Massage Today
October, 2012, Vol. 12, Issue 10

Hospitals Embracing Massage

By Kathryn Feather, Senior Associate Editor

An increasing number of hospitals are throwing their doors open to qualified massage therapists as savvy health care consumers are requesting massage therapy to deal with certain health conditions.

The research showing the validity of massage as a drug-free option for patients to consider has been steadily growing over the last few years and hospitals are finding it a profitable business practice to offer massage and other complementary therapies to their patients.

According to the latest American Massage Therapy Association (AMTA) industry facts, almost 10 percent more people received massage for a medical or health reason. Forty-four percent of adult Americans surveyed who had a massage between July 2010 and July 2011, received it for medical or health reasons as compared to 35 percent the previous year. Of the people surveyed who had a least one massage in the last five years, 40 percent reported that they did so for health conditions such as pain management, injury rehabilitation, chronic pain management or overall wellness. As more people--especially baby boomers--request these services, and have the discretionary income to pay for them, hospitals and other health care providers are taking notice and making changes to the services they offer.

Finding a Career

"Massage in a hospital setting is ideal," said Edie Black, a registered nurse and licensed massage therapist working at Connecticut Children's Medical Center. "As I provide massage therapy to inpatients at our hospital, I see my patients finding a deep sense of relaxation, pain relief and an increase in body awareness."

Black paints a positive relationship between patients and the massage therapists. "Due to the nature of the hospital setting, each patient benefits differently. Our hospital has one floor dedicated to children with cancer and blood disorders and the majority of massage consults are found there. Some [patients] are looking for pain relief as they recover from surgical procedures such as amputation or reconstruction after tumor removal. Some are anxious about the hospital and the painful procedures they have experienced," said Black. "The massage therapist can help by offering that ‘safe' time, not only for the patient but for the family as well."

Elizabeth Schroeder was hired by Children's Mercy Hospital in Kansas City in 2008 as an Occupational Therapist in 2008 and became more interested in complimentary therapies such as massage while she was in school. "I had been researching why the therapeutic use of touch was benefiting the patients I was treating. As I found more evidence-based research in massage, I spoke with my supervisor at the hospital regarding becoming licensed and she was very supportive. Schroeder has been a licensed massage therapist for a little over a year now.

Schroeder says "pain related conditions are the most frequent referrals: idiopathic arthritis, juvenile rheumatoid arthritis, and neck, back or joint pain. I do use massage frequently with ADHD, Autism Spectrum Disorders and Sensory Processing and Modulation Disorder." The survey also found that 59 percent of massage consumers surveyed said they would like to see their insurance cover massage therapy.

Educating Doctors and Consumers

According to the AMTA survey, massage therapists received an increase in referrals from health care professionals, with the number of nurses recommending massage doubling in 2011 and 96 percent of the massage therapists surveyed receiving at least one referral every six months from a hospital or medical office. The survey shows that, on average, massage therapists received about four referrals per month, twice as many as in previous years.

There is also a growing body of research that therapists can point to--and other health care professionals are noticing--that shows the positive benefits and effectiveness of therapeutic massage. Recent studies have examined the effects of massage in dealing with a variety of specific health conditions such as cancer related fatigue and pain, low-back and chronic neck pain, lowering blood pressure, reducing the frequency of headaches, boosting the body's immune system and even easing the symptoms of alcohol withdrawal.

"Our patients and their families have provided positive feedback, including scheduling their planned admissions for treatment around the days the massage therapist is available," said Black. And hospitals are taking notice of the demand. The Mayo Clinic in Minnesota offers a hospital based massage therapy course for therapists who want to join the hospital health care team. The program is divided into three modules and takes two months to complete and requires completion of a 500-hour minimum massage therapy program. The Mayo Clinic states that "through the course, participants will gain an enhanced understanding of the utilization of massage therapy and integrative medicine in the acute care hospital setting. Participants will experience self-care exploration, a team-based approach to integrative health care and scope of practice, navigation and documentation in a medical record, establishing therapeutic relationships and treatment planning." This program is only offered twice a year and is limited to 12 students to ensure that therapists receive close one-on-one instruction and a more comprehensive experience. The Mayo Clinic campus includes extensive facilities including an outpatient complex and research areas, in addition to the well-known hospital. Placement for therapists completing this instruction is very good, according to the Clinic.

