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Image courtesy of Birth Balance Blog

By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Prenatal Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Prenatal massage therapy is an area that is generating more and more research. Right now a few of my massage clients are pregnant. I thought I’d share some of the tips on prenatal massage with you that I share with them!

Benefits of Prenatal Massage

Pregnancy Today’s Kelly Lott, RMT, suggests that, in addition to feeling good, prenatal massage therapy can have other benefits for the mom-to-be and her baby, too.  “A study conducted by Dr. Tiffany Field at the University of Miami School of Medicine showed that massage actually reduces stress hormones in the body. Touch is vital to the mother’s physical and emotional well-being as she adapts to her new body image. Regardless of individual circumstances, a pregnant woman’s body is challenged, changed and stressed in many ways. Massage gives special attention to the mother-to-be, which in turn nurtures the new life that grows within her.”

In addition, other benefits include:

  • Relieves swelling/edema in legs
  • Reduces low back pain
  • Relieves muscle soreness and pain in neck and shoulder area
  • Gives mothers-to-be a place to be pampered, to relax and feel nurtured!
  • And according to Shirley Vanderbilt at MassageTherapy.com, “Recent studies from the Touch Research Institute (TRI) in Miami, Fla., indicates that pregnancy massage provides more than just symptom relief for the mother. A group of 26 pregnant women were given either massage or relaxation therapy during a five-week study. In addition to experiencing a reduction in symptoms of anxiety, stress, sleep problems and back pain, the massage group had fewer complications in their delivery. Their newborns also had fewer postnatal complications. Another TRI study reported massage during labor resulted in shorter labor times for the mothers, shorter hospital stays and less postpartum depression.” (Read more from Shirley Vanderbilt on Pregnancy Massage at massagetherapy.com here.)

Cautions for Prenatal Massage

There are, however, times when expectant mothers should avoid seeking massage therapy. Because of the increased risk for miscarriage in the first trimester, it is commonly recommended to wait until second or third trimesters to explore prenatal massage. If an expectant mother is experiencing any of the following complications or conditions, she should abstain from prenatal massage as well:

  • heavy discharge (watery or bloody);
  • diabetes;
  • contagious illness;
  • fever;
  • vomiting;
  • unusual pain;
  • preeclampsia;
  • high blood pressure;
  • morning sickness;
  • abdominal pain;
  • diarrhea;
  • any malignant condition.

Additionally, areas of the body that should not be massaged include:

  • skin rashes, open sores, bruises
  • raised or distended varicose veins
  • Points on the hand between the thumb and index finger*
  • Points on the inside of the lower leg about 4 inches above the inner ankle bone*

*These are accupressure points thought to stimulate contractions and labor

Prenatal Massage Positioning

For table massage, pregnant women should not lie on their stomachs. Prenatal massage should be done with the mother to be in a side lying position, usually hugging  a body pillow. Some massage therapists will also use a body cushion system that allows the mother-to-be to lay face down with her belly supported by the pillows. Pregnant women love this pillow because ti allows them to lay face down without any pressure on their bellies. However, there is some concern that this body cushion position may over stretch ligaments in the woman’s abdomen and some massage therapists (myself included) prefer to avoid the risk and use the side lying position exclusively.

For chair massage, most massage chairs have a “pregnancy bolster” which allows the expectant mother to sit in the chair without putting any pressure on her belly. The massage chairs at Working Well massage stations are designed to move the breast plate high enough to that the expectant mother’s belly is under the breastplate.

Finding a Good Prenatal Massage Therapist

Massage therapists must be certified in prenatal massage to perform prenatal massage. If you already see a massage therapist, ask him or her if they have this certification or if they can refer you to a massage therapist that does. If you are in Chicago, I, myself, am certified in prenatal massage and I also know of several massage therapists with prenatal certification I can recommend.

To find a reputable prenatal massage therapist in the US, visit the Association of Bodywork and Massage Professional’s massage locator service here. Or visit the National Massage Therapy Certification Board and search for ‘pregnancy massage.’

Read more at Suite101: Benefits of Prenatal Massage: When and Why to Get a Massage During Pregnancy

Read “12 Reasons to Administer Prenatal Massage Therapy” here.

