Positioning for Prenatal Massage - by admin@mcb on June 01 2018

Positioning for Prenatal Massage

There are two schools of thought on client positioning for prenatal massage therapy.

  1. Some therapists prefer to keep the woman in as close to fully prone and supine as possible to provide prenatal massage in the same positions as a standard massage. This is achieve with the use any number of specialty tables and support systems to achieve this purpose.
  2. Other therapists prefer to use a sidelying and modified supine position for performing massage therapy during pregnancy.

At the Institute of Somatic Therapy, we carefully considered positioning for prenatal massage. Our decision has been to teach in the  sidelying and modified supine (semi-reclining) positions. The routine we teach focuses on the back and legs while the pregnant woman is in a sidelying position, and the abdomen, arms, neck and face when she is in a modified supine position.

Why IST Prefers Sidelying Positioning for Prenatal Massage

Image from Istockphoto
Image from Istockphoto

There are several reasons why the Institute of Somatic Therapy prefers sidelying positioning for prenatal massage rather than the use of a support system that allows for a fully prone position.

Some of our reasons for preferring the side-lying position include the following:

1. Potential Strain to Uterine Ligaments: With some prenatal massage tables, it can be difficult to get a perfect, firm fit over the abdomen, so uterine ligament strain can be caused. While the woman may not notice it during the duration of the massage, she may have some discomfort afterwards.  Other systems do not provide good support for the legs, and others only allow for prone and don’t provide a way to modify the supine position to keep the weight of the uterus off the vena cava for the supine portion of the massage.

2. Ease for Client: As the pregnancy reaches the final trimester, it can be difficult for the client to get into and out of the prone position without assistance, and it can be difficult to assist an undressed client in and out of that position without compromising her privacy.

3. Cost Efficient: Most therapists already own a standard table, and can’t afford the expense of another table when it is not absolutely necessary. The cost of the sidelying and modified supine bolsters are often less than a specialty table.

4. Comfortable: A sidelying, fetal position is a very nurturing, comfortable position, one in which most people sleep, so it is very calming physically and psychologically.

5. Effective: A sidelying position places the client in a position which makes it very easy for the therapist to access her hip, IT band, piriformis, and sciatic nerve areas. These areas of the body are often in need of special focus to relieve the strain of the pregnancy. You cannot get the same access to these trouble spots in a prone position.

That being said, we realize this is a personal choice, and do not require our students to adopt this position if they have strong feelings about the prone positioning. Most of the techniques we teach are easily adapted into a prone position if that is what you and your client prefer.

Becoming Certified as a Prenatal Massage Therapist

To learn more about becoming certified as a prenatal massage therapist with Institute of Somatic Therapy, click here.

Institute of Somatic Therapy  is approved by the NCBTMB (Provider #280672-00) as a continuing education Approved Provider. Institute of Somatic Therapy is also approved by Florida (#MCE-326), and New York (#0019). Our courses are  valid for AMTA, ABMP, and most individual states.


Massage Doula Impact on Traumatic Birth - by admin@mcb on December 01 2015

Massage Doula Impact on Traumatic Birth

Approximately 1 woman out of every 4 considers that her labor and delivery experience was a traumatic birth. With 4 million births in the US per year, that is one million women per year who experience traumatic births. (Source: Prevention and Treatment of Traumatic Childbirth (PATTCh.org) By having a massage doula with her during birth, a pregnant woman can increase her odds of not being part of these statistics.

Feelings of a traumatic birth tend to occur if the mother feels that she or her baby were in some type of danger during the labor process. These feelings can also occur if the woman feels that she was out of control and helpless during the labor. Having a massage doula helps to reduce both of those, due to the loving presence of a birth support provider.

Post traumatic stress disorder (PTSD) is not outside the range of possibility if the traumatic birth experience is not dealt with. As a massage doula, you should know the signs of birth PTSD. The signs are: nightmares, dwelling on the birth, avoidance behaviors, and reluctance to talk about the birth. Other signs are avoiding postpartum obstetric appointments, blame or negative feelings toward people who were part of the birth, anger, and sleep disorders. If these signs are present for more than a month after the birth, the mother likely has some degree of birth PTSD.

