Elaine Stillerman is licensee of the month. Elaine received her New York State massage license in 1978 and began her pioneering work in prenatal massage in 1980. In 1990, she developed and started teaching the professional certification course “MotherMassage ®: Massage during Pregnancy” at massage schools and resorts across the country and internationally. She is the author of MotherMassage: A Handbook for Relieving the Discomforts of Pregnancy (Dell, 1992), The Encyclopedia of Bodywork (Facts On File, 1996), Prenatal Massage: A Textbook of Pregnancy, Labor, and Postpartum Bodywork (Mosby, 2008), and Modalities for Massage and Bodywork (Mosby, 2009). She has authored numerous articles on prenatal massage for massage magazines and professional journals and is the columnist of “Womankind” which appears in Massage Today. She has been featured in every major magazine in the United States, on radio, and on numerous television shows including “Live with Regis and Kelly”, “Access Hollywood”, CBS-News, and “Real Savvy Moms”, where she was also an award winning writer. She is the creator and proprietor of the website www.BigAppleOranges.com which is a comprehensive resource for NYC families of children with special needs. During her pregnancy, she trained with Julie Tupler and her diastasis got smaller as her belly got bigger! In 2010, Elaine became a licensee of the Tupler Technique® and created CoRehab – Diastasis Repair. She lives and works in Brooklyn, NY.
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Elaine, one of the funniest and smartest women I know, has shared with me how she teaches core integrity to massage professionals. I would like to share it with you.
“One thing I teach my prenatal massage students about is the importance of proper body mechanics. Not just theirs when they work, but their clients as well, throughout their daily activities. Restorative work is easy to do with a client on the massage table. But all of this work can easily go down the drain if the client doesn’t use proper body mechanics once they stand up.
And this is where education about core integrity – and core awareness – comes into play. Massage professionals and body workers have to be able to explain this concept to their clients, so they have to be informed.
While describing the physiological changes that occur during pregnancy, I explain that as the uterus grows from a pelvic organ to an abdominal one, the abdominal muscles stretch and weaken as the connective tissue of the linea alba stretches and widens from both the growing baby and hormonal influences. This stretching, the diastasis recti, provides necessary space for the baby to grow, but severely compromises mother’s structural integrity. Locally, the diastasis recti contributes to an anterior pelvic tilt which exacerbates the lumbar curve and tightens the muscles of the lower back. Abdominal core weakness fails to support the gravid uterus in an optimum position and contributes to its anterior placement. This in turn can make labor longer.
The effects of a weakened core can also be felt distally. The body normally seeks homeostasis, so when one part is out of position (or alignment), the body compensates (to seek balance) by placing another body part in an equal but opposite misalignment. During pregnancy, the anterior pelvic tilt causes the shoulders to laterally rotate (and subsequent trigger points to become active) and the head to protract. All to seek postural balance. The head position places pressure on the lower cervical vertebrae which, in turn, weakens the neurological message to arms and hands. Parasthesia or carpal tunnel syndrome are associated with pressure on the lower cervicals. The lower half of the body is also affected by the anterior pelvic tilt. The attachment of the hamstrings on the ischial tuberosities is tightened and the knees hyperextend.
With this maladapted posture, expectant mothers often complain about muscle aches and pains. Is there a solution? Is there a way to improve prenatal posture even as the baby grows? Yes! By minimizing the diastasis recti (or at least stabilizing it), abdominal muscles shorten and strengthen and the connective tissue is not stretched as severely. With these stronger core muscles, the anterior tilt is minimized and the sequelae are reduced.
About this time in my class I have the students get up and walk around. It’s a good thing to get my students off of those unforgiving chairs and get them moving. I ask them to walk around the room and pay attention to their core, their shoulders, head placement, etc. Then I ask them to fill their bellies with air, exhale and pull their transverse abdominus in as far as they can, hold it there as they continue to walk and breathe, and shout out what they feel. “Taller!” “Stronger!” “More supported!” “I can’t breathe!” (there’s always a few) “Sexier!” “Thinner!”
Then I have them sit back down on their chairs and pretend they are doing dumb-bell shoulder presses at the gym. Initially I have them do a ‘set’ with their abdominals relaxed (first floor). Then I have them expand their bellies with air, exhale and contract their TvAs and shout out what they feel. “Stronger!” “More stable!” “It feels easier!”
And that’s how I show my students the value of core integrity. But I leave them wanting more. I take them through a single set of elevators. Most of them are losing it before we even reach a count of 30. After that, I do a set of 50 contracting exercises, 3rd to 5th, with them. Most of them can’t do it. But I encourage them to do it daily, and by the end of the workshop (Day 3), many students reported that their backaches were gone.
I demonstrate how to get their clients – all their clients – on and off the treatment table using the TvA which protects the lower back and minimizes pressure against the linea alba. I show them how to test for a diastasis and all are eager to see what theirs measures. And I encourage them to follow up by adding diastasis repair to their prenatal practices. It is a perfect adjunct to what we do. “