Chapter 19: Massage for Special Populations

Vocabulary flashcards covering prenatal, infant, pediatric, elderly, disability, cancer, hospice, and related topics from the notes.

Prenatal massage

Massage applied to pregnant clients, using trimester-specific positioning and safety considerations to promote relaxation and alleviate discomfort.

Benefits of prenatal massage

Relaxation, pain relief, improved sleep, reduced stress, and potentially better maternal
–fetal outcomes when performed safely.

Supine position (pregnant client)

Lying on the back; after ~22 weeks use semi-reclined support to avoid vena cava compression.

Supine Hypotensive Syndrome

A condition in pregnant clients after roughly 22 weeks where lying supine compresses the vena cava, reducing blood flow to the heart and fetus, causing dizziness and nausea.

Semi-reclining position

A 45–70 degree incline used in later pregnancy to minimize abdominal pressure and maintain blood flow.

Side-lying position (pregnant client)

The most comfortable position for pregnancy massage; pillows support head, abdomen, knee, and arm.

Prone position (pregnant client)

Used only early in pregnancy or when safe; abdomen supported by cushions and pressure on abdomen avoided.

Abdominal massage contraindication during pregnancy

Abdominal massage is restricted to very light gliding after the second trimester and only with consent; avoid deep stimulation.

Preeclampsia

Pregnancy-induced hypertension with potential danger; massage is contraindicated until evaluated by a physician.

Gestational hypertension (PIH)

High blood pressure during pregnancy; massage requires physician clearance before proceeding.

Varicose veins

Veins enlarged by pregnancy hormones and pressure; use light gliding and avoid deep techniques to reduce clot risk.

Deep vein thrombosis (DVT)

Blood clot risk in pregnancy; avoid deep or heavy massage of the legs and refer if signs appear.

First trimester concerns

Nausea, breast tenderness, mood changes, fatigue; higher miscarriage risk; massage often postponed or carefully monitored.

Second trimester considerations

Often a period of increased energy; focus on supporting growing abdomen, addressing emerging back/pelvic pain, and adjusting to side-lying/semi-reclining positions.

Third trimester considerations

Significant weight gain, increased edema, potential for sciatic pain and shortness of breath; side-lying position is crucial, focus on comfort and circulatory support.

Maternal concerns by trimester

Overview of trimester-specific concerns guiding massage planning and positioning.

Edema in pregnancy

Swelling, especially in legs/feet; massage may help with gentle lymph/creeping massage if limited; widespread edema requires medical input.

Hormonal changes: relaxin

Hormone that softens ligaments in preparation for birth; increases risk of overstretching during ROM.

ROM caution

Limit range of motion in pregnancy massage to avoid overstretching ligaments due to relaxin.

Contraindications for prenatal massage

Conditions requiring medical clearance (e.g., high-risk pregnancy, preeclampsia, vaginal bleeding, severe medical complications).

Labor massage

Massage during labor to relieve lower back pain and improve relaxation between contractions.

Postpartum massage

Massage after birth focused on relaxation and recovery; supports adapting to infant care and physical changes.

Infant massage

Therapeutic touch taught to caregivers to promote bonding, communication, and development through gentle strokes.

History of infant massage

Origins traced to multiple cultures; popularized by Leboyer and Vimala McClure; CIMI development.

Skinship

Tactile bonding between infant and caregiver, enhancing awareness of infant states and cues.

CIMI

Certified Infant Massage Instructor; credential for teaching infant massage.

Infant massage routines

Two common routines: a simple routine for premature/newborns and a well-baby routine for older infants.

Lubricants for infant massage

Edible, fragrance-free oils such as sweet almond, grapeseed, or olive oil; test for allergies.

Signs of engagement

Eye contact, cooing, and smiling indicate engagement; disengagement includes gaze aversion, fussing, or crying.

Infant disengagement cues

Behaviors such as gaze aversion, fussing, crying, arching away, or turning the head, indicating the infant is overwhelmed or uncomfortable and needs a break from massage.

Rooting reflex

Turning the head toward touch on the cheek, often indicating hunger and suggesting feeding may be needed.

Where to massage infant

On a blanket on the floor with a nest of pillows to elevate the head and torso safely.

Infant massage safety cues

Keep room warm; start with stationary touch; progress slowly to avoid overstimulation; watch for cues.

Who should perform infant massage

Primarily the parent or caregiver, trained by a certified instructor; therapist teaches, not massaging the infant alone.

Benefits of infant massage

Bonding, improved communication, support for body system development, relaxation, and relief of tension.

Disabilities: general accommodations

Modify massage for safety and comfort; ask what assistance is needed; tailor plan to each disability.

Auditory impairment accommodations

Speak clearly, face the client, use writing or gestures; interpreter if needed; read nonverbal cues.

Visual impairment accommodations

Guide the client safely; describe surroundings; allow service animals; maintain client contact during session.

Limited mobility accommodations

Ensure wheelchair access, appropriate table height, and assist with transfers as needed.

Paralysis (types)

Hemiplegia (one side), paraplegia (legs), quadriplegia (all four limbs); avoid deep work on paralyzed areas and tailor ROM carefully.

Prosthetics and amputees

Consider stump care and phantom pain; ask permission to work near prosthesis; coordinate with clinicians.

Cancer: oncology massage

Massage adapted for cancer patients; aims to reduce pain and anxiety; plan tailored to site, stage, and treatment.

Cancer metastasis

Spread of cancer via direct invasion, body cavities, bloodstream, or lymphatics; treat metastasis sites with caution.

Staging (I–IV)

System describing cancer extent: Stage I localized, Stage IV distant spread; Recurrence indicates return.

TNM classification

Tumor (T), Node (N), Metastasis (M); supplementary to stage to describe cancer extent.

Oncology massage guidelines

Consult physician; individualize plan; use light to moderate pressure; avoid tumor sites and fragile areas.

Modifying pressure in oncology massage

Light to very light pressure, typically no more than 5g per square centimeter, is recommended in oncology massage, especially over fragile areas, tumor sites, and areas affected by treatment.

Surgery contraindications in cancer

Recent incisions, healing tissue, clots, infection; avoid massage near surgical sites unless cleared.

Chemotherapy side effects

Nausea, vomiting, mucositis, anemia, leukopenia, thrombocytopenia, fatigue, neuropathy; adjust massage accordingly.

Radiation side effects

Skin changes, burns, tissue fragility, lymphedema risk; avoid irradiated areas and follow physician guidance.

Lymphedema (cancer context)

Swelling caused by lymph fluid accumulation, often a side effect of cancer treatment (surgery, radiation) impacting lymph nodes; requires specialized massage techniques and medical clearance.

End-of-life/hospice massage

Gentle, comforting touch to improve comfort and quality of life; involve family; tailor to patient wishes.

Six phases of cancer progression

Onset, diagnosis/pretreatment, treatment, remission, advanced disease, end of