During labor support, if a massage doula believes that her client’s birth expectations are not being met, she needs to try to focus her client on getting through the moment and help her deal with the trauma as it happens, to help prevent long term negative consequences. After the birth, encourage her to get plenty of sleep, exercise, use some type of relaxation method (massage, yoga, etc), or seek counseling. You can also refer them to http://pattch.org/resource-guide.

To become trained as a massage doula, click here: Massage Doula Certification

To find a certified massage doula in your area, click here: www.massagedoula.com

Benefits of skin-to-skin contact - by admin@mcb on October 29 2015

Benefits of skin-to-skin contact

Scientists are confirming that infant/mother skin-to-skin contact in the first hour after birth has both short-term and long-term consequences. These include everything as far reaching as brain development, mothering, and social behavior patterns. Healthy newborns who are placed skin-to-skin with their mothers immediately after birth show both physical and emotional benefits  compared to newborns who were separated for routine care immediately after birth.

The physical benefits include more stability in their respiration, glucose levels, and body temperature. They also have fewer stress hormones and more regulated blood pressure. Additionally, they experience increased brain development over time. On the emotional side, these babies cry significantly less than the babies who are separated from their mothers at birth.

When left skin-to-skin with their mothers, healthy, full term babies demonstrate an instinctive skill to breastfeed without assistance. Researchers have identified that the baby goes through nine observable behaviors within the first hour that lead to the first breastfeeding.

Multiple studies dating back as early as the 1970–1980s compared two groups: Mothers who had at least 15 minutes of skin-to-skin contact with their newborns, and mothers who were only allowed to briefly view their infants. Infants in the second group were taken to a separate nursery and returned to the mother every 4 hours for feeding. At the end of the hospital stay, the mothers with  even brief  contact with their infants were more confident and comfortable handling and caring for their babies than mothers who had been separated from their babies.

In follow-up studies three months after birth, mothers with early skin-to-skin contact kissed their babies more and spent more time looking into their infant’s faces. At one year they demonstrated more touching, holding, and positive speaking behaviors. They also kept more follow-up appointments with their primary care providers, and they breastfed their babies longer.

Prenatal massage therapists and birth doulas should educate their pregnant clients about the importance of this once-in-a-lifetime experience.

Source: Medscape.com

To learn more about pregnancy massage, doula labor support, and infant massage, the Institute of Somatic Therapy offers a variety of continuing education courses. Visit https://www.massagecredits.com/pages/course_listing.php?SB=22&CAT=12.

Is prenatal massage contraindicated in the first trimester of pregnancy? - by admin@mcb on September 03 2015

Is prenatal massage contraindicated in the first trimester of pregnancy?

My friend Rachel in her first trimester, holding her one year old son.
My friend Rachel in her first trimester, holding her one year old son.

Is prenatal massage contraindicated in the first trimester of pregnancy? This is a question that certified pregnancy massage therapists encounter quite a bit.

The first trimester is the first 13 weeks of the 40 week pregnancy cycle. The 40 week (280 day) cycle count actually begins on the first day of the last menstrual cycle. With that definition, a woman is considered two weeks pregnant when she ovulates, which is the time conception actually takes place. Then it is another two weeks before her next menstrual cycle is due to begin, so if she conceived, she is considered four weeks pregnant before she even knows that she is a day late on her next period.

That means that the first third of the first trimester has elapsed before most women even knows that they are pregnant. Not all women are perfectly regular on their cycles, or if they are not trying to conceive might not even be tracking the exact dates of their periods to suspect they are pregnant for another one or two weeks or more. Often women are about halfway into their first trimester before they know that they are pregnant. As hard to imagine as this may be, there have been cases of women at full term not knowing they were pregnant until they went into labor. If the client doesn’t know they are pregnant, then the pregnancy massage therapist obviously won’t know their client is pregnant either, but technically that massage would be considered a prenatal massage since the client is pregnant.

