Question for the ladies, Clients and therapists

[Love is great]

First of all as a male therapist I try very hard to be sympethic of the needs of my female clients. I understand that in some cases that is it difficult to work on certain parts of your body. My client intake form (http://www.lakeconroemassage/Packet.pdf) I try to go into great detail of what is exceptable for you to be massaged.

But I have some questions.

My rule of thumb is that a clients underware is a no-go area. I do not touch those areas or re-adjust the garment

If you have given me permission to have your glutes massaged and you are wearing a pair of panties is it acceptable for the male therapist to move the panties in a way that the glutes can be worked on or is it better to have the therapist ask you to move them?

Without written permission I will massage from the head down to the collar bone. I have two sign offs for women as far a breast massage goes. 1 for the pectorial area from the colar bone to the top of the breast tissue. And the second for a full breast massage. The second was reciently added because I have had a couple of regular clients request it.

For information on breast massage please look at http://www.massagelondon.org/pages/msg4wmn.htm . It is a great resource for both client and therapist.

Thanks for your time and feedback.

 

[CF_]

Have you ever asked your client how they feel about having their underwear moved when they have given consent for glutes?

I usually tell my clients before the massage the areas that will be massaged and so if they leave their undergarment on I will work around them. Or they tell me what they would rather not have massaged.

With my clients who wear underwear I won't massage the skin underneath. I will do compression type techniques over the sheet. I just don't know cmfortable it would be to have briefs stretched/bunched/moved in such a way to get to the glutes.

If you say to someone, "Undress to your level of comfort," and you come back in and they have their clothes on still, I would not move the clothing around so that I can get to their skin. To me that they have choosen to remain clothed is a sign that they are not comfortable with portions of their body being exposed and to move their clothing around, to me, seems like not respecting their modesty.

 

[Evehr]

I do in home massage therapy, So I set up in the living room, extra bedroom, outside on the deck(yes and It was a very nice day) or where ever they have room. He was done with his massage and was going back to the kitchen when she asked. I asked if she was sure and then asked her husband if he minded? Both said that it was ok. So I said I would and did.

 

[Yoyo]

I explain "undress to your level of comfort" and also my options for draping by showing an example card. I also explain the general sequence of the session and what areas will be treated. I give plenty of time to question. I also say that I will ask permission to move aside underwear when I am ready to work glutes. This gives them another chance to say no. Most have not minded, some didn't like the wedge effect and switched to a thong for the next session, some chose to go nude the next, etc. Once they've felt the benefit of the work, they expect it in future sessions, and understand. I have clients that find that the asking is a disturbance to the relaxation, even asking to turn over some have said is a flow breaker. No easy way around that, but for all else they have given an "everything is OK" and know what my limits are so no further permissions are needed during the session. I've also found some clients are more comfortable in an out-call situation than in the office, and continue to be that way even after several of both.
Outdoor is interesting... don't forget your sunscreen. My favorite is at a private island in northern Ontario... fly in, 4 sessions / day for 4 days (owner and guests), personal cabin, meals, access and use facilities except main coteforum.xxxe, and big tip from owner and some guests. Aug will be my fourth time doing this for the client.

 

[miss_j]

First: breast massage. I don't do it, and I wouldn't allow it to be done to me. Upper pecs, yes. Addressing pec minor from the top and side? yes. Unless someone had a scarring issue that needed attention, breast massage is something I choose not to do, even if requested. If they need it for drainage, I would refer out, since I'm not trained in those techniques.

My personal opinion is that in most cases a male offering or performing breast massage, even at the request of the client, unless it is for demonstrably medical reasons, is more than just a little odd. Maybe it's my Quaker ancestory coming out, but if a male practitioner was even offering breast massage, I would cross that one off my list as a potential therapist either for me, or for referrals. (And no, I don't have that same bias toward male Gynecologists. Go figure. :? )

I realize there are legitimate, professional reasons for breast massage. I also know that most accusations directed at male massage therapists for sexual reasons involve breasts, and you never know which woman will even give permission, then feel uncomfortable and upset later on. Even if she is the one that initiated the procedure.