True Integration

For those already working in hospitals, they know they are a part of an integrated health care approach to wellness for their patients. At the Children's Mercy Hospital, Schroeder sees this integration first hand. "I am in contact with every patient's doctor regarding plan of care and progress toward goal directed therapies. Specifically for pain-related diagnoses, I am frequently in contact with the patient's psychology support systems. In all of these relationships...I find these providers to be open and willing to see the effects of massage as a modality used in treatment."

Candace Linares has been a massage therapist for 19 years and has worked in the hospital setting for the last seven years. In her experience, the doctors and nurses she works with ask for massage therapists on a regular basis. "I believe there is a reliance and confidence regarding massage services to assist patients' special health concerns," she said. As hospitals and doctors become more aware and accepting of the benefits and effectiveness of massage therapy, and as a greater number of patients continue to request these services, the demand for more massage therapists who are ready and able to become competent and contributing members of the health care team will continue to grow.

Welcome to the Barbara Brennan School of Healing® !

The Barbara Brennan School of Healing is dedicated to the evolution of the human spirit. A global healing institute with graduates worldwide, BBSH® has more than 160 students from all over the world.

Dr. Barbara Brennan, the School's founder, is a world-renowned healer, teacher and former NASA physicist, and the best-selling author of Hands of Light®, Light Emerging and the Seeds of the Spirit® book series. She has devoted the last 35 years to research and exploration of the Human Energy Field.

Dr. Brennan draws on scientific and metaphysical sources to bring together many aspects of human experience which describe and explain the healing process.

Established in 1982, the Barbara Brennan School of Healing is the world's premier institute of hands-on healing and personal transformation. BBSH is licensed by the Commission for Independent Education, Florida Department of Education to grant both Professional Studies Diplomas and Bachelor of Science Degrees in Brennan Healing Science®, the specialized form of holistic healthcare taught at BBSH. This is a hands-on healing system that works with an individual's energy consciousness system to create physical, emotional, mental and spiritual health.

Students have a compelling desire to heal and make a difference in their own lives and in the lives of others. They come with a passion for learning, for community, and for experiencing the fullness of themselves while being in loving relationship with life. BBSH supports and honors these longings, welcoming the essential unfoldment of the healer within.

Whether you enroll in the program to become a professional healer, to integrate this healing modality into your current profession such as medicine, business, law or teaching, or for personal transformation and self-healing, BBSH will change your life.

You have a choice of programs, both of which involve five separate week-long resident training classes in beautiful South Florida. The most popular program culminates in a Professional Studies Diploma in Brennan Healing Science, and the other in a Bachelor of Science Degree.

Both are four years, and all graduates are then eligible to establish a professional practice as a Brennan Healing Science Practitioner—one of the most highly regarded titles in the field of energy healing and holistic healthcare.

The bulk of the curriculum is the same, with the Bachelor Degree requiring 36 additional semester hours of coursework.

By combining resident training classes with distance learning modules (homework!), as well as General Education online courses for degree candidates, students are able to participate in the training while maintaining their regular work and personal responsibilities.

The Program is designed for adults who live worldwide and travel to South Florida five times per year. Through both campus and home study, four years of training are offered. BBSH is staffed with talented and experienced faculty members that provide a low student-to-teacher ratio.

BBSH also offers additional events and products that we hope will enhance your life and create new opportunities for healing and self-transformation for you and your loved ones.

Please come join us on an uplifting journey of healing and personal transformation!

What is the Brennan Healing Science® Difference?

Brennan Healing Science (BHS) is recognized by many as the most advanced of any healing modality that works through the human energy field or aura.

The laying on of hands is an age-old process. People of all cultures have employed it for centuries, and today it is the foundation of many popular—but often imprecise—ways of healing.

Brennan Healing Science propels the methods of the ancients into a whole new and sophisticated dimension—in fact, several dimensions. As Dr. Brennan says, the human energy field is a deep and fascinating place, familiar to some of us but unknown to most, and waiting patiently to be explored.

Each person's field consists of numerous levels, each holding great volumes of information on health, behavioral patterns, personal issues, past histories, and much, much more. BHS gives its practitioners not just the keys to the door, but to all the rooms. This ability that we call High Sense Perception—the tools of exploration—is learned relatively swiftly, because it has simply lain dormant.

So students are taught not only how to read the field, but also to discern why it is damaged or distorted, and to utilize the appropriate healing technique from among a whole array developed by Dr. Brennan.

With BHS, the healer's personal wisdom and Divine Intelligence operate hand in hand, unlike other energy healing systems where you are primarily in "allow" and more or less working blind.