The biggest concern about prenatal massage is the possibility of inducing a spontaneous abortion. Common sense should dictate that if something as pleasurable as massage was abortion inducing, there would be no such thing as a surgical abortion industry. Why go have surgery when you could have a massage instead? Nothing done in the course of a standard massage has ever been shown to trigger a miscarriage in the first trimester. However, if a client does know that she is pregnant and is still in the first trimester (a time for which miscarriage is most likely to occur), it is reasonable for the prenatal massage therapist to err on the side of caution, for the peace of mind of the newly pregnant woman.

In our prenatal massage certification course, we advise our students to lighten any pressure on the low back and to omit all abdominal massage during the first trimester. We also advise our students to avoid any tapotement (percussion) or shiatsu (sustained pressure to various acupressure points), at least not to the points that relate to the reproductive system. Simply performing traditional effleurage and pettrisage massage strokes over these areas would not be enough to trigger any negative response from the acupressure points.

There is no evidence based rationale for considering the first trimester of pregnancy to be a contraindication for massage therapy. The same holds true for the second and third trimester. It is advisable, however, that massage therapists who plan to work on pregnant clients on a regular basis have specialized training. Pregnancy impacts every system of the body, each of which impacts massage. By taking an advanced continuing education course in prenatal massage, massage therapists are prepared to made adjustments for each of the changes taking place in the body of their pregnant massage clients.

If you have ever considered becoming certified as a prenatal massage therapist, we hope that you will consider the courses offered at Institute of Somatic Therapy. For more information on our pregnancy massage certification courses, click here.

(Special thanks to my friend Rachel for letting us use her photo. She used this photo to announce that she is pregnant with her second baby.)

Massaging Infants Can Also Help Parents - by admin@mcb on June 08 2015

Massaging Infants Can Also Help Parents

Learn more about the benefits of massage for both infants and their parents. Source: Pixabay
Learn more about the benefits of massage for both infants and their parents. Source: Pixabay

Infant massage offers a whole host of benefits to babies, including calming, stress reduction, and bonding with their parents. But many parents don’t know that massage for infants can also benefit them. Participating in infant massage therapy sessions can help calm overstressed or worried parents and allow them to focus on the individual needs of their baby.

Massage for infants helps parents feel:

  • Connected- A parent’s touch is the primary way that an infant begins to form emotional bonds. This connection should also be nurtured to benefit the parent. Parents need to feel connected to their infant and the soothing touch of infant massage is an effective method of strengthening the parent/child bond.
  • Confident- Caring for an infant can be difficult at times and many parents may doubt their abilities. Infant massage helps parents feel confident in their ability to meet their baby’s unique needs.
  • Competent- Each baby is different and it’s the parent’s responsibility to try and figure out what the baby needs. Participating in infant massage sessions allows parents to grow their competency and become better able soothe and calm their child.

If you are interested in learning more about massage for infants and utilizing it as part of your massage therapy practice, contact us at the Institute of Somatic Therapy. We are committed to help massage professionals grow their practices and better meet the needs of their clients.

Another Reason Massage is Better Than OTC Pain Meds - by admin@mcb on May 07 2015

Another Reason Massage is Better Than OTC Pain Meds

Many  massage therapy clients use over-the-counter pain medicines on a regular basis for temporary relief of minor aches and pains. But it turns out they could also be “relieving” themselves of their ability to feel the maximum amount of joy in life.

Researchers at the Ohio State University recently concluded a study that showed that medications that contain acetaminophen (drugs like Tylenol, Benadryl, Dayquil, Nyquil, Anacin, Midol, and many more) dull not only the aches and pains their users are targeting, but can also dull emotions. According to the website Medication Use Safety Training for Seniors (www.mustforseniors.org), acetaminophen is the “most common drug ingredient in America.”

Photo from Shutterstock
Photo from Shutterstock

The Ohio study consisted of 82 college students, some of whom took a placebo and some of whom were given 1000 milligrams of acetaminophen. The students were then shown a series of 40 photographs that were designed specifically to trigger an emotional response, some heartwarming and others disturbing. (Examples: people happily playing with cute pets, children experiencing the pain of malnutrition). The study showed that the students who had received the drug reacted with considerably less emotion to both types of photos as compared with the students who had taken the placebo.

