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Self-myofascial release has benefits for pregnant women.

During pregnancy a woman's body goes through a substantial amount of physical changes to accommodate a growing baby. Mothers commonly experience pain related to soft tissue and general discomfort during pregnancy. Massage has become a welcome remedy to the challenges the human body faces while growing a baby (Cassar, 2001; Kimber, 2002). Mothers who practice massage during pregnancy report fewer aches and pains, experience less edema, are less likely to have an episiotomy, and have a notable release in myofascial trigger points (Coban & Sirin, 2010; Kuehn; Osborne, 2008). Massage has also shown to decrease stress and depression, as well as improve overall relaxation in pregnant women (Agren & Berg, 2006; Field, Diego, Hernandez-Reif, Schanberg, & Kuhn, 2004; Osborne, 2008). Babies born from women who had massage during pregnancy are less likely to be born prematurely and to be at a low birth weight (Field, Diego, & Hernandez-Reif, 2008; Field, Diego, Hernandez-Reif, Deeds, & Figueiredo, 2009; Field et al., 2012; Field, et al., 1999). Assuming a healthy, low-risk pregnancy, massage may help the pregnant mother relieve common discomforts experienced during pregnancy. A low-cost, effective way to practice massage throughout pregnancy is to perform a technique of self-massage called self-myofascial release (SMR).

Exercise including strength, cardiovascular, and flexibility training offer many benefits for the pregnant mom. Improved core strength, stress relief, weight control, and preparing the muscles and body for labor are a few of these benefits (Clinic, 2015; Cochrum, 2015). A supplemental component to add to the current pregnant exerciser's routine is performing SMR. SMR first became popular with world class athletes who used SMR to aid in their athletic performances through increased range of motion, increased flexibility, and quicker recovery (Okamoto, Masuhara, & Ikuta, 2014; Trigger Point Performance, 2015). As athletes continue to perform SMR, it has also gained popularity with other populations such as those with chronic disease, older adults, and the general public (Ajimsha, Daniel, & Chithra, 2014; Castro-Sanchez et al., 2011; Okamoto, et al., 2014).

Like massage, SMR in particular has also shown to decrease stress, increase flexibility, and provide relief from back pain in the non-pregnant population (Ajimsha, et al., 2014; Okamoto, et al., 2014). The technique of SMR helps to loosen up fascial adhesions found in the connective tissue throughout the body (myofascia is the specific fascia connected to muscle fibers (Trigger Point Performance, 2015)). The fascia adheres due to overuse or trauma. SMR done correctly may loosen up the fascial adhesions and in turn, can lessen perceived pain and soreness, increase mobility, increase flexibility, and increase range of motion (Ajimsha, et al., 2014; Okamoto, et al., 2014; Trigger Point Performance, 2015). The exerciser can choose to do SMR techniques before, after, or without exercise. The purpose of performing SMR prior to exercise is to warm up and prepare soft tissues for movement to come during the exercise session. Benefits of performing SMR after exercise allow the body to cool down after physical activity and administer self-care. Some mothers-to-be may also enjoy doing SMR outside of organized exercise to relieve soreness found in the soft tissues. Mothers may try incorporating SMR techniques before, after, and without exercise and to continue doing these practices when and where it feels best.

SMR may be performed with many different tools including foam rollers, massage sticks, massage balls, and hands. These tools range from $2 to $65+ depending on which tools the user prefers, making SMR an inexpensive alternative to visiting a massage therapist (Burgan, 2013; Trigger Point Performance, 2015). SMR may also be used in addition to regular massage by a massage therapist to aid in the gains made during a prenatal massage session.

As with all exercise during pregnancy, it is recommended moms speak with their provider about risks and benefits of any physical activity. It is cautioned to avoid directly rolling over bones or joints while performing SMR (Trigger Point Performance, 2015). Other conditions which require a discussion with the pregnant woman's provider include: open wounds, infection of the skin or soft tissue, muscle and tendon ruptures, bursitis, tumors, broken bones, rheumatoid arthritis and gout, artificial blood vessels, hemophilia and other blood disorders, and pregnancy (Trigger Point Performance, 2015). While research in the field is scarce regarding the risks or benefits of rolling on the lower back, applying general exercise recommendations during pregnancy is advised. Specifically, this includes not rolling on the lower back, side of the belly, and the front of the belly.