The other major component of Brennan Healing Science is personal transformation.

The Barbara Brennan School of Healing has been called the fast track to personal growth because of the importance it places upon healing the self—imperative if healers are to work clearly and compassionately, unhindered by their own issues and fears.

The powerful combination of leading-edge techniques, High Sense Perception, and acute self-awareness has tremendous benefits for both clients and healers. Each healing session teaches and transforms the healer, bringing about even greater understanding of the intelligence and mystery of the body, of the higher dimensions of consciousness, and of life itself.

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 Women’s Health and Cancer Rights Act

The Federal law

The Women’s Health and Cancer Rights Act (WHCRA) helps protect many women with breast cancer who choose to have their breasts rebuilt (reconstructed) after a mastectomy. This federal law requires most group insurance plans that cover mastectomies to also cover breast reconstruction. It was signed into law on October 21, 1998. The United States Departments of Labor and Health and Human Services oversee this law.

The WHCRA:

·  Applies to group health plans for plan years starting on or after October 1, 1998

·  Applies to group health plans, health insurance companies, and HMOs, as long as the plan covers medical and surgical costs for mastectomy

Under the WHCRA, mastectomy benefits must cover:

·  Reconstruction of the breast that was removed by mastectomy

·  Surgery and reconstruction of the other breast to make the breasts look symmetrical or balanced after mastectomy

·  Any external breast prostheses (breast forms that fit into your bra) that are needed before or during the reconstruction

·  Any physical complications at all stages of mastectomy, including lymphedema

Questions and answers about the WHCRA

Yes. The law also requires that insurance providers notify you of this coverage when you enroll in their plan, and every year after that.

Several states have their own laws requiring health plans that cover mastectomies to provide coverage for reconstructive surgery after a mastectomy. These state laws only apply to those health plans purchased by an employer from a commercial insurance company. If an employer is self-insured, state laws do not apply but federal laws do. Federal laws (like the WHCRA) are enforced by the US Department of Labor.

A self-insured (or self-funded) plan is one in which the employer, rather than a commercial insurance company, pays for the insured person’s health expenses. Some employers that self-insure will hire a commercial insurance company to write the checks and track the paperwork, even though the money for the payments still comes from the employer. So it can be hard to tell whether you are in a self-insured or a commercially insured plan unless you ask.

If you are unsure of your plan’s status, ask your employer’s benefits manager. You can contact your state’s insurance department to find out if your state provides extra protection that will apply to your coverage if you are not in a self-insured plan. The WHCRA applies to self-insured plans that aren’t covered by state law and sets a minimum standard to be sure this service is available for all women in every state. This includes states with weaker or no laws covering breast reconstruction.

Under the Act, group health plans, insurance companies, and HMOs that offer mastectomy coverage must also provide coverage for reconstructive surgery after mastectomy. This coverage includes reconstruction of the breast removed by mastectomy, reconstruction of the other breast to give a more balanced look, breast prostheses, and treatment of physical complications at all stages of the mastectomy, including lymphedema (swelling in the arm that sometimes happens after breast cancer treatment).

Yes. Both health plans and health insurance issuers are required to tell you about WHCRA benefits. They must do this when you enroll and every year after that. The annual notice may be sent by itself or it may be included in almost any written communication by the plan or insurer, such as newsletters, annual reports, policy renewal letters, enrollment notices, and others. Enrollment notices may even be a phone number or Web address from which to get more information about coverage.

No. The WHCRA does not keep a plan or health insurance issuer from bargaining about amounts and types of payment with doctors. But the law does forbid insurance plans and issuers from penalizing doctors or providing incentives that would cause a doctor to give care that is not consistent with WHCRA.

No. The WHCRA was not changed by the ACA and there are no provisions or regulations that affect it. Health insurance plans that offer mastectomy must continue to offer breast reconstruction.

No. The law does not apply to Medicare and Medicaid.

Still, Medicare covers breast reconstruction if you had a mastectomy because of breast cancer. Medicaid coverage varies in each state, so you will have to get this information for your state. (See the section called “To learn more” for contact information.)

If you have more questions or concerns, you can contact:

·  The US Department of Labor, which has the WHCRA information on its Web site at www.dol.gov/ebsa/Publications/whcra.html, or you can call their toll-free number at 1-866-487-2365

·  Your health plan administrator (a number should be listed on your insurance card)

·  Your State Insurance Commissioner’s office [The number should be listed in your local phone book in the state government section, or you can find it at the National Association of Insurance Commissioners online at www.naic.org/state_web_map.htm. If you can’t find the number elsewhere, call 1-866-470-NAIC (1-800-470-6242).]

