The Missing Pieces: Less and less body is being included in "full body" massage - It doesn't have to be.
This article came across my desk and caught my attention. The discussion is about how and why more and more, therapists and schools in the US are backing away from a true full body experience. It does not have to be. with proper training, good client communication and informed consent there is no reason why in 2019 this should be. I have interjected my thoughts in italics, but otherwise this is re presented in abridged form from Massage Magazine. published from
The anterior (front) torso, including the chest and abdomen; hips; buttocks; and medial thigh are often avoided or only given cursory attention during many massage sessions.My awareness about this developed after reading many posts on social media about “full-body massage.” Discussions with massage colleagues, educators and therapists indicate this problem is real. I Have seen many posts about the chains not allowing massage 1" below the collar bone, or glutes at all.
“There is a significant decline in the number of massage therapists that are willing to perform massage therapy on gluteal, pectoral and abdominal areas,” said Brent F. Jackson, academic program manager, massage therapy, at Central Carolina Technical College, headquartered in Sumter, South Carolina. He said he believes there are three factors contributing to this situation.
First, he said, massage therapy businesses and schools alike are wary of being involved in litigious situations, because of criminal acts by some massage therapists have made the news and are therefore overly conservative when it comes to creating curriculum.
Second, he said, “In academia, we are also encountering a broad spectrum of skill, and therefore a possible lack of qualified and confident massage therapy educators. That lack of training may be inhibiting the student’s professional growth.”
Third, said Jackson, there is simply a growing trend of the therapist not wanting to put in the effort required of a true full-body massage. Instead, he said, therapists are cutting corners.
“As a profession,” Jackson said, “it is necessary to be open to treating these areas when warranted, as would any other health care professional.”
Educator Nancy Dail, of Downeast School of Massage in Waldoboro, Maine, has also witnessed this trend. “I have long been aware that massage therapists have been cutting corners around the human body, basing massage on a rote recipe and repetitive sequence versus a treatment based on the individual’s medical history, posture, repetitive actions or injuries,” she said.
“Since society has a vulnerable perception of the abdomen, it has been the most logical area to skip,” Dail continued. As to other areas, she said, state regulations on breast massage, draping and professional conduct have led to restrictions on how the client’s body is addressed.”
However, student ignorance and state regulations cannot fully explain the diminishment of the full-body session. In my research and conversations, I have come to realize there are three pieces to this situation: incomplete massage education; apprehension on the part of clients; and insufficient informed consent across the profession.
Massage Education“Attempting to avoid excessive intimacy, my students’ hands often tense up around buttocks, chest, belly and inner thighs. I teach them instead to deliberately connect with these tissues using safe touch,” said Barbara Helynn Heard, a continuing education provider and practicing massage therapist in Seattle, Washington.
Although many massage schools provide a comprehensive education that prepares students to offer complete, full-body massage sessions, Heard’s approach isn’t how all massage students are being taught to touch clients’ bodies.
I, and many other massage educators, believe some schools’ entry-level education falls short in developing skills in positioning, draping, time management, communication and consent about the process of massage. Massage education sometimes creates fear related to boundaries and sexual misconduct litigation instead of developing professionalism. Instead of assessment and critical thinking skills imbedded into the massage session, a massage sequence is sometimes drilled into students.
For example, the common statement, “Disrobe to your level of comfort,” only creates confusion. Instead, direct instruction needs to be given. Such an instruction might sound like one of these two examples:
“I regard the anterior torso as crucial, yet it is avoided in 90 percent of the massages I receive,” said Eric Stephenson, who was interviewed for this article when he was director of education at imassage continuing education and consulting company and who is now chief wellness officer for Elements Massage. “This is one of the great paradoxes of massage therapy.”
Part of the problem, in my opinion, is that the two national massage organizations do not accurately educate the public. One association’s website states, “A typical full body session will include work on your back, arms, legs, feet, hands, head, neck, and shoulders. You will not be touched on or near your genitals (male or female) or breasts (female).” This statement essentially omits the chest, abdomen, hips, buttocks, thighs and face. With these areas unmentioned, what type of expectation does this create in the consumer and employer?
Another association’s website states, “Depending on your needs, the massage therapist will massage either the full body (except private areas) or only specific areas that need attention, such as especially tight muscles.” This statement is so ambiguous that the information is confusing. What are private areas?
