A drawing showing a timeline of a pregnant woman's body growing and changing is used to illustrate the concept of a massage therapist working in a healthy manner throughout pregnancy.

Massage therapists are conditioned to be on their feet all day, moving, bending and sometimes lifting. Therefore, when an LMT finds out she’s pregnant, it’s natural for her to think, “Will I be able to work throughout my entire pregnancy?”

Whether it’s a first pregnancy or a first pregnancy as a massage therapist, let’s look at what to expect with body mechanics throughout this time of physical change.

The largest number of changes in the adult body is experienced during the 40 weeks of pregnancy. These changes are vast, but for the massage therapist professional, there are two main areas to note. The first is the hormonal differences, and the second is the shifting of the center of gravity. These two areas will affect body mechanics the most.


Hormone changes begin immediately after conception. While hormones may cause mood swings, heartburn, and morning sickness, the hormone Relaxin will be our topic of discussion, as it’s responsible for body mechanics changes.

Relaxin’s job is to relax or stretch the ligaments of the body. The hormone doesn’t target specific ligaments, like the pelvis, but affects all the body’s ligaments. Relaxin even affects the arteries to widen them to accommodate the increase in blood volume during pregnancy. This helps blood pressure stay within normal ranges. The increased blood volume may cause lightheadedness for some women when bending over quickly and returning upright.       

Some massage therapists feel the laxity in their shoulders, knees, hips or ankles. This can result in aches, pains, inflammation or even clumsiness. 

Center of Gravity

Before pregnancy, we are used to massaging with our center of gravity around the level of our belly button. As the abdomen expands during pregnancy, posture, balance, and gait change. Posture at the massage table will need to be maintained upright as much as possible to prevent fatigue. Balance, as well as weight shifting during massage work, may feel different. 

Weight shifts in both the symmetric and asymmetric stance will feel different as the center of gravity changes through pregnancy. Some women don’t report noticing much change, but others who experience a lot of fetal growth quickly find the center of gravity shift to feel very foreign. 

Trimester One

Fatigue during the first trimester (1-12 weeks) is the biggest complaint for massage therapists. A massage therapist can expect to continue the workload she was doing prior to becoming pregnant as long as her doctor agrees. While longer breaks or shorter days might be in order, there are no changes to body mechanics during this time. Conserving energy and listening to her body will be the focus during trimester one.

Trimester Two

The second trimester (13-26 weeks) is often when the massage therapist feels her best. Any morning sickness that may have been experienced during the first trimester is usually gone. Energy levels are back to normal from the dip experienced in the first weeks of pregnancy. 

As the fetus grows, the woman’s center of gravity is displaced anteriorly and superiorly. This center of gravity change is at the beginning stages during the second trimester, and some women aren’t showing much of a “baby bump” until the end of the second trimester. 

As far as body mechanics, this is the time the pregnant massage therapist may begin to notice some lower backaches. Even though there may not be many visible signs of pregnancy, the laxity of ligaments has already started due to the relaxin hormone released by the body during pregnancy. This is how the low back can begin to feel sore during pregnancy.

To help low back soreness at the massage table, keep a tall, upright posture and avoid standing in one place for any length of time. Weight shift during your massage to help low back fatigue, and take a seat for the areas of the massage that allow a seated position. 

Stretches like a gentle spinal twist or supine knee to chest can help low back soreness during the second trimester. 

Trimester Three

The third trimester has an ever-increasing abdomen for the pregnant massage therapist. Lower backaches are often reported, but mid-back and wrist pain are also common. 

The center of gravity is at its most significant difference during the end of the third trimester. Continual awareness of good posture is the best practice at this time. Moving the body slowly and deliberately throughout the massage may help when feeling unbalanced. Avoid hunching and slouching.    

During the third trimester, the pregnant belly may start to get in the way of massaging. Having a pregnant belly bump the client during the massage isn’t ideal. Some therapists use a seated position more often, and some adjust their stance slightly sideways. 

Good body mechanics are performed with straight elbows, keeping the body an arm’s-length away from massage work. With this practice, it will be apparent if and when it’s time to stop working. Many therapists work up until delivery with no problems. The growth of the abdomen is usually gradual enough that the body adapts.

This trimester is when sports massage, Thai massage, or 90-plus minute massages may want to be removed from the pregnant massage therapist’s schedule. 

Exercises & Stretches to Support the Pregnant MT’s Body Mechanics

Gentle hamstring and back stretches will help the low back, while shoulder stretches can reduce tension in the mid-back and neck. Stretch carefully, as the joints will be able to go further than usual due to the increase in the relaxin hormone.

One example of a mid-back stretch is the yoga pose thread-the-needle. I also like tracing large circles with my arm on the wall while the same side hip touches the wall. This removes more rhomboid and trapezius tension than thread-the-needle alone. 

Sitting on the floor in the butterfly stretch may feel good to the hips and inner thighs.

Exercise Suggestions

Core stability helps support the back during pregnancy, but abdominal exercises are limited in the second and third trimesters. Even though you shouldn’t do any “crunching” type ab exercises, there still are plenty of abdominal exercise options.

Here are some suggestions. Be sure you listen to your body, stop if anything hurts, and always get your doctor’s consent before exercising. 

These are loose recommendations per trimester, but individuals must decide what is safe for them. Some women “show” much later than others, and women carrying twins or triplets have a heavier and larger center of gravity shift.

  • The cat part of cat/cow—second trimester
  • Incline planks—second trimester
  • Birddogs—second and sometimes third trimester
  • Hip rotations seated on exercise ball—all trimesters
  • Side plank—first and second trimester

Every pregnancy comes with different conditions and variables. It is imperative to listen to the body and work closely with a doctor to keep the therapist and baby safe and healthy.                  

Angela Lehman

About the Author

Angela Lehman is a massage therapist of 25 years turned online educator, promoting fitness and nutrition for massage therapists. She runs The Fit MT (thefitmt.com). With her kinesiology degree specialized in nutrition, she trains therapists in healthy eating, exercise and body mechanics to prolong their careers. Search massagemag.com to read her The Fit MT column on topics including body mechanics, gut health and more.