Massage has shown to benefit mother and baby throughout pregnancy. The positive associations of massage and mothers' overall wellbeing may give providers a better understanding of massage's effects when speaking about massage with pregnant mothers. By breaking up myofascial adhesions, or sore areas, SMR in particular can alleviate discomfort and pain felt in the soft tissues of the human body during pregnancy. SMR is a technique all mothers can learn and is relatively inexpensive. Providers can feel confident in encouraging SMR to mothers with a low-risk healthy pregnancy.

To perform SMR, practice the following suggestions:

1. As with all things exercise related, you should ease yourself in gradually.

2. Start with a softer roller. It is better to apply too little pressure than too much, especially in the beginning.

3. Always roll on soft tissue.

4. Never roll over joints or directly on bone.

5. Use short, slow rolling motions to go over the entire muscle.

6. Once you feel a comfortable level of control, administer pressure to the most sensitive areas for roughly 20 to 30 seconds. As you get to know your body and how it responds to foam rolling, you may go shorter or longer as needed.

7. Do not hold over areas with PAIN. If pain occurs, then back off from the area and work the surrounding tissues.

8. Consult an exercise professional to assist with the movements for more instruction on SMR techniques. A list of exercise professionals certified as an International Childbirth Prenatal Fitness Educator can be found on the International Childbirth Education Association's website at


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Ajimsha, M. S., Daniel, B., & Chithra, S. (2014). Effectiveness of myofascial release in the management of chronic low back pain in nursing professionals. Journal of Bodywork Movement Therapies, 18(2), 273-281.

Burgan, B. (2013, 7/2/13). How much does massage therapy cost? Retrieved October 23, 2015, from

Cassar, M. P. (2001). Massage in pregnancy. Practicing Midwife, 4(5), 10-13.

Castro-Sanchez, A. M., Mataran-Penarrocha, G. A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J. M., & Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidenced Based Complementary and Alternative Medicine, 56/753(10), 28.

Coban, A., & Sirin, A. (2010). Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: a randomized controlled trial in Turkey. International Journal of Nursing Practice, 16(5), 454-460.

Cochrum, R. (2015). Postpartum Weight Control and the Contribution of Exercise. International Journal of Childbirth Education, 30(1), 48-53.

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Field, T., Diego, M., Hernandez-Reif, M., Deeds, O., & Figueiredo, B. (2009). Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behavior and Development, 32(4), 454-460.

Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapy, 16(2), 204-209.

Field, T., Diego, M. A., Hernandez-Reif, M., Schanberg, S., & Kuhn, C. (2004). Massage therapy effects on depressed pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 25(2), 115-122.

Field, T., Hernandez-Reif, M., Hart, S., Theakston, H., Schanberg, S., & Kuhn, C. (1999). Pregnant women benefit from massage therapy. Journal of Psychosomatic Obstetrics & Gynecology, 20(1), 31-38.

Kimber, L. (2002). Massage for childbirth and pregnancy-8 years on. Practicing Midwife, 5(3), 20-23.

Kuehn, B. M. (2006). Massage during last weeks of pregnancy reduces episiotomies during delivery. JAMA, 22, 295(12), 1361-1362.

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Okamoto, T., Masuhara, M., & Ikuta, K. (2014). Acute effects of self-myofascial release using a foam roller on arterial function. Journal of Strength and Conditioning Research, 28(1), 69-73.

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by Desiree J. Ahrens, MA IBCLCICPFE EPC

Desiree Ahrens is a Health and Wellness Coach at the Dan Abraham Healthy Living Center, Mayo Clinic. She has a MA in Exercise Physiology from the College of St. Scholastica, a BS in Kinesiology from the University of Minnesota, is Exercise Physiologist Certified by American Society of Exercise Physiologists, is an International Childbirth Prenatal Fitness Educator and is an International Board Certified Lactation Consultant. She currently works with both prenatal and postnatal wellness programs at the Mayo Clinic.
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Author:Ahrens, Desiree J.
Publication:International Journal of Childbirth Education
Article Type:Report
Geographic Code:1USA
Date:Jan 1, 2016
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