Despite professional strides in the massage industry, confusion between massage therapy and illegal sexual solicitation continues to occur. Something must be done so that the massage therapy profession as a whole can move beyond this degrading situation. I challenge our professional organizations and major employers of massage therapists to collaborate and directly address this issue.
Additionally, there is gender bias pertaining to male massage therapists.
“As a male therapist, I have to maintain trusted professional relationships with clients, [which includes] education about various body areas included in the massage session, to achieve client goals,” said massage therapist (and my son) Luke Fritz, an instructor at my school, Health Enrichment Center in Lapeer, Michigan.
I believe the massage field should launch a public awareness campaign that clearly discusses sexual inappropriateness by both the client and the massage therapist, and that describes body areas included in general massage coupled with an example of informed consent. There should be ethical guidance by our professional associations and employers that frames clear statements to the public and massage therapists about appropriate behavior.
Such a statement might read: “Massage therapy is a nonsexual health service. Sexual behavior by the therapist toward the client or by the client toward the therapist is always unethical, inappropriate and illegal. It is always the responsibility of the massage therapist and business management to ensure that sexual misconduct does not occur and to report sexual solicitation by clients to law enforcement. Clients who feel that the massage therapist engaged in sexual misconduct should immediately report to the business management and to law enforcement.”
The problem is that major employers are accepting substandard massage as the norm.
One reason for this may be that the confusion between massage and sexual interaction will just not go away, so employers might limit massage application to particular body areas because of the fear of sexual misconduct lawsuits.
It is very concerning if we have come to believe that the major body areas cannot be massaged in the typical 50- to 60- minute session. Massage employers and clients need to be assured that all massage therapists are providing quality massage services and can provide massage to all appropriate areas of the body.
I welcome comments on all my posts but especially would welcome comments on this one. What has your experience been? What is your preference?
Original Article written 10/17 - updated 5/2019 with resources
UPDATE / PART II TO AN ARTICLE WRITTEN 10/17
With this subject coming up more and more online and with clients, here are some further thoughts utilized t.
Breasts aren’t usually invited to the self-care party—despite the fact that there’s a restorative practice for pretty much every other part of the body (hair included). But there’s an argument, more than one, for incorporating full chest and breast massage into your treatment.
“Massage is a wonderful, stress-relieving, detoxifying practice for the whole body,” says natural beauty expert Jessa Blades.
“It’s odd that we don’t massage the breasts [in the West].”
And no, you don’t need to be pregnant or nursing to reap the rewards, a fact the holistic wellness world’s been clued in to for ages. “In Ayurveda, if you get a full-body massage, your breasts are massaged too,” Blades notes. “It’s odd that we don’t massage the breasts [in the West].”
Breast massage may provide huge psychological and emotional benefits, especially for those recovering from breast disease and the aftermath of invasive treatments.
While this work is not even close to being mainstream at the moment, that’s starting to change as word gets out about the physical and emotional benefits the practice produces. And lets not forget about choice. There is an emotional long tail effect about subconsciously feeling the need to "hide" them.
Breast health is too often ignored until after a problem arises. It’s an area of the body with powerful associations that sometimes makes women hesitant to seek care, despite the fact that the vast majority experience discomfort at some point.
Breasts are often compressed with sports bras, constrained by underwire, or enhanced with padding. This can restrict the flow of lymph, the clear liquid derived from blood that contains disease-fighting cells called lymphocytes. It is widely speculated that chronic impairment of lymph drainage may be implicated in many breast health problems, including cancer.” This is the case for not wearing a bra.
Therapeutic breast massage also loosens the tissues of the chest, shoulders, and neck, using a combination of deep-tissue massage techniques, movement, breathing, and stretching. Whether your breasts are healthy or compromised, every woman can benefit from this work, and it can be a powerful aid to emotional healing or healing after surgery or radiation therapy.
If you are It is important that you find a therapist who is qualified; trained and experienced with this work. Just as it is surprising to many clients, it is surprising to many therapists. A qualified therapist will be able to explain the work, discuss benefits, address curiosities, fears and or/concerns, go over the protocols for consent and choice - and ultimately help determine if you might be a good candidate for this work.
I have created an FAQ page that for the moment is password protected. It contains further discussion, FAQ's, and other information along with testimonials. If you would like to access it, please go here
Here is a list of prior blog posts for further reading on this topic:
If you have had breast massage and would like to share your story, it may help others - please send me an email.
