Cautions, Indications and Contraindications

Question 1

When is abdominal massage contraindicated? (6)

Answer 1

FIRST TRIMESTER
\+
HIGH RISK
\+
CERVIX/PLACENTA PROBLEMS
\+
PRE-TERM LABOUR OR THREAT
\+
VAGINAL/UTERINE BLEEDING
\+
WHEN HEALTH OF FETUS IN QUESTION

Question 2

What are the two great benefits to massage when indicated in the 2nd, 3rd trimesters?

Answer 2

ENHANCE BIRTH PARENT’S CONNECTION
+
INCREASES TISSUE STRATCH

Question 3

You should always massage the abdomen lateral to medial so you are not increasing the ___________ _________.

Answer 3

DIASTASIS RECTI

Question 4

Name the contraindications to breast massage? (6)

Answer 4

HIGH RISK PREGNANCY
\+
MASTITIS
\+
BREAST CANCER/ UNDIAGNOSED LUMP
\+
POST-SURGICAL INFECTION
\+
CURRENT ACTIVE INFECTION
\+
ABSCESS

Question 5

Name the indications to breast massage during pregnancy? (5)

Answer 5

HIGH LEVEL OF CHANGE IN BREAST TISSUE
\+
PAIN
\+
CONGESTION
\+
MSK STRUCTURAL IMBALANCES (POSTURE, PECS)
\+
TOS DUE TO PREGNANCY POSTURE

Question 6

Name the indications to breast massage during breastfeeding? (4)

Answer 6

PAIN
\+
CONGESTION
\+
MSK STRUCTURAL IMBALANCES (feeding positions)
\+
TOS DUE TO BREASTFEEDING POSITIONS

Question 7

What may appear for the first time in pregnancy, and when severe, serve as a warning sign to possible clots in deeper veins?

Answer 7

VARICOSITIES

Question 8

Name the symptoms of blood clots? (5)

Answer 8

SUDDEN, SEVERE PAIN
\+
LEFT LEG/ILIOFEMORAL VEIN (80-90% occurrences)
(NO deep pressure to adductor/inguinal region - contr)
\+
DECREASED CIRCULATION TO AFFECTED LIMB
\+
PAIN ON PALP
\+
NOTE ~ CLOTS CAN BE ASYMPTOMATIC

Question 9

What increases the likelihood of clots?

Answer 9

BEDREST, SURGERY

leg injury, smoking, age 40+, obesity, history of DVTs

Question 10

DVTs are _____x_ more likely to occur in pregnant patients.

Answer 10

6 x

Question 11

DVTs are _____x_ more likely to occur in the postpartum period, and the patient has a _____x_ greater risk for developing a pulmonary emboli (in comparison to pregnancy).

Answer 11

5 x
and
15 x

Question 12

If there are known blood clots in the leg, or serious varicosities, what should you treat?

Answer 12

NOT THE LEGS. CONTRAINDICATED.

Question 13

Any technique that may slow or stop ________ _______ is contraindicated.

Answer 13

BLOOD FLOW

stripping, specific comp, deep tapotement

Question 14

In considering general ligament movement, pregnant patients have MORE difficulty with ___________ than ___________.

Answer 14

more difficulty with
STABILITY
than
MOBILITY

Question 15

Although we want to decrease MRT, it may be there to support structures compromised due to amount of __________. Therefore we need to carefully balance decreasing tension and maintaining stability.

Answer 15

RELAXIN

compromises ligaments (and stability)

Question 16

Name the two hormones which soften connective tissue in the body?

Answer 16

RELAXIN
and
PROGESTERONE

Question 17

When are ligaments considered lax/soft during pregnancy? (from relaxin)

Answer 17

10 WEEKS GESTATION
to
6 MONTHS POSTPARTUM

Question 18

Name the structures most affected by lax ligaments?

Answer 18

PELVIS
+
LUMBAR SPINE

Question 19

Because joints may feel “wobbly”, use low grade jj mo applications and no _____________.

Answer 19

OVERPRESSURE

Question 20

Name the contraindicated jj mo which may induce pre-term labour, especially in high risk pregnancies?

Answer 20

PELVIC/SACRAL JOINT MOBILIZATION

contraindicated

Question 21

Along with prescribing the butterfly stretch for self care, how might you instruct they do it?

Answer 21

MID-RANGE
\+
SLOWLY
\+
BREATHING

Question 22

In high risk pregnancies, any stretch that has the potential to destabilize the __________ is completely CI’d, as it may induce pre-term labour.

Answer 22

PELVIS

Question 23

If pubic symphesis dysfunction is present, which muscles would you be certain NOT to stretch?

Answer 23

PSOAS

other HIP FLEXORS

Question 24

What is the false rumor about foot massage during pregnancy?

Answer 24

INDUCES PRE-TERM LABOUR - TOTALLY FALSE

FOOT MX IS GREAT!

Question 25

Where should the therapist avoid acupressure? (7)

Answer 25

LARGE INTESTINE
SPLEEN
KIDNEY
URINARY BLADDER
LIVER
GALL BLADDER
BLADDER

Question 26

Name the only time sacral work is completely CI’d in pregnancy?

Answer 26

HIGH RISK PREGNANCY

otherwise broad techniques are great

Question 27

Name the two high risk sacral contraindications which may induce pre-term labour?

Answer 27

DEEP/ PROLONGED/ POINTED PRESSURE
+
SACRAL JJ MOBES

Question 28

Name the temperature which a pregnant body cannot exceed, and therefore contraindicates full body heat treatments?

Answer 28

102.6 DEGREES F
or
39.2 C

Question 29

List some indications of heat hydrotherapy in pregnancy?

GT Flip

Answer 29

localized examples:
THERMOPHORE low back/ gluteals
PARRAFIN WAX to the IT band
HYDROCOLLATOR to posterior trunk

Question 30

Name the max bath temp, and how deep the pregnant lady can get in?

Answer 30

36.7 - 37.2 DEGREES C
\+
TORSO and ARMS out of water
\+
COMPLETELY CI'd FOR HIGH RISK

Question 31

How can hydrotherapy help with edema and carpal tunnel syndrome?

Answer 31

COLD TOWEL WRAPS + ELEVATION

wrists or hands or feet or ankles

Question 32

How can hydrotherapy help with breast congestion/TOS/mastitis?

Answer 32

COOL FIGURE 8 TOWELS
\+
COLD TOWEL ON CHEST WALL
\+
WARM TOWELS POSTPARTUM OK, IF CONGESTION DECREASED

Question 33

How can hydrotherapy help with caesarean birth scar tissue?

Answer 33

WARM TISSUES = EFFECTIVE SCAR WORK
CASTOR OIL
\+
PARRAFIN WAX
\+
DEEP MOIST HEAT