Are there any important reasons why abdominal massage should be included in a session? Not everyone should receive abdominal massage; the massage therapist needs to be aware of abdominal massage techniques including contraindications and cautions that apply.

Are there any important reasons why abdominal massage should be included in a session?

The answer is definitely yes, there are important reasons to include abdominal work as part of massage sessions, including full-body relaxation sessions.

Before looking at these reasons, a few caveats should be mentioned.

Not everyone should receive abdominal massage; the massage therapist needs to be aware of abdominal massage techniques including contraindications and cautions that apply.

Who Should Not Receive Abdominal Massage Techniques

Clients with certain gastrointestinal tract disorders or inflammatory intestinal conditions, such as Crohn’s disease, celiac disease and ulcerative colitis, should not receive abdominal massage during flare-ups.

While light, soothing abdominal massage techniques are OK, pressure should not be applied into the abdomen of a hypertensive client or one in the first trimester of pregnancy.

Some high-risk pregnancies have elements, such as placenta previa, that generally preclude abdominal massage.

Some reproductive-system conditions, including unstable ovarian cysts and severe endometriosis, should be added to the list.

This is not an exhaustive list, but common sense and reasonable research skills make decision making about abdominal massage contraindications fairly straightforward.

In many instances, the presence of less acute gastrointestinal or reproductive disorders, aortic aneurysms, high-risk pregnancies or abdominal surgeries requires physician consultation, and the work should be done by massage practitioners with more than basic massage education.

There are emotional and psychological factors that may apply as well.

Some clients have histories that make abdominal touch undesirable to them, and some view the abdomen as a more private body part.

Massage therapists must respect these stances.

If a client who would benefit from abdominal massage techniques sets this type of boundary, one can talk neutrally about the pros for doing the work and hope the answer might change once there is better familiarity and trust with the therapist.

Ultimately, however, it is the client’s decision.

That said, I believe it is fair to claim that for the vast majority of individuals who do not receive abdominal work, it is because their massage therapists never do it—or have not suggested it because of practitioner discomfort, lack of training or overblown safety worries.

Let’s take a look at some good reasons to provide abdominal massage.

1. The Massage Feels More Complete & Holistic

Most clients do not receive anterior chest or abdominal work, making for a huge section of the body that has not received touch or had its issues addressed.

Clients will often make comments after receiving abdominal massage that describe feeling lighter, more integrated, calmer or more energized.

2. Abdominal Massage Techniques Aid in Intestinal Function.

A number of studies have shown massage promotes peristalsis, soothes minor intestinal discomforts and helps with constipation.

The effects are partly mechanical, helping move intestinal contents, including for people with neurological gut control challenges, as in Parkinsonism, multiple sclerosis and spinal cord injury, and for high-stress and more anxiety-prone individuals.

There are also reflex and neurologically mediated effects that support better ease and effectiveness of intestinal function.

Most clients can receive these health benefits with proper abdominal massage techniques.

3. The Connection Between Abdominal Massage & A Sense of Well-Being

Fascinating new information is filtering through to us, as scientists learn more about the enteric nervous system, now categorized as a third division of the autonomic nervous system, its connection to emotions and the role of the vagus nerve.

While there isn’t much direct massage-connection research data yet, there certainly is enough information to stimulate our thought processes.

The enteric nervous system predates much of our more advanced brain development and has many independent features.

In our early evolutionary ancestors, drives and feelings of satisfaction related to food search and eating, crucially tied to survival, were an intrinsic aspect of how the enteric “little brain” operated.

We have retained this direct connection.

A human has more serotonin receptors in the gut than in the brain.

Understanding this relationship has many implications.

For example, new medication guidelines for many chronic intestinal disorders recommend antidepressants over traditionally used drugs.

As we all know, emotions can have a profound impact on how our digestive system functions.

It is also now becoming recognized that conditions in the gut can determine influences on mental state and development of mood disorders.

The vagus nerve is understood to be the messenger between the enteric nervous system and the brain, including playing a role in the regular dialogue between higher centers of autonomic regulation and the limbic centers of emotional expression and control.

While we tend to view the vagus nerve as primarily the carrier of commands from the brain to glands and viscera, it actually has a significantly higher percentage of afferent neurons versus efferent neurons.

This means it is likely an important mediator of the connections between conditions in the abdomen and emotional state.

One study found facial stroking causes transmission along the anterior branch of the vagus that quickly reaches the limbic system and produces feelings of being soothed and cared for.

It is quite likely manual stimulation of abdominal structures will be found to send messages with similar types of results via the posterior vagal branch.

At minimum, the connection between vagal stimulation and helping shift the body into a parasympathetic state helps support the use of abdominal massage for relaxation and sleep promotion.

4. Abdominal Benefits Physical, Mental & Spiritual Conditions

Abdominal massage has real benefits for people with abdominal conditions, and perhaps some mental illnesses like anxiety, depression and eating disorders.

Low-back pain, postural abnormalities and post-childbirth fascial syndromes are also examples of conditions that usually indicate abdominal work as an effective treatment.

Obviously, we need to consider cautions and contraindications, doing due diligence about massage therapy appropriateness, and we need to work within our scope of practice, collaborating well with other health practitioners and using correct abdominal massage techniques.

At the same time, we really should be more focused on the fact, considering the effects discussed in the previous points, there are strong indications for using abdominal massage to help many of our clients manage—and perhaps sometimes successfully overcome—a number of different types of disorders.

About the Author

Debra Curties, RMT, works at Sutherland-Chan School and Teaching Clinic in Toronto, Ontario, Canada, as executive director and an instructor of pathology and clinical theory. A co-founder of Curties-Overzet Publications, Curties is the author of Breast Massage and Massage Therapy and Cancer. She wrote “Heart Health: Massage Therapy, High Blood Pressure and the Heart” for the June 2012 print issue of MASSAGE Magazine.


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