The London Breast Massage link that you posted makes a very weak case for breast massage being performed by massage therapists. As a breast exam? Better to train the woman to do it correctly herself. The article claims that since MTs have better palpating skills they will find things better. Maybe, maybe not. Most women know where the lumps are in their own bodies if they are paying attention.

One of the problems I have with general breast massage being performed by MTs, is that we are NOT medical practitioners. Yes, we deal with soft tissue pathologies, but most of our training involves muscles, tendons, ligaments... none of which are contained in breast tissue. Most of us do NOT have any but the most basic of training in Lymph Drainage, which is much more relevant to breast treatment. So unless that is really the MT's specialty, why would I want him/her "treating" my breasts? Scar tissue... yes! There is an obvious reason to treat the breast tissue. Reaching the Pec tissue located under the breasts? Not really. In most cases, that would cause a great deal of pain to get through the sensitive breast tissue to those muscles, and it can be mostly addressed in other ways already, without massaging directly on the breasts.

Yes, I also realize there are other reasons, but now we are getting into less defined territory. And while I would never question the motives of a male massage therapist who always does glute massage, or who often does abdominal massage, I'll admit that I am nearly always suspicious of the male therapist who offers, or even suggests the availability of breast massage during his sessions. YMMV.

Glute... different story. They are a vital part of pelvic stability, and must be treated for many different conditions that make up the primary reasons people come to massage therapy for treatment of pain. If my intake reveals that they need low back pain or hip pain addressed, I talk quite frankly about underwear during the intake. I tell them that hip/lowback work requires access to the glutes, there are certain techniques that are better applied on bare skin, but that we can still treat those areas even through underwear. So they have three choices: Nude, all underwear, or underwear nudged out of the way. I get a pretty even mix. I move the underwear up simply because I do it simultaneously with tucking a small cotton towel to prevent oil staining. (Also, because one time I asked a client to move her own underwear and she sat up, fully exposing herself, and gave herself a full wedgie - front and back. :shock: Thank you, I didn't need to see all of that.)

 

[wite boi]

(Also, because one time I asked a client to move her own underwear and she sat up, fully exposing herself, and gave herself a full wedgie - front and back. :shock: Thank you, I didn't need to see all of that.)

Too funny... that certainly interrupts the flow...

 

[SaiyanX50]

First of all thanks to everyone for responding.

Stacey I understand your concerns about a male offering breast massage. Since I started practicing I have seen less than 200 clients. the largest portion of which are female(65/35). With all my client during the intake I sit down and explane exactly what I do(most have read my website prior to contacting me). Before I let them sign the paperwork I ask them to let me know of any areas that they do not want me to touch. I respect their wishes. As I have more sessions with them they become more trusting and comfortable with massage and goto a complete full body massage. And for the record of all 5 women who has requested a full breast massage 4 have implants(3 saline and 1 gummie) and the other was one of my best friends wife.

Granted that is not a high perceneforum.xxxe, but I want to be able to cover my butt if I am requested to provide the service. Since the state of texas REQUIRES that a client give written concent to perform breast massage. I see it as a CYA.

My biggest fear is being acused of sexaul herisment or sued, so I am overly cautious that is why I have a 4 page client intake form and a 2 page contraindication sheet.

As far I go, I perfer a female therapist and not to have my glutes touched by anyone other than my wife.

 

[Jamie]

I'm curious, why is it that you feel this is a service you need to provide? What is your motivation? What is your training, and what specifically are you treating when you give breast massage?

