resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
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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