The lead author of the study, Geoffrey Durso, a doctoral student in social psychology at Ohio State University, said, “This means that using Tylenol or similar products might have broader consequences than previously thought.” He continued,  “Rather than just being a pain reliever, acetaminophen can be seen as an all-purpose emotion reliever.”

Another of the study’s authors, Baldwin Way, assistant professor of psychology, stated that the students in the study were not aware of the effect the drug was having on their emotions, failing to recognize that they were reacting differently than if they had not been given the drug.

As much as 23% of the American adult population (52 million people) take this drug every week, according to the Consumer Healthcare Products Association.

Wouldn’t you rather relieve your pain with massage, than take a drug that can limit your joy in life?

Thailand Massage from an American Standpoint - by admin@mcb on February 24 2015

Thailand Massage from an American Standpoint

Thai menuTo celebrate 25 years in the massage industry, the Institute of Somatic Therapy held their annual corporate retreat in Thailand this year. Director of Education, Judith Koch, wanted an opportunity to find ways to better market Thai massage and Thai massage continuing education courses in the United States, and to explore the Thai massage establishment model to see what aspects, if any, might be incorporated into the United States.

Massage therapy in Thailand is everywhere. It is not unusual to see two or three massage establishments on a busy block. A typical hour-long session is in the 250-300 baht range. At approximately 31 baht per dollar, that makes an hour session roughly eight to nine dollars. Most massage businesses have a full menu of services, with the two most popular being the one-hour foot massage (which also includes the arms, neck, and upper back) and the traditional Thai floor massage and bodywork session. Variations of these include some oil massage combined with Thai stretches and pressure points. Most facilities also offered pedicures, manicures, and facials. The photo of one such menu was taken at one of the higher priced locations.

In the course of our visit, Judith had three traditional Thai massages (one with coconut oil massage incorporated), by three different practitioners, and six Thai foot massages (five of which were one hour) by six different practitioners. She also had a facial massage with clay treatment the final day, when she was feeling too overworked from all the bodywork to be able to comfortably receive any that day.

The first session was held at a massage school located at the famous Wat Po (“wat” is the Thai word for temple), home of a famous enormous side-lying Buddha. This temple is located next to the Grand Palace, which is a major tourist attraction in Bangkok.

The massage school here (www.watpomassage.com) has four affiliated schools in other areas of Thailand. Founded in 1955, and the first approved Thai medical school accredited by the Thai Ministry of Education, it offers courses in massage as well as in Thai pharmacy, Thai medical practice, and Thai midwife nurse training. The two basic courses are General Thai Massage and Foot Massage, both of which are 5 day courses. Advanced courses include Thai Herbal Compression (3 days), Thai Medical Massage (10 days), Massage for Women’s Healthcare (5 days), and Oil Massage and Aromatherapy (5 days). Their professional Thai massage course is 165 hours  (tuition roughly $1,000 American dollars), spa body treatment for 120 hours, and a professional Thai massage therapy program for 200 hours (tuition roughly $1,400 American dollars).

At Wat Po we opted for a 30 minute foot massage, which included an approximate 15 minute wait due to their popularity. This was the only facility where we had to wait for a therapist.  We also paid more for a student massage than we did for established therapists the rest of the trip, and had also paid admission to get into the temple area. Of the six foot treatments I had, this was in the top two as far as skill of practitioner. It was also the only location where we had (or even saw)male therapists.

A typical Thai foot massage includes some warm-up strokes, and the deeper work is done with the use of a small wooden tool. The tool was about six inches long, about half an inch around at the large end and a little smaller on the tapered end. The therapist would grip it so that the tip of the tool was right along their thumb, almost making it difficult at times to tell if they were using their thumb or the tool. The tool was also used perpendicular to the skin to perform light strokes along the top and sides of the foot.

One foot was thoroughly massaged, both by hand and with the tool, then cocoon-wrapped with a hand towel while the other foot was massaged. Strokes were generally restricted to the foot area, with some strokes extending all the way to the knee. It was very common to start with a double tapotement “thump, thump” with the little finger side of their closed fist. This would be done on the bottom of the foot or the middle of the calf muscle as a warm up and closing stroke. During the hour-long foot session, the foot work is extended to around 40 minutes, with the remaining time on the arms (with the therapist approaching from the side), the head and neck (with the therapist standing behind the lounge chair), and then the client would move to sit on the footstool with their back to the therapist for the final back work. Some therapists included arm stretches at this point, while others did not. They always ended with a series of tapotement strokes.