In looking over your site, I can see clearly your fear of anything being perceived as inappropriate. Your draping pictures leave a large portion of some of the body's largest and most important stabilizing muscles unexposed for treatment. Even if the client has given (written) consent for the glutes to be addressed, and doesn't wear underclothing during the session, you stop at the top of the pelvis and the navel? I can assume from your draping that coming from the leg, the highest you will treat is the ischial tuberosity? Yet you offer breast massage, though I don't see any special note about the typical treatments for such (lymph drainage,) and you have your "wife's permission?" Do you also have her permission to perform abdominal massage? Calf massage? Back massage? Do you touch ears without her permission? If you need your wife's permission for this one specific area, are you really sure that you have no issues surrounding the propriety of YOU offering this modality?

While I'm not questioning the benefit of breast massage for pain, mastitis, implant recovery, etc, I am curious about your choice to offer your services as a qualified and comfortable practitioner of this rarely requested service, when it is clear from both your website and your posts here that you are NOT comfortable with it? Not only that, but on a purely technical level, are you qualified to offer therapeutic breast massage? Is this a little bit like someone coming to a MT and requesting reflexology, and the MT saying "okay I'll do it," even though they only had a 3 hour intro class in the technique, but they do the session because "reflexology would be helpful?"

(I apologize if that assumption is incorrect and you have had training/mentoring in breast massage techniques. I am guessing you haven't since you had to get permission before working on these clients. I'm guessing that if you had training you would already have had permission.)

I actually know several men in the local LMT community who offer breast massage. (One was arrested for assault, one probably will be eventually. The other, AFAIK, is totally legit, having taken extensive training in Chikly's MLD techniques.) And while I don't think male MTs in general are predatory for offering breast massage, I can't help but wonder about a few of them, and for those remaining, I think some offer it because they feel that to refuse to offer breast massage calls attention to gender issues.

So to repeat the question, (which may have been lost in all of my "opinionating,") why is it that you feel this is a service you need to provide? What is your motivation? What is your training, and what specifically are you treating when you give breast massage?


Stacey

 

[bballgurlis]

I would not open my self up to the litigation potential... I do MLD, and have treated breast cancer patients, and even in those incidents breast work is rarely indicated as most of the MLD is done on the opposite side.
If it is, I refer out to a female practitioner. MLD is very specialized, and as such most requesting or being referred are in need and better informed.
In my experience I can usually give them relief by working the surrounding lymphatic, making room for the congestion to drain, without going closer that the 5th intercostal space, or lower than the 2nd.

The risk is to high for me, and even a wrongful charge does unrepairable damage.

 

[fly with me:)]

Here in Australia, moving aside undies to work the glutes is common practice and taught in the schools.
The majority of my clients leave undies on and I work their glutes this way.
Chest massage with the chest uncovered to work between and around the breasts was also taught in the 4 shools I trained at.
This is entirely the client's chouce, they can opt for work to be restricted to above the breasts with breasts covered, or not to the chest at all.

I do not offer breast massage, cannot see the point therapeutically and it would create too many problems

 

[eskie lover]

The only times I've ever come close to approaching it was when some gals I've had who had undergone breast augmentation surgery begged me to work the surrounding tissue to free up adhesions formed post surgery. This was by the way very effective in helping them.

Very different, IMO, than "breast massage."

 

[YooHoo]

Granted that is not a high perceneforum.xxxe, but I want to be able to cover my butt if I am requested to provide the service. Since the state of texas REQUIRES that a client give written concent to perform breast massage. I see it as a CYA.

if you are legally and ethically offering this service with full written consent, i don't see what the problem is.
i have not taken a moment to view your webpage. i would encourage you to take a exceptionally professional stance articulated with brevity to convey your qualifications, intention, and requirements to provide these services.

as for the glute thing, please don't wedgie me t009
be clear in your "comfort level" pitch to explain that if they leave the undergarment, their glutes will not be massaged with lube, but through the drape. if they take it off or are wearing a thong, their glutes will get lubed massage.
simple.

 

[Julie loves Hoochieboy!]

I'm curious, why is it that you feel this is a service you need to provide? Because I have been asked by regular clients.

