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How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
September, 2001, Vol. 01, Issue 09
The Evolving Practice of Breast Massage
By Kate Jordan, NCTMB
I was intrigued by a course entitled: "Making the Case for Breast Massage" at the most recent annual meeting of the California Chapter of the American Massage Therapy Association. Intrigued, I confess, because I didn't know that a case needed to be made.In my own practice, I regularly perform therapeutic modalities on the breasts of pregnant and nursing mothers; on women who have had breast reduction or augmentation; and on women who have endured mastectomy or breast cancer treatment. However, since my early days as a massage therapist, it had never occurred to me that there might be a rationale, much less a mandate, for well-breast massage.
The issues surrounding the applications of breast massage are numerous, ranging from legal to medical, to therapist comfort and competence, to protection of the consumer. These issues also spotlight some of the confusion in our emerging profession about the purpose and scope of practice of massage therapy and bodywork.
When I was first introduced to massage in the early 1970s, two mass-market books, George Downings' Massage Book and Gordon Inkeles' The Art of Sensual Massage, described the use of gentle effleurage strokes over undraped breasts as a part of relaxation massage on the anterior torso. This approach was also used at the Esalen Institute in Northern California. When I began to practice, however -- at a medical clinic and a health club in Phoenix; in a spa in Honolulu; and later in the decade, when teaching at a new massage school in San Diego -- it was a given that the breasts would be draped, primarily to conform to local and state regulations.
Over the years, and with continued training, I developed expertise in treating various dysfunctions related to the breast, but never taught any form of breast massage to students -- it seemed to be an area of the body riddled with pitfalls. When Dianne Polseno Crawford surveyed a representative sample of massage therapists in 1997, she found that while 45% reported receiving some training in breast massage, only 9% reported performing it on a regular basis. In an informal survey of massage schools throughout the country, Crawford reported that only 10% were teaching any kind of breast massage.
One of the primary barriers to the teaching of appropriate breast massage is the prohibition in state and local laws in most jurisdictions of any touching of the breasts. Some states, like Washington, do allow therapeutic breast massage with informed client consent. In my own city of San Diego, recently enacted legislation specifies no prohibited body areas for practitioners who have more extensive training than the minimum required for a massage license. These legal barriers to breast massage result from massage therapy's shadow-side -- its link to prostitution and adult entertainment. Hannah Hanlon, who teaches breast massage courses throughout the United States, caused such controversy in advertising her course in North Carolina that she was banned from teaching in that state. As standards for the education and practice of massage therapists are elevated, it's possible that there will be more latitude given in state laws to appropriate touch in currently restricted anatomical areas.
The American Massage Therapy Association does not have a specific policy regarding breast massage, and Associated Bodywork and Massage Professionals "discourages" its members from providing breast massage unless they have advanced training and work in a jurisdiction permitting it. The National Certification Board for Therapeutic Massage and Bodywork addresses the issue of breast massage in its Standards of Practice. It provides that certificants can "only provide therapeutic breast massage as indicated in the plan of care, and only after receiving informed voluntary consent from the client." This position provides an ethical framework and scope of practice for those individuals who become nationally certified, but is irrelevant in states that restrict the practice.
What is the status of breast massage in the United States? Who is using it, and for what purpose? I did an internet search for "breast massage" and found, along with the few "adult" sites that appeared, that there were sites that promoted breast massage as a cancer preventive; "wellness" breast massage; massage for breast augmentation; breast massage to prevent adhesions after implant surgery; self-massage to promote lactation in nursing mothers; and therapeutic lymphatic massage to treat lymphedema. These sites ranged from do-it-yourself websites, to plastic surgeons, to the American Cancer Society.
In Europe, where breast exposure is not taboo, lymphatic drainage massage and Bindegewebsmassage are used on the breasts in clinical settings. It is the rare therapist in the United States who does so.
In Canada, where massage training in most provinces is more extensive and clinical than in the U.S., therapists are taught protocols to deal with breast discomfort, dysfunction, trauma, and disease. Debra Curties, the executive director of the Sutherland-Chan School in Toronto, has been one of the leading proponents and teachers of clinical breast massage in North America. She has written extensively about the many potential barriers that may face therapists contemplating providing breast massage as a client service. They may, for example, feel personal discomfort with manipulating breast tissue because of its sexualization in American society.
Hannah Hanlon has reported that when teaching co-ed classes in breast massage, men and gay women seem more comfortable with the learning experience than heterosexual women, who may feel embarrassed and squeamish about touching either their own, or another woman's breasts. Many men, however, are understandably concerned about boundary issues in cross-gender massage. There is considerable uncertainty among many therapists about the purpose of and potential value derived from breast massage, especially the "wellness" or prevention model.
Public perception of the components of a massage therapy session, and individual client issues and concerns, can impact a therapist's desire to perform breast massage. Does the client have adequate boundaries? Has the client been sufficiently informed about, and is able to consent to breast massage? Does the therapist feel safe in providing breast massage for the particular client?
Hannah Hanlon has written that "breast massage has been regarded at best, as an integrative measure in a holistic alternative therapy, or at worst, as an invasive and abusive undertaking, if offered without informed consent in the hands of a therapist lacking experience or integrity." This is the crux of the issues surrounding breast massage. Breast massage administered by massage therapists will be more readily accepted by the public if its medical rationale and physiologic basis are spelled out for clients, and if therapists receive adequate training in its psychological ramifications and the appropriate use of specific techniques to promote breast health and address dysfunction.
This kind of educational outreach can only be provided by therapists who receive comprehensive training in breast massage. Unfortunately, even the most competent, effective practitioners will not be able to address the needs of the female population in the presence of laws that prohibit touching of the breasts.
In my next column, I will address the indications for breast massage and the specific techniques that have been developed to address both "normal" and dysfunctional breasts.
In the interest of a national dialogue, I would like to hear the experiences of therapists who currently practice breast massage (as a part of a full-body session or as separate modality), and the reactions and comments of therapists who do not.
Click here for previous articles by Kate Jordan, NCTMB.
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