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 How does Inert Gas Ionization Instruments Work on the Body?

Is Massage Therapy Safe for People Living with Cancer?

Yes, when practiced by a skilled therapist with background or training in massage and cancer. If this was not covered in their basic training in detail, they should have advanced training in the work.

Massage should be modified to work around side-effects or complications of radiation, chemotherapy, surgery, and medications. Blood counts should be considered in massage design, as well. Even after years of survivorship, there are a few simple but critical adjustments in massage therapy, for example, if lymph nodes were removed or treated with radiation, or if bone metastases are present.

Therapists with experience or training are aware of these and other adaptations for cancer treatment. Be sure to see a massage therapist who asks about treatments during the interview and who explains any needed massage modifications.

A skilled therapist will combine a thorough intake process with sound clinical judgement and clear communication about what to expect in the session. She or he will adapt the massage to your needs and requests, fashioning a hands-on session that relaxes, energizes and reduces pain and discomfort.

Can Massage Spread Cancer?

No, it cannot. Massage of a solid tumor site should be avoided, but there is more to a person than a tumor site.

An old myth warned that massage could, by raising general circulation, promote metastasis since tumor cells travel through blood and lymph channels. We now recognize that movement and exercise raise circulation much more than a brief massage can, and that routine increases in circulation occur many times daily in response to metabolic demands of our tissues. In fact, physical activity usually is encouraged in people with cancer; there is no reason to discourage massage or some form of skilled touch. Massage is practiced widely at the Dana-Farber Cancer Institute, Memorial Sloan-Kettering, and growing numbers of hospitals around the country. Metastasis is not a concern; instead, patients and researchers report countless benefits.

How can Massage Benefit People who are Living with Cancer?

Massage has many benefits for people living with cancer. A few are listed, below. We know some of these from clinical observations, some from controlled research, and some from what clients tell us directly.

Massage Reduces Anxiety

Many clients report being less anxious in general when receiving regular massage. In particular, clients in cancer treatment state that massage eases anxiety before and during uncomfortable procedures and interventions. Research literature reports that massage helps anxiety in patients with cancer and in other populations. In repeated studies of various populations, massage helps reduce depression, as well.(1)

Massage Eases Pain

Recipients of massage therapy express less cancer-related pain, treatment-related pain, and pain related to muscle tension. They claim that massage helps “take the edge off” of acute pain and in some cases relieve it entirely. Although the direction of evidence suggests massage is effective for pain relief, (2), (7) more study is needed to firmly establish the role of massage in pain relief for people with cancer.(3)

Massage Helps Control Nausea

Gentle massage has been shown to reduce nausea in inpatients receiving autologous bone marrow transplant. (4)

In a pilot nursing study, stimulation of acupressure points has been suggested to reduce nausea in patients in chemotherapy.(5)
A small study suggested that massage helped decrease medical costs of managing nausea and vomiting.(6)
Massage may be a viable, low-cost approach to minimizing this difficult side-effect of medication.

Massage Improves Sleep and Eases Fatigue

Again and again, clients tell their massage therapists that massage improves their energy level and helps them sleep better, and clients in cancer treatment are no exception. But sleep can be especially hard to come by during cancer treatment, and cancer fatigue is common and poorly understood—a difficult symptom to treat. People in treatment, often with a high degree of symptom distress, are especially in need of good sleep. At least one study shows massage facilitates sleep.(7)

As a massage therapist, what do I need to work with people with cancer?

Continuing education training is strongly recommended, preferably with a hands-on component. During their basic massage training, many massage therapists were discouraged from working with people with cancer, and training is needed to move forward with the work.

To work with people with cancer, massage therapists need to know how to work with complex medical conditions: detailed interviewing, recognizing possible massage contraindications and other red flags, researching cancer treatment's effects, applying massage adjustments in massage pressure, joint movement, areas of focus, position, massage lubricant, and when and how to consult the client's physician for needed information. Therapists need to "know what they don't know" and how to fill in gaps in information.

Some therapists may be able to teach themselves how to work safely and effectively with people with cancer, using texts, massage literature, research skills, or on-line courses. Some have medical or nursing training that enables them to sort through clinical presentations and adapt their massage work accordingly.

