Increased laryngeal and facial edema | ■ Sinus drainage technique ■ Cranial bone lifts and effleurage Soft tissue and myofascial techniques addressing secondary muscles of inspiration | Relaxes the sternocleidomastoid and scalene muscles to aid in the drainage of the superficial and deep cervical lymph nodes. Allows improved respiration by relaxing the attachments to the manubrium and clavicle. Balances autonomics. | ■ Avoid prolonged treatment in the supine position. ■ Left uterine displacement: When supine, a rolled towel should be placed under the right hip to decrease caval compression, improve venous return, and maintain uterine blood flow and fetal oxygenation. ■ Perform in the seated position. |
Increased sympathetic activity | ■ Occipito-atlantal decompression ■ Suboccipital release | Decreases muscle spasms and restores upper cervical mobility while freeing the passage of the vagus nerve to balance autonomic tone by decreasing sympathetic and increasing parasympathetic tone. | ■ Left uterine displacement: When supine, a rolled towel should be placed under the right hip to decrease caval compression, improve venous return, and maintain uterine blood flow and fetal oxygenation. |
Increased sympathetic activity Poor lymphatic and vascular drainage from the lungs | ■ Rib raising ■ Lumbar paraspinal inhibition ■ Thoracic pump | Normalizes the sympathetic/parasympathetic nervous system. Decreases inflammatory cytokines. | ■ Left uterine displacement: When supine, a rolled towel should be placed under the right hip to decrease caval compression, improve venous return, and maintain uterine blood flow and fetal oxygenation. |
Lymphatic congestion | ■ Thoracic inlet (necklace technique) | Releases restriction of the thoracic duct, improving lymph drainage into the subclavian vein. | ■ Perform in the seated position. |
Abdominal diaphragm dysfunction Impaired diaphragmatic movement especially in expiratio | ■ Redoming of the diaphragm | Decreases the hypertonicity of the diaphragm and restores its normal shape. | ■ Perform the technique in the supine position in the earlier half of pregnancy. ■ Perform in the seated position at later gestational ages. |
Splenic congestion | ■ Splenic drainage | Enhances the immune system by improving flow of lymph through the lymphatic system. | ■ Left lateral recumbent positioning. |
Lower extremity congestion | ■ Pelvic diaphragm release | Improves flow through both the lymphatic and circulatory systems. Decreases venous stasis to help prevent venous thromboembolism in the hospitalized patient. | ■ Perform in the supine position with a rolled towel placed under the right hip to minimize caval compression ■ Perform in the seated position. ■ If patient is already prone, treatment can be given without additional position modifications. |