What is the correct order for postpartum recovery massage?

The core sequence of postpartum system recovery massage, which is currently generally recognized in clinical and rehabilitation fields, is to relax the whole body first, and then from the deep organs to the superficial muscles, from the core of the waist and abdomen to the extremities of the limbs. The premise must be that there are no abnormalities in the postpartum review 42 days after normal delivery, the caesarean section wound is completely healed (usually at least 3 months), and the lochia is basically eliminated before the operation can begin.

Two years ago, I treated a mother who had just given birth. She was anxious to improve her big belly, so I found a small workshop to massage her belly and rub her rectus abdominis. The day after the massage, the amount of lochia doubled, and her belly dropped so much that it was difficult to even hold the baby. When she came to us for evaluation, she frowned and held her waist. Later, I adjusted the plan for her. The first three massages did not touch her belly at all. First, I massaged down her tight shoulders, neck, and calves, which were all hard knots from having a baby. She felt so comfortable that she yawned every time for 20 minutes. After she relaxed, I started to massage gently. The point activation of the pelvic floor muscles helped her regain the deep support first. After her lochia was completely cleared, she slowly added abdominal massage. After more than two months of adjustment, the rectus abdominis separation returned from two and a half fingers to half a finger, and there was no more discomfort.

Speaking of this, some people must have questions. I usually want to relieve the pain in my wrists and shoulders and neck when I hold a baby. Do I have to do it in this order? This is also a controversial point in the industry now. Many massage agencies that focus on relaxation will advocate "pressing where it hurts" and giving priority to the current discomfort. There is actually nothing wrong with this. If you are just doing daily relaxation, you can press the pain points first. There is no need to stick to the order. However, if you want to solve postpartum problems such as diastasis recti, pelvic tilt, and organ prolapse, and perform systematic recovery massage, you must follow the logic from the inside to the outside, from the core to the periphery. Otherwise, it will be like painting a wall before the foundation is laid. No matter how loose the superficial muscles are, the deep-seated problems will not be solved, and the painful area will rebound in half a month. The problem of organ prolapse may even be aggravated due to improper adjustment of abdominal pressure.

When I have reached the stage where I can press the core of the waist and abdomen, I don’t just rub my belly vigorously when I come up. I usually start from the veins on both sides of the waist and slowly push toward the middle, just like smoothing the corners of a crumpled cotton T-shirt, and then slowly flattening the folds in the middle. If I come up and press hard against the separation of the rectus abdominis, it is easy to press the already loose transversus abdominis muscle even more. After the core massage is finished, relax the limbs again to smooth out the Qi and blood gathered in the waist and abdomen. Otherwise, if you stand up just after the massage, many mothers will feel dizzy and think there is something wrong with the massage. In fact, they did not finish the relaxation.

Of course, there is no 100% universal order. For example, for a mother with severe pubic symphysis separation, I would loosen the muscles around her pelvis first, and then touch other positions. Therefore, the safest way is to do a complete postpartum assessment first, and find a certified rehabilitation therapist or masseur to customize a plan. Don’t just follow the short video at home and rub it randomly. Otherwise, if something goes wrong, the gain will outweigh the loss.