According to the World Health Organization (WHO), preeclampsia (PE) affects two to 10 percent of pregnancies worldwide. (1) Meanwhile, the March of Dimes reports that preeclampsia is a factor in as many as 5 to 8 percent of pregnancies in the United States. (2)
Typically occurring after the 20th week of pregnancy, preeclampsia is a hypertensive disorder that can lead to a range of health issues during pregnancy. Not the least of which is high blood pressure (which puts added stress on Mama’s heart) and impaired function of the kidneys and liver. Preeclampsia is one of the most common complaints during pregnancy, and the condition often comes with a helping of insomnia and anxiety.
In a little good news for pregnant mamas diagnosed with PE: help may be at the fingertips of their partner or masseuse. A new study published in the Journal of The Brazilian Medical Association found that classical foot massage, an age-old arbiter of what ails us, may provide significant relief for insomnia and anxiety symptoms in preeclamptic women. (3)
The Study
Noting that preeclampsia is a major cause of maternal and fetal mortality worldwide, researchers set out to examine a non-pharmacological approach to treatment as standard pharmacological approaches can further complicate the issue for pregnant mothers and their unborn children. (3)
In a randomized controlled trial with 71 women hospitalized in the obstetrics ward of Elazıg Fırat University Hospital with a diagnosis of preeclampsia, researchers split participants into two categories: an experimental group that received foot massages for 3 days a week and a control group where no applications were done. Both groups were assessed for insomnia and anxiety levels.
More specifically, pregnant women in the experimental group received a 20-minute massage three times a week (10 minutes for each foot three days a week for a total of 60 minutes per week). The massage therapy included a combination of petrissage and effleurage techniques applied to five parts of the foot ( the back of the foot, inner and outer sides, toes, and soles of the feet). The control group was treated for insomnia and anxiety using routine hospital protocols.
At the conclusion of the study, researchers found that classical foot massage (one that uses stroking and rubbing) significantly reduced insomnia and anxiety levels in preeclamptic women.
How Does Massage Help with Sleep?
While this study focused on preeclamptic pregnant women, massage has a long history of therapeutic benefits, with its medicinal roots dating as far back as 2700 BC in China, India, and Egypt. (4) Today, there’s no shortage of research supporting the use of massage therapy to improve sleep and duration and mitigate anxiety, but, we also found quite a few studies that specifically focus on the ameliorating effects of foot massage.
One study from 2016 showed that participants who were given a foot massage three times per week for four weeks showed a marked decrease in anxiety levels compared to the control group. (5) Another study in 2021 revealed that back and foot massages (given two days a week for three weeks) significantly decreased blood pressure and improved sleep quality in the experimental group. (6) And finally, a 2022 study found that insomnia, anxiety, and fatigue symptoms of postmenopausal women were significantly reduced after the group received foot massages every day for one week. (7)
Regarding the mechanisms at work with massage and sleep, Marie Watkinson, a Licensed Massage Therapist and Owner of Spa Chicks On The Go, says, “Massage can help your sleep cycle as it encourages the production of serotonin, which, in turn, helps the body produce the “sleep hormone” melatonin.” (8) (9)
The quick science here, folks, is that melatonin plays a key role in our sleep and wake cycles. Melatonin levels rise during the evening hours (usually in response to low light, a la sunset), promoting sleepiness. (9) Our bodies continue to produce melatonin throughout the night, keeping us asleep. Then, with exposure to light (sunrise), our melatonin production tapers off, making us more alert — and the process repeats itself day after day, night after night. (9)
Beyond stimulating serotonin production, Watkinson says, “Massage increases your circulation, bringing more oxygen to your cells, which helps you reduce stress and anxiety — a big reason why many have a hard time either falling asleep or staying asleep.” (10) And finally, she adds “Massage helps alleviate pain and general tension in the body, allowing people to be more comfortable and therefore able to sleep better.”
What Massage Technique Is Best for Sleep?
