resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
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.
comments powered by Disqus