But most therapists need training that provides skill building in interviewing and clinical thinking, hands-on practice, and supervised clinical work. They need a framework to work within, opportunities to ask "what-if?" questions, to hear clinical scenarios, to use appropriate intake and other forms, and to have materials for further learning at home. Therapists need to be able to adapt to clients with lymphedema, lymphedema risk, bone metastasis, vital organ involvement, risk of deep vein thrombosis, and suppressed blood cell populations. They need to craft an intake and a session for someone with a cancer history, not just with active cancer.

Moreover, therapists need to customize their work to individual client presentations, not offer a one-size-fits-all massage for everyone with cancer. In fact, some people in cancer treatment are active and robust; others are medically frail. A well-prepared therapist recognizes the difference and can adapt to a full range of clinical possibilities. Good training supplies the tools to meet this range in clients and the chance to practice using them, so that one client doesn't receive massage that is too gentle for them, and another too strong.

What exactly are the benefits of receiving massage or bodywork treatments? Useful for all of the conditions listed below and more, massage can:

• Alleviate low-back pain and improve range of motion.
• Assist with shorter, easier labor for expectant mothers and shorten maternity hospital stays.
• Ease medication dependence.
• Enhance immunity by stimulating lymph flow—the body's natural defense system.
• Exercise and stretch weak, tight, or atrophied muscles.
• Help athletes of any level prepare for, and recover from, strenuous workouts.
• Improve the condition of the body's largest organ—the skin.
• Increase joint flexibility.
• Lessen depression and anxiety.
• Promote tissue regeneration, reducing scar tissue and stretch marks.
• Pump oxygen and nutrients into tissues and vital organs, improving circulation.
• Reduce postsurgery adhesions and swelling.
• Reduce spasms and cramping.
• Relax and soften injured, tired, and overused muscles.
• Release endorphins—amino acids that work as the body's natural painkiller.
• Relieve migraine pain.

A Powerful Ally

There's no denying the power of bodywork. Regardless of the adjectives we assign to it (pampering, rejuvenating, therapeutic) or the reasons we seek it out (a luxurious treat, stress relief, pain management), massage therapy can be a powerful ally in your healthcare regimen.

Experts estimate that upwards of ninety percent of disease is stress related. And perhaps nothing ages us faster, internally and externally, than high stress. While eliminating anxiety and pressure altogether in this fast-paced world may be idealistic, massage can, without a doubt, help manage stress. This translates into:

• Decreased anxiety.
• Enhanced sleep quality.
• Greater energy.
• Improved concentration.
• Increased circulation.
• Reduced fatigue.

Furthermore, clients often report a sense of perspective and clarity after receiving a massage. The emotional balance bodywork provides can often be just as vital and valuable as the more tangible physical benefits.

Profound Effects

In response to massage, specific physiological and chemical changes cascade throughout the body, with profound effects. Research shows that with massage:

• Arthritis sufferers note fewer aches and less stiffness and pain.
• Asthmatic children show better pulmonary function and increased peak air flow.
• Burn injury patients report reduced pain, itching, and anxiety.
• High blood pressure patients demonstrate lower diastolic blood pressure, anxiety, and stress hormones.
• Premenstrual syndrome sufferers have decreased water retention and cramping.
• Preterm infants have improved weight gain.

Research continues to show the enormous benefits of touch—which range from treating chronic diseases, neurological disorders, and injuries, to alleviating the tensions of modern lifestyles. Consequently, the medical community is actively embracing bodywork, and massage is becoming an integral part of hospice care and neonatal intensive care units. Many hospitals are also incorporating on-site massage practitioners and even spas to treat postsurgery or pain patients as part of the recovery process.

Increase the Benefits with Frequent Visits

Getting a massage can do you a world of good. And getting massage frequently can do even more. This is the beauty of bodywork. Taking part in this form of regularly scheduled self-care can play a huge part in how healthy you'll be and how youthful you'll remain with each passing year. Budgeting time and money for bodywork at consistent intervals is truly an investment in your health. And remember: just because massage feels like a pampering treat doesn't mean it is any less therapeutic. Consider massage appointments a necessary piece of your health and wellness plan, and work with your practitioner to establish a treatment schedule that best meets your needs.

Review the clinical research studies examining the benefits of massage.

Review massage information from the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health.

Why use Lymphatic Drainage as an important modality for your patients to implement post surgery?

• LD Therapy may begin soon after surgery with the following results:

• LD Therapy within 15 to 20 minutes can significantly take down the swelling which results from surgery without any stress to the sutures.

• LD Therapy encourages lymphatic "fluidity