“Noting that every “body” is different and we all respond to massage differently,” Watkinson says, “If you are receiving a massage to assist with sleep-related issues, it is best to opt for firm effleurage-type strokes to help relax the body.”
The TLDR on effleurage: It’s a massage technique that uses long, stroking movements to encourage relaxation.
Self-Massage Techniques for Sleep
CG Funk, Chief Therapeutic Experience Officer at Massage Heights, says, “Receiving professional massage on a is one of the healthiest interventions we can provide to our body and mind, and the simple act of healing touch can be incredibly powerful.”
Understandably, though, life goes on, but for those who can’t get an appointment when they need it or those looking to tap into the power of massage between sessions, Funk says, “We can all manage our stress and pain through self-massage techniques. Whether it’s applications to our scalp, face, hands, feet, legs, or arms, self-administered massage can help to calm our body and relax our mind.” Moreover, Funk adds, “Self-massage can be used to energize our bodies in the morning, reset during a busy workday, and relax in the evening at the end of the day.” Ahead, Funk offers some tips on self-massage.
Simple self-massage techniques for the feet:
- Use your hand to twist one foot from side to side. Repeat on the other foot.
- Grasp the heel with one hand while supporting the top of the foot with the opposite hand. Press on areas in the heel with a thumb. Work the entire heel, then repeat on the other foot.
- Hold the top of the foot and massage the arch using the thumb on the other hand. Be sure to cover all areas of the arch, including the side of the foot. Repeat on the other foot.
- Stretch the joints of the foot, including toes and ankles. Use one hand to flex and extend each toe and then flex and extend the foot at the ankle.
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Sources
1. Khan B, Allah Yar R, Khakwani AK, Karim S, Arslan Ali H. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus. 2022;14(11):e31143. Published 2022 Nov 6. doi:10.7759/cureus.31143
2. Preeclampsia. March of Dimes. (n.d.). https://www.marchofdimes.org/find-support/topics/pregnancy/preeclampsia
3. Kırca AŞ, Çetin NŞ. The effect of classical foot massage on insomnia and anxiety in preeclamptic pregnant women: a randomized controlled study. Rev Assoc Med Bras (1992). 2024;70(2):e20230744. Published 2024 Feb 26. doi:10.1590/1806-9282.20230744
4. Riggs, K. (2023, December 21). The history and evolution of massage therapy. Blue Cliff College. https://www.bluecliffcollege.edu/blog/the-history-and-evolution-of-massage-therapy/
5. Eguchi E, Funakubo N, Tomooka K, Ohira T, Ogino K, Tanigawa T. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial. PLoS One. 2016;11(3):e0151712. Published 2016 Mar 24. doi:10.1371/journal.pone.0151712
6. Arslan G, Ceyhan Ö, Mollaoğlu M. The influence of foot and back massage on blood pressure and sleep quality in females with essential hypertension: a randomized controlled study. J Hum Hypertens. 2021;35(7):627-637. doi:10.1038/s41371-020-0371-z
7. Gökbulut N, Ibici Akça E, Karakayali Ay Ç. The impact of foot massage given to postmenopausal women on anxiety, fatigue, and sleep: a randomized-controlled trial. Menopause. 2022;29(11):1254-1262. doi:10.1097/GME.0000000000002062
8. Field T. Massage therapy research review. Complement Ther Clin Pract. 2014;20(4):224-229. doi:10.1016/j.ctcp.2014.07.002
9. Vasey C, McBride J, Penta K. Circadian Rhythm Dysregulation and Restoration: The Role of Melatonin. Nutrients. 2021;13(10):3480. Published 2021 Sep 30. doi:10.3390/nu13103480
10. ScienceDaily. (2014, April 16). Massage therapy improves circulation, alleviates muscle soreness. ScienceDaily. https://www.sciencedaily.com/releases/2014/04/140416125434.htm
Funk, CG. Author interview. April 4, 2024.
Watkinson, Marie. Author interview. April 3, 2024.