Not all cultures view breasts with the same sense of fascination and conflicted sensibilities and childishness as we do in the US in particular. Breasts are simultaneously elevated and shunned. It is an odd duality, again seemingly leftover from the the arrival of the puritans. We are still living with their ghosts. I am certain somewhere out there I will be criticized for even writing this post, however I was asked to create a small post on the importance of breast massage and since it is so difficult to find, some self care suggestions.
The breasts have been used in symbolism since time immemorial. They have represented love and fertility, as well as sex and pleasure. But dream interpretation theories show that in the deep recesses of our minds, for men and women alike, breasts symbolize something even more integral--our primal need for motherly love, support, security, care, and nourishment, because their function as an organ is to give just that.
The breasts serve not only physical needs of sexual intimacy and breastfeeding but also energetic needs. Likewise, the state of breasts and changes in them can be clues as to what emotions are being processed or need processing. In this way, caring for your breasts is caring for your soul. A beautiful statement by Susun Weed in her book Breast Cancer? Breast Health! sums up this idea: “We cannot nurture others fully or well unless we also nurture ourselves.”
In terms of the mind/body connection - never have I seen an area of the body correlate so well with what is manifesting within a person’s heart and mind. Both men and women often go to their doctors with a feeling of discomfort in the chest, without any cause found after numerous tests and scans. But the discomfort is real—the causes are often too subtle for Western instruments to detect. Ayurveda can recognize these subtle sensations as signs of imbalance.
Ayurveda ( a 5000-year-old healing wisdom tradition from India, teaches in order to maintain a state of balance, the whole person must be addressed—no part of the body or energy is excluded) relies on massage as preventative medicine, and traditional ayurvedic massage doesn’t overlook the breasts as in the West.
Jennifer Johnson, spa director of the Chopra Center writes "Over years of work, we found that many women work through complicated issues with their breasts, confusion from oversexualizing, and shame carried through various belief systems, and also that women very rarely touch their breasts," says Johnson. "We also saw women confronting complicated emotions after recovery from breast surgeries—everything from biopsies, lumpectomies mastectomies, reconstruction, and augmentations. I have written on this topic before here and if you are interested please go over and read my prior post. But for now, back to the self care. Here is a basic 10 15 minute ritual that will help you get connected to your body, and can be practiced with frequency.
A Simple Breast Massage Ritual
Practice breast massage frequently, taking special care to notice the health and condition of your breasts and note fluctuations around your monthly cycles. Daily, weekly, whatever you can do. Not only is this ritual good for your physical health, it is grounding and could be a key to your emotional well being..
Ayurvedic medicine favors Sesame as a nourishing and neutralizing base oil. One oil I use daily is cold pressed almond oil. Add essential oils if you are comfortable with them or simply use as is.
Stand or sit in front of a mirror.
That's all there is to it. Pleas let me know your thoughts on this article, if you found it helpful, and feel free to share it.
~ with Aloha
Breast massage therapy, although uncommon in many massage practices, and sometimes controversial on the health front, should be a higher priority for women and their physical, emotional and spiritual wellness.
How Ayurvedic Breast Massages Can Help Promote Lymphatic Flow
Why Your Breasts Need To Be Massaged
I have just returned from certification training in full chest and breast massage on the west coast and the timing was interesting as October is Breast Cancer Awareness Month.
Although this work is not specific to breast cancer patients or breast cancer survivors, there are a number of physical and psychological benefits to those either facing this disease, going through it and recovering from it. Some of which I have discussed here.
During our training, we were fortunate to have among us cancer patients and survivors, including women who have undergone a partial lumpectomy, a double mastectomy, reconstructive surgery, enhancement and breast reduction.
If anyone needs and deserves the healing, caring touch of massage, it is women living with breast cancer, whether before, during or post-treatment. Massage and touch at any stage of breast cancer will take a woman to another place than her disease. Massage can assist her throughout her entire journey, from diagnosis to recovery. It can be difficult for the patient to deal with family issues, body image, finances, friends and do-gooders.
Massage can help.
When asked what massage does for them, clients have replied with comments such as:
Massage therapy has been shown to offer a number of benefits for breast cancer patients. Performed by a skilled and qualified therapist, the immediate benefits of massage therapy include reduced stress and anxiety. Long-term massage effects include reduced depression and hostility and increased serotonin values, .