What is your motivation? The same reason I took massage and I am working on a physical therapy degree. To help people and to help them releave pain or any ailment

What is your training? I worked for over a year in a small chronic pain care practice as the office manager. During that time the doctor certified me as a medical assistant. I assisted and was being trained in trigger point injection therapy. One of my massage instructors was train and certified in Canada, and another is a certified Rolfer. Inbetween the two I spent most of my free time picking their brains and learning as many trick and tip they would give. I have also taken sports massage, deep tissue and pregnancy massage. Over the past twent years or so I have been facinated with Acupressure and Acupuntrure and I have read volumes on there history and practice. I am currently working a degree in physical therapy and plan on getting at least my masters

What specifically are you treating when you give breast massage? I have adopted the invasive trigger point therapy that the doctor used to an acupressure style. I also do deep tissue on the pectorialto help relieve the stress and tension. I have also been known to suggest Emu oil to help reduce scar tissue in this and other areas.

I have also done alot of work with the National Chronic Pain society. I do free massages for there member in the Houston area and I also work 1 day a month at the local womens shelter giving freen massages to their clients and staff.

If you would had looked at my intake form it clearly has a human body in antomical position with instructions the the client to mark any areas that they DO not want touched. This is my bible which I do not stray from.

As far as the pictures of the draping on my web site goes, My wife is the model. She was gracious to pose for the pictures on the web site. There were other that she didn't want published. So unless you would like to pose for the other pictures I am missing, lets drop that.

You know nothing about me or my ethics, and lumping me in the the questionable actions of some massage therapist in your area isn't fair. That would be like me saying because that there are massage parlors here that offer sex that you offer sex as a service. Is either statement fair, no.

I have several discussions with my wife on this and other topics about me doing massage. She knows that there is a line that I will not cross and she fully supports me.

To anyone I have offened with this statement, I am sorry. I did not intend this to turn into a flame war. Stacy you do have some valid questions and statements and concerns. Hopefull I have answered them. As far as the eithics of this topic that is another question that every massage therapist has to address.

 

[uber]

Actually, you haven't really answered them at all. Why is this a service you need to provide? I have been asked by many clients to give them CST. I've had 10 hours of training, but I still say no because I don't know enough about it. Clients ask frequently about hot stone massage. I say no because I don't really care to do that technique. And I have been asked to provide breast massage. I decline and refer out. Just because a client asks, doesn't automatically make it appropriate.

Trigger Point therapy is NOT (and should NEVER) be used on breast tissue. TPT can be appropriately applied to pectoral muscles -- the parts that are accessible AROUND the breasts, not directly under the breasts. You can damage tender breast tissue and glands by applying triggerpoint or acupressure techniques to the breasts. What is your training specifically regarding treatment of breast tissue with massage? I'm a little disturbed that you suggest you apply TPT, rolfing techniques or the others you've mentioned to the tender breast tissue, or even through the breast tissue to the muscles below. Also, working on people who possess breasts does not necessarily qualify you to work on them.

I did look at your intake form. It struck me as another example of your extreme caution (fear?) regarding gender/sexual issues, and further confuses me regarding why you would do breast massage.

Regarding your wife posing for draping pictures, it was not meant to disparage your wife or your photography, it just seemed to be further proof there are some issues surrounding treating the glute muscles, and highlighted to me a disconnect between being okay with breast massage, but iffy about glute massage.

My questions are not to insinuate that you are offering sex. I don't think you are, I just wonder why you offer breast massage, a technique that is clearly problematic for male MTs, even though you seem to have no training, no goal, and only did it because you were asked. Rather than being a sexual issue, it seems to be a boundary issue. Maybe you are already very clear about these things, and have sufficient training to provide serious therapeutic relief for pain and congested breast tissue. If so, I apologize for having missed that in your posts and website. I don't believe this is a "flame war," and I'm sorry you feel that way. It was you who took my comments as an accusation of prostitution, and for that misunderstanding, I again apologize if my words came across in that manner.