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Massage in Frankfurt, Germany
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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Whilst researching around the internet, I found a link to a chat room thread that exemplifies one of the problems massage therapists face to this day: the misconception that massage therapy is a sexual service. In this thread,  a young man inquires how to go about getting sexual services from a “legitimate massage therapist.” Which is really an oxymoron.

All too often, men (and some women) think that massage IS a sexual service and get confused as to what they are getting when they schedule a massage session. This makes it tough on those of us that are legitimate massage therapists. How do you know if your massage therapist or massage center is legit or a cover for prostitution?

Massage is Not Prostitution, But Massage “Parlors” Are Often Fronts for Prostitution

Because prostitution is illegal, prostitutes and massage parlor operators look for creative ways to mask the real intent of their product: Sex for hire. And what better way to conceal your true product than to market it under the name of a similar product or service: Call it “massage.”

Massage parlors don’t typically use licensed massage therapists. Why bother? Licensing for massage therapy requires at least a year or so of schooling, including anatomy and kineseology, at a cost of about $10,000-$12,000. And in Illinois, massage therapists get fingerprinted and go through a criminal background check–tough to pass if her or she has a record of convictions for prostitution.

Who Are Legitimate Massage Therapists?

Which brings me to my point. How do you know the difference between a legitimate massage therapy center and a massage parlor? Let’s run through a legitimate massage therapist’s goals, training and ethics to demonstrate how we differ from massage parlor masseuses.

Massage Therapy Goals

Legitimate massage therapists are people that like to help other people, non-sexually. We aim to relieve muscle pain, relax your nervous system and give you a period of time in which you and your wellness is the focus (which is tough to find these days between work, family, fitness and social obligations).

Legitimate massage therapy gives clients a safe space to relax. Licensed massage therapists are trained to respect client’ boundaries, be non-judgemental and compassionate.

True, there is a wide range of skill levels between licensed massage therapists, and some are far better than others, but overall, legitimate massage therapists strive to provide a clean, safe and relaxing massage session for clients.

Massage Therapy Ethics

Legitimate massage therapists agree to abide by a code of ethics that prohibits sexual massage. In fact, if a legitimate massage therapist is convicted of giving sexual massages, aka prostitution, she/he can lose their massage therapy license, face disciplinary measures from their professional association and be barred from performing professional massage.

Massage Therapy Training

Licensed massage therapists train in massage techniques as well as proper draping techniques to ensure your genitals are never exposed during your massage. In massage therapy school, we learn about skin conditions and how to avoid contagion.We learn about good hygiene and general health conditions. We undergo extensive testing in each massage class as well as at the end of our training in order to obtain our massage therapy licenses.

In Chicago, legitimate massage therapists must apply for and maintain current licenses with the State of Illinois. Any massage therapist that has been disciplined for performing sexual massage can have this license revoked. You can look up the validity of a massage therapists license online here. Your can also request that your massage therapists show you his or her state license. In addition, in Chicago, every Massage Therapy “Establishment,” from the Working Well Massage chair massage station at Whole Foods to the big spas, must have a Massage Establishment License.

Where Do I Find a Legitimate Massage Therapist?

You can find legitimate massage therapists on massage locater services such as ABMP, or Massage Today’s websites.  Link to my previous post, “How Do I Find a Good Massage Therapist?” here.

A massage therapy session can be a wonderful, positive, relaxing experience. Or it can be a way to relieve muscle pain, heal from injury or help you better cope with stress. What it’s not is an open invitation to harass, proposition or fondle the massage therapist!

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Injured soldiers find relief through massage and other “alternative therapies.”

By Michael Devitt from Massage Today magazine

Wars have been fought since time immemorial. From simple sticks and rocks to guided missiles and uranium-tipped artillery shells, the methods civilized nations have used to annihilate one another have changed dramatically over the centuries.

Despite the advances in modern warfare, the types and degrees of injury suffered in combat have remained frighteningly constant. Surprisingly, research suggests a major cause of attrition (a reduction in number or strength) among military personnel in recent wars has resulted not from injuries incurred on the battlefield, but, rather to more typical conditions such as accidents and musculoskeletal complaints.

To determine what types of painful conditions affect soldiers during wartime, researchers in the United States and Germany examined 162 soldiers engaged in Operation Iraqi Freedom who were evacuated to pain treatment centers outside the theater of combat. Results of the study, published in the journal of Anesthesia & Analgesia, show that many of the injuries suffered by military personnel during conflict are indeed similar to those sustained by people in the civilian sector. Even more important, the use of alternative therapies in the treatment of pain among injured soldiers appears to be growing, with massage the most common alternative therapy used for pain relief.