Massage can also enhance one's feeling of well-being. It can stimulate the nerve endings in the skin, release endorphins (the feel good hormone) and inhibit the stress hormones, cortisol and adrenaline.
In a study published in the Journal of Psychosomatic Research, the Touch Research Institute found that massage therapy reduced anxiety and depression. It also improved immune function, including increased NK cell number in breast cancer patients. Additionally, breast cancer patients have improved immune functions following massage therapy.
Another study* found that therapeutic massage reduced cancer pain perception by an average of 60 percent, decreased anxiety by 24 percent and enhanced relaxation by 58 percent. A Touch Research Institute study involving 20 children with leukemia found that daily massages by their parents increased the children's white blood cell and neutrophil counts (neutrophils form a primary defense against bacterial infection).
Why Mastectomy Massage?
The benefits of mastectomy massage are numerous. The therapist's intentions and the quality of touch provided can make a world of difference to a client who has recently experienced a variety of invasive and painful tests and procedures. The intention is not to "fix" the client, but to provide love, nurturing, relaxation and quality of life.
Massage can relieve post-operative pain and edema, and promote the removal of toxins as it assists in the flow of lymph, blood and oxygen. Over time, clients will experience increased range of motion, reduced scar tissue, restored feeling and sensation by stimulating nerve endings, an improved body image and may become more aware and reconnected to themselves. Aside from massage generally promoting better health and overall well-being, it just feels good!
Can Massage Spread Cancer?
The concern that increasing circulation via massage will cause the spread of cancer is unfounded. Cancer can spread with little or no activity, such as sleeping, breathing, eating, walking, etc. Therefore, there is every reason to believe that gentle, light or compassionate touch can be administered safely and effectively, provided that no direct pressure or massage is applied to the traumatized area affected by disease.
Light massage may actually have a protective effect, as it keeps the blood and lymph circulating. Touch may help prevent tumor proliferation, as it reduces the body's levels of glucocorticoids and cortisol & hormonal measurements of the body's stress levels. Conversely, high levels of these substances in the body have been linked to tumor growth.
Massage therapy does not treat cancer. But it can have a profound impact on a patient's well being. If you are facing breast cancer, talk to your doctor about seeking massage therapy and then book an appointment to begin your journey of healing and self care.
- with aloha
updated 10/2017 with resources
This post is dedicated to a friend and fellow therapist, Barbara Heard, who has had the passion and dedication and courage to lead the way to normalize full chest and breast massage, de-sexulize it and make or keep this work legal in her state, and other states, Her mission is to properly educates the public, therapists and public officials about why this work is important. First and foremost, what is full chest and breast massage? It is not sexual, in fact it is exactly the opposite,
When receiving full chest massage done with professional, neutral, totally non sexual touch one has the most amazing holistic experience of feeling their chest as an integrated part of their body. Full chest massage on men is very common but discouraged or assumed to be sexualized on women, in America mostly,
Massage of the anterior chest wall is effective treatment for injuries to the chest, shoulders and neck. Full chest massage with pressure applied to the muscles deep to the breast tissue with consistent firm flow over the rib cage helps both tone and relax the chest muscles as needed, just as happens when we massage the muscles on the posterior rib cage, or other parts of the body. The effect is to enliven the rib cage so that it gives better support to the shoulders and neck, which relieves tension and discomfort in these areas and assists in treating neck and shoulder injuries.
Massage of the anterior chest wall and breasts facilitates experiencing one's breasts as a normal and natural part of our bodies.
By encouraging easy breathing, releasing tension in the muscles and bones located in the chest, and encouraging healthy flow of blood and lymph, chest and breast massage can support overall physical wellness, as well as mental, emotional and spiritual well being. It is effective as part of treatment protocol for shoulder and neck injuries.
Breast massage with a treatment focus
Breast massage can also effectively treat conditions such as scar tissue, lymphedema and other cancer related issues, recovery from mastectomy, recovery from breast reduction or breast augmentation procedures, problems with lactation, and swelling related to cycles.
Reclaiming an often lost natural connection to parts of the body
Informed Consent / Supporting public safety: You always have the right and the responsibility to direct any therapist not to massage any part of your body which you prefer to be avoided. The informed consent protocol designed by Barbara includes a full detailed explanation and written detailed consent. This is designed to support public safely by preventing incidents in which clients receive unwanted touch. It is not universal, as not all states allow for this work, but where it is legal, the protocol should be applauded and adopted. It removes shame, keeps the client in control and promulgates the idea that the human body is normal, in all shapes and sizes.