Our second session was in a private establishment, where we had a traditional Thai massage on a floor mat.  Judith felt this first Thai-styled massage session was the best she experienced, or maybe it was just the many miles she had walked the day before. It definitely helped loosen up her sore legs. The first practitioner seemed to have a smoother flow to her technique, and a better sense of limitations on stretches, which is why it was rated the best. Since our standard of expectation was set by the enormously talented Michael “Mukti” Buck of Vedic Conservatory as seen in his video training courses that we offer, we were disappointed at the “pushy” lack of flow that several of the therapists displayed. To receive traditional Thai massage, the patron was given a two-piece cotton outfit, much like a pair of pajamas, to wear during the session, regardless of how loose and comfortable the clothes being worn at arrival.

The best foot massage was done so smoothly that Judith had difficulty determining at times if the therapist was using her thumb or the wooden tool. (It was the wooden tool.) She held it so close to the tip of her thumb that they almost become one. Some therapists who were not as proficient with the tool either had too much tip exposed, which felt rough, or not enough depth of pressure, which felt more tickling than therapeutic. In addition to using the tip of the tool to make a series of vertical and horizontal passes along the bottom of the foot, the side of the tool was used to stroke along the top of the foot and whirled between the toes. Many therapists would wrap the tip of the tool in a towel or cloth (to prevent slipping) and apply pressure to various points along the top of each toe and along the side of the big toe, likely corresponding to reflexology points. Unfortunately most of the therapists did not speak much English, to it was difficult to have a detailed conversation with them about their training and practice.

Most of the facilities were set up in a similar fashion, with several reclining chairs in the front area for the foot massages, and several individual curtained-off areas in the back or upstairs for the Thai sessions. Privacy was minimal. For the oiled sessions, some establishments had large wooden tables (approximately four feet wide, about one foot off the ground) while others used the same mat as for traditional Thai bodywork. I saw no American-style massage tables in any of the establishments.

Massage therapists who were not working on a client would solicit in the street, calling out to passersby with their laminated schedule of services in hand. Rumor has it that the locations where the women were wearing a certain color of t-shirts was a code that they offered services of a sexual nature, although prior to hearing that rumor we had not encountered any establishments fitting that description, and we avoided the one we saw afterwards just to be on the safe side. One establishment in Phuket had a “no sex” sign on the front door, which was the only open reference we saw to sexual services. A newspaper article in the Bangkok Post that same week discussed governmental efforts to reduce sex tourism and human trafficking, so hopefully that aspect is being addressed, although the article seemed to indicate that it was the women victims who were being humiliated and arrested instead of the patrons.

One of the establishment owners was interested to know what massage establishments were like in the USA. He was curious if the Thai model would work here. As we discussed the logistics, we both agreed that we did not think that it would transfer well, except perhaps in high tourist zones like a beach or riverfront boardwalk, busy shopping malls, or airports. Most of us don’t have the needed amount of foot traffic to bring in a significant number of passersby off the street without an appointment. But even in high foot traffic zones, considering the high rent that would accompany such locations in the states, and the typical wage paid to massage therapists, the prices would be so much greater in the US that they would probably not do a fraction of the business. A $10 service is an easier impulse decision than the same service for $60 and higher.

Overall, while I enjoyed the low cost and the variation, I must admit that I’m looking forward to getting back on my local therapist’s soft table in a private room to receive an American style massage. As the old saying goes, it was a great place to visit but I wouldn’t want to live there.

For students interested in learning Thai massage, we offer two continuing education courses to choose from. The first is the traditional style on a floor mat, the second is modified for American-style massage tables:

Thai Yoga Massage

Thai on the Table

For therapists who would like to earn continuing education credits through Michael Buck’s training titled Four Attitudes – Nuad Borarn Thai Massage, we offer a “test only” option. You will obtain the DVD series through www.vedicconservatory.com and then when you are ready to earn your continuing education hours, you can take the test through our online system.