All of the soldiers included in the study had been injured during OIF between March 2003 and June 2004, and were medically evacuated to one of two treatment facilities: Walter Reed Army Medical Center in Bethesda, Md., and Landstuhl Regional Army Medical Center in Landstuhl, Germany. Most of the injured personnel received “consultations for treatment recommendations to be implemented at military treatment facilities located at the patient’s home duty station.”

Analysis of the complaints showed most soldiers suffered injuries comparable to those that would have been sustained by similarly aged civilians. Not surprisingly, more than half of the pain complaints reported by the soldiers (53 percent) involved the low back. The second most common complaint was “nonradicular extremety pain,” which accounted for 23 percent of the presenting complaints.

The most common diagnosis of injury was lumbar herniated disk which, according to the researchers,” accounted for almost one-quarter of all pain disorders.” Postsurgical pain was the second most common diagnosis, and was experienced by 14 percent of all patients.

More than three dozen treatment modalities were utilized for pain relief; on average, each soldier was treated with 3.5 different therapies. Not surprisingly, drugs were the most popular form of pain relief, beginning with nonsteroidal anti-inflammatory drugs (NSAIDs), which were given to 91 service members. Seventy-nine patients received opiods; 66 patients received some kind of neuropathic pain medication.

Drugs and surgical procedures weren’t the only treatment options available, however. According to the study authors, 28 soldiers (17 percent of the study population) were treated with “some type of alternative therapy.” The most common alternative therapy offered was therapeutic massage, which was performed on 13 soldiers, and administered more frequently than chiropractic manipulation, acupuncture and glucosamine/chondroitin supplements combined. More than half of these patients treated with alternative therapies (15) were diagnosed with postsurgical pain or lumbar herniated disk before receiving care. In fact, more than one-third of all military personnel diagnosed with postsurgical pain were treated with massage.

The study pointed out the number of injuries suffered during combat was significantly less than the number of non-combat injuries; in fact, only 17 percent of the patients stated they were injured during battle.

Such nonbattle-related injuries, or NBIs, can take a serious toll on overall troop strength in modern warfare. According to the authors, “Among the 21,655 soldiers admitted to army hospitals in Southwest Asia during the Persian Gulf War, acute NBI comprised 25 percent of all hospitalizations, with musculoskeletal conditions ranking second at 13 percent.”

Presenting Pain Complaints in Soldiers Injured in Operation Iraqi Freedom*
Pain Presentation (n=162) Frequency Percentage
Lumbar radicular pain 49 30.2%
Axial low back pain 37 22.8%
Nonradicular leg pain 24 14.8%
Nonradicular arm pain 16 9.9%
Groin pain 15 9.3%
Thoracic pain 10 6.2%
Neck pain 10 6.2%
Abdominal pain 8 4.9%
Cervical radicular pain 6 3.7%
Headache 6 3.7%
Thoracic radicular pain 2 1.2%
Polyarthralgia 1 0.6%
Facial pain 1 0.6%
* The percentage of pain complaints is based on the number of patients (162), not the number of presenting symptoms (185).

Taking these numbers into account, this would mean that more than 2,800 soldiers were hospitalized due to musculoskeletal complaints during the Gulf War. Given the increasing number of low back and other musculoskeletal injuries that seem to be the norm in modern warfare, and given that these conditions often are seen by massage therapists in the civilian sector, it would appear that massage therapists are just as qualified as other health care providers in helping to ease the pain and suffering of injured military personnel.

For more information, go to the article here.

Resources

  1. Cohen SP, Griffith S, Larkin TM, Villena F, Larkin R. Presentation, diagnoses, mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: An epidemiological study conducted at two military pain management centers. Anesth Analg 2005;101:1098-1103.
  2. Hoeffler DF, Melton LJ. Changes in the distribution of Navy and Marine Corps casualties from World War I through the Vietnam conflict. Mil Med 1981;146:776-9.
  3. Writer JV, DeFraites RF, Keep LW. Non-battle injury casualties during the Persian Gulf War and other deployments. Am J Prev Med 2000;18:64-70.

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By Sue Shekut, Licensed Massage Therapist, ACSM Personal Trainer, Certified Wellness Coach, Owner, Working Well Massage

I like to think of myself as not only a good massage therapist but also a good judge of massage therapists. I’ve had thousands of massages and given thousands of massages. As the owner of a wellness company, I interview many massage therapists and receive regular massage myself. Often, when clients travel or move out of town, they ask me how to find a good massage therapist.

It’s a question very similar to “how do I find a good dentist or a good doctor”. Since massage is a personal service, my first impulse is to say, ask your friends and coworkers who they go to and start there. But then, we’ve all had referrals to service people that our friends liked that were not a good fit for us. (One person may like a deep massage and you may like a lighter touch or vice versa. One person’s fantastic hair stylist may be great for that person but be unable to cut your style of hair well.)

Before you search out massage therapists, take a minute to think about what you want from a massage experience. Then when you call different therapists or massage centers, ask questions to make sure you get the massage therapist that best fits your needs.

Good questions to consider:

1. Are you going for stress relief or pain relief or both? Swedish massage or “relaxation massage” tends to be best for stress relief. Deep tissue or therapeutic massage tends to be best for pain relief. If you have a specific injury or chronic pain pattern, you will want a massage therapist with skill in relieving muscle pain, not just in relaxation therapy.

2. What’s your budget for massage?
Can you afford a weekly full hour (prices ranging from $65 to $120) or only mini-sessions (like the 15-20 minute $1 per minute chair massages offered at Whole Foods and similar places). If you have a chronic neck and shoulder pain, it’s often more cost effective to get weekly 20-minute massages than a one hour once a month.

3. Do you want someone you can go to regularly or just on a pamper yourself basis?
Spas tend to charge the most for massages and tend to be the place people go for pampering. However, some independent massage therapists may be able to offer you better prices and a really personalized pampering experience. Spas charge the most but they will give you the whole pamper yourself experience. However, if you want a regular massage your best bet is to find a good practitioner that is reasonably priced. If you can’t afford an hour regularly, try chair massage for 15-20 minutes if you want more frequent upper body massages.

4. How much do you care about the quality of the massage?
If you just want someone to pamper you and rub oil on your back while you relax and snooze away your stress, you don’t need someone with extensive experience or medical massage training. If you want someone to help you recover from an injury or deal with a chronic tension issue, you will likely want someone with a good deal of experience and skill working with similar conditions. Make sure you massage therapist meets minimal licensing and certifications standards if you want more than just relaxation massage!

5. Do you want the whole massage enchilada: the robe, slippers, the soothing music and spa environment? Or do you care more about the environment or more about the actual massage?

For the slippers and robe, go to a spa like Urban Oasis or Exhale in Chicago. For a great therapeutic massage, it’s more important to find a good practitioner. Use the locator services below and then speak with the therapist about his or her skill before you commit to the appointment.

Massage Locator Services
My top sources for great massage therapists are massage locator services (versus Google or any other search engine). Massage therapists that register with these services must meet minimum standards of training, normally 500 hours or more and have graduated from an accredited massage school.

One of the best is the Association of Bodywork and Massage Professionals massage practioner site here.

Massage Today also has a great service as well here.

Insider Pages is a review site that provides user comments about massage and spa services.

How Do I know if My Massage Therapist is Qualified?
In the State of Illinois, Licensed Massage Therapists are required by law to have at least 500 hours of training and graduate from an approved school. You can look up your therapists to see if he or she is licensed at this site. This site will also display a Y or N to indicate whether the massage therapist has ever undergone disciplinary action by the state of Illinois’s Department of Financial and Processional Regulation.

Other states vary in requirements. Some states do not require a license at all and allow municipalities to regulate massage. For example, in California, there is no state license. Hours of training required vary depending on the city. So some therapists in Northern California only have 100 hour of actual massage training! The Truth About California Massage Licensing here. However, at the other end of the spectrum is New York State, which requires 1000 hours of training. New York Licensing Requirements here

Still Unsure, Try a Sample Massage
Lastly, if you want to try a sample massage, your best bet is to try a chair massage at Whole Foods Gold Coast or Lincoln Park in Chicago. Or at a local health food store or mall. You can get a few minutes of massage, determine if the therapists fits your needs, then ask for his or her business card to set up a longer massage!

If you have questions about Chicago area massage therapists, feel free to contact Working Well Massage here!

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