For more information on Barbara's work click here
For a European perspective click here
Interested in learning more? Check out these resources
Chest & Breast Massage Resources
online articles & websites
Breast Wellness: article by Debra Curties, published in 2003 in ABMP magazine. ~ Debra Curties is a well respected author in the field of breast massage education. She is the author of the book entitled Breast Massage. Debra lives and works in Canada.
Breast Massage: article by Kellum Johnson ~ how to do breast massage, along with some insightful comments. Kellum Johnson is a massage therapist licensed in Texas.
Breast Massage Therapy: information on website of Tony Ruggeiro in Texas ~ summary of benefits of breast massage, and more. Tony Ruggeiro is a massage therapist in Greensville, South Carolina
Breast Massage Good for Mothers Before and After Delivery: article by Phyllis Hanlon, published in 2013 in Massage Magazine. Phyllis Hanlon is a professional author and frequent contributor of articles in Massage Magazine.
Breast Massage from a Massage Therapist: Have you considered it?: article by Pam Fitchner in WHOlife, Wholeness & Wellness Journal of Saskatchewan, Canada. Pam Fitchner is a massage therapist in Saskatoon, Canada. She also facilitates workshops on breast and belly and complementary health.
A series of blogs articles on breast care and massage: article by Aristide M. LaVey in the Massagewallah blog. Aristide M. LaVey is a massage therapist who practices in Los Angeles, CA.
Breast Massage: on the Brink of Understanding? article by Karrie Mowen (Osborn) in the ABMP website, first published in 2001. Karrie Mowen is/was a contributing editor of the ABMP Massage & Bodywork magazine.
Female Breast Massage for Better Health: article by Nancy L. Ring on an ABMP supported website, published in 2009. Nancy L. Ring is a massage therapist in Cornell, Michigan.
Desexualizing the Touch Experience – A Proactive Approach: article by Cherie Sohnen-Moe, published in Massage Today. Cherie Sohnen-Moe is a highly respected massage therapy educator.
Innate Traditions, postpartum care: an organization offering training on postpartum care for women, a holistic system of care which honors women's physiological design. Rachelle Garcia Seliga’s work is dedicated to midwifing a cultural shift that honors innate wisdom, personal authority and the sanctity of Life.
Breastnotes.com: BreastNotes.com was created to help people to understand the breast: its development and growth patterns, its function and purpose, its role in various societies, its care, and its problems. It has information about going without a bra, health practices, cancer and lots more. One could spend days reading this fascinating website!
Post Surgical Therapy for Mastectomy and Implants an article by Paul Lewis on the Massage Therapy Canada website.
The Happy Breast Book by Cheryl Chapman
Breast Massage by Debra Curties
Therapeutic Breast Massage 1hour 48 minute DVD by Meade Steadman, published by Aesthetic Video Source.
short video by Barbara Helynn Heard: this 2+ minute video on YouTube demonstrates how I massage the chest as part of a fullbody, wellness focused massage for both men and women.
short video by Barbara Helynn Heard: this 3+ minute video on YouTube demonstrates how I massage the chest as part of a fullbody, wellness focused massage for women.
Abhyanga Ayurvedic Massage: this 2+ minute video introduces a full body Ayurvedic massage which integrates the full chest into the treatment.
Ayurvedic Massage at Indian Spa: This video shows the chest and abdomen being massaged as an integrated whole starting at 12:45.
Breast Self Massage In this brief, how-to video, Aubrey Lesicki, BS, LMT, teaches the PHAST technique of breast self-massage. The PHAST breast self-massage technique is a quick, simple way to manage your breast care, improving breast circulation as well as the quality of the tissue texture.
Phluff Your Girls and the Happy Breast Book with Cheryl Chapman: Cheryl Chapman is a breast health advocate & teacher & lectures on breast health nationally.
short video showing movement of diaphragm a YouTube video
Video showing full Breast Massage
Another Video showing full Breast Massage
This article was written from and excerpts taken with permission from Barbara Heard
I write about things that I myself need to be mindful of. ways in which I would like to improve. It is not from the perspective of preaching - but rather writing helps me work out what I myself need to do - we are all in this together.