To tell you the truth, the one and only male MT I know who does this work ethically, (with training and intent,) has a very good personal reason for wanting to offer the service, AND he works in a hospital environment with cancer patients. Most male MTs choose not to offer it. I was just wondering why it is part of your services, and in fact, why you choose to promote it on your website? I'm sorry if that makes you defensive, it was not my intent in asking.

 

[Latise J]

-deleted-

 

[PossiblyNotMaybe]

Alan,

With regard to your original question about underpants - did an informal survey of the females who have been in this week regarding a) why they wear their underpinnings, b) is it okay to massage over said apparel, c) breast massage... so from a total of 8 women here are the replies [by the by, all of them know I asked because of this forum - just so there is no confusion on the weirdness of asking them about this in the first place]

A] 5 wear their underwear because of pantyliners, menstrual pads, and personal privacy issues, 1 wears her panties cause it takes help for her to get them on in the first place, 2 never wear panties on the massage table.

B] 6 YES it is definitely okay to massage over my panties - just don't gunk 'em up with oil or cream!
2 If I wore panties it wouldn't make a darned bit of difference just do the job I'm here for!

C] 5 Don't think that would be necessaries unless there is a health problem, 1 if it would help fix something I've screwed up, sure, 2 it would depend on what it was being done for

And, as an additional bit of info, even though you didn't specifically ask about it - working around brassieres w/ client face down is okay. All 6 of my ladies ask me to unfasten and refasten their bras so their backs can receive unimpeded massage. For the 2 who go sans underpinnings at all, it is obviously no issue. Of the 6 wearing their bras, it is done for convenience sake, for privacy issues, and for more rapid dressing on a lunch hour. None of the ladies with lingerie had and problems with my performing appropriate massage by sliding my fingers under their bra straps - but, then, we've all been together for a long time and we have high levels of trust all around.

Hopefully their answers will help with your personal questions re: propriety.

J

 

[Tommy C]

Alan, you seem to be concerned a LOT about possibly making females feel uncomfortable. From describing with pictures how a client will be draped so that they are not exposed, to mentioning that a woman's chest will be comfortable laying on your table because of the memory foam and that their breasts will not be exposed nor accessable, to worrying about having a woman feel uncomfortable with breast massage, you may be overcautioning yourself AND the client. Your clients that call you probably don't think you're going to expose them, otherwise they wouldn't call you.

I would have to concur with Seforum.xxxgnant. I did take a look at your website and the over cautions about "Not exposing the breast", is too much.

This is just something to think about. When looking at the pictures with the client (your wife) prone and on the memory foam, it's very hard to establish that there is memory foam on the table. You might want to take a picture of your table with the memory foam on the table without the client and more of a side angle. As a client, not from a Massage Therapists point of view, I would have a better understanding of how the memory foam may help.

The whole thing seems to be more of your concern than the clients. This is just my observation.

 

[Suz123]

Well, being that Alan of Dale is very near Houston, and Houston is very big on breast augmentation... I think running a close one behind Southern Cali., I guess that could also be a reason he is being asked to perform these services. Dunno. Is this part of it Alan?

If I were a male, I'd probably stay away from it. But, to each their own. t102

 

[DukeofDixie]

Houston the birthplace of the breast implant

Yes it is true, the Breast implant was invented here.

A couple of things about Houston. Houston has a very large number of strip clubs. THere is also a huge number of modeling studios/massage parlers/escorts. Because of of papers like the Houston Press, Speak OUT, and alot of the spanish papers not to mention all of the web sites that offer massage and escort listings, there are a lot of MT or people claming to be MT performing extras or flat out no massage at all.

SO it is a huge problem in my area. I have to very careful in the wording of my web site so I can make it very clear that I do not perform anything but massage.

I want to thank Stacey for getting me fired up on this topic. I am in the process of writeing a paper on breast massage and I will post a copy when I am done. I have also signed up to take the MTI (massage therapist instructor) class so that I can help educate the next generation of therapists.

 

[Pompal 09.]

You're welcome. erm... I think...

Stacey
...inspiring controversy on the web since 1999... :wink: