginning of pregnancy, RSL sculpting can be used when a woman is placed on the abdomen.

If there is soreness in the projection of the mammary glands, it is advisable to put a bolster or small pillows under the subclavian areas.

The procedure may be also performed while lying on the side or in the sitting position.

It is not advisable to perform the massage while lying on the back, especially after the 17th week of pregnancy, because it leads to compression of large vessels and nerve stems in the abdomen and pelvic area. During the procedure, while lying on the side, the leg placed below should be almost straightened, and the upper leg should be bent at the knee and hip joints. To stabilize the body position, a pillow is placed under the bent knee ^1,2,9. Sometimes another pillow is required under the stomach for more relaxation. Performing RSL sculpting in the first trimester (1–16 weeks) is aimed mostly at overall body reinforcement. RSL sculpting in the second trimester (17–32 weeks) can be focused on some specific issues (reducing pain in the back, decreasing swelling). During pregnancy, the RSL sculpting should not cover the abdomen area. It is not recommended during the first 3 months of pregnancy to make a strong pressure in the lumbar region. Most often, muscular tension during pregnancy is clustered in the collar zone and scapular area, which leads to pain, neck stiffness, and headaches. Due to the exposure of the skin mechanoreceptors by vibration, the strength of pain significantly reduces ^1,2.

RSL sculpting is especially effective in swelling, tired and aching legs. Swelling and pain in the lower limbs are removed due to the following effects:

• vasodilating effect: compression and subsequent restoration of tissue volume due to its elastic properties provide vasodilation and a significant increase in microcirculation;
• draining effect: rhythmic pulsation stimulates lymph flow, facilitating the removal of excess fluid;
• relaxing effect: the device has a stretching effect on muscles, effectively relieving muscle spasms.

As regards the lower limb treatment, avoid strong pressure with a handpiece on the inner thigh area as well as on the inner area of the lower third of the leg.

During pregnancy, the procedure may be performed as a general or local massage. In case of normal pregnancy, it is possible to perform general massage with a frequency of about 2 times per week and a duration of 1 hour.

Special massage using the Beautylizer device involves exposure to the collar zone, lumbosacral area, joints, and soft tissue of the limbs (especially the lower limbs). Such 15–20 min massage can be performed every other day or even daily ^1,2,9.

Signs of early and late pregnancy toxicosis necessitate point impacting. The treatment program includes 5–10 procedures.
Some specialists believe that massage helps accelerate toxin excretion from the tissues, resulting in a temporary increase in their concentration in the blood and thus in breast milk. That’s why experts do not recommend performing the massage during lactation. The term “toxins” means compounds with noci-influence on the cells ¹¹. There are exotoxins and endotoxins ^12,13. Exotoxins enter the body from outside as inorganic and/or organic compounds. Endotoxins are synthesized and metabolized by the organism ¹⁴. Intoxication is a stage pathological process prone to progression and generalization, which is accompanied by the accumulation of toxic substances (toxins) of exogenous and/or endogenous origin in the bloodstream ^12,13. Intoxication as a typical pathological process determines organ or systemic reactions in the patient’s body. Otherwise, it is not possible to miss the symptoms of prolonged intoxication ¹⁵. Toxin excretion from the body occurs mainly through the renal, hepato-, and gastrointestinal systems, and to a lesser extent through the lungs. Skin and glands of internal secretion (sweat, sebaceous, salivary, mammary etc.) play a relatively small role in the process of toxin excretion. Through them, small amounts of nonelectrolytes are excreted (ethyl alcohol, acetone, arsenic compounds, bromides, quinine, etc.) ^14,16. Thus, it is impossible to cause intoxication of an organism by methods aimed at toxin excretion, especially when the organs of the excretory system are functioning normally ¹⁷. RSL sculpting can be started one month after natural childbirth that passed without complications, and 1.5–2 months after a C-section or childbirth with complications ¹.

The mechanical exposure during lactation shouldn’t cause any pain. The release of stress hormones in response to pain can reduce oxytocin production and, thus, lead to a reduction of muscle cells around the alveoles and push milk through the ducts to the nipple. The correct performance of the procedure, on the opposite, can normalize the lactation due to the improvement of the psychoemotional state of the lactating woman and the proper organization of her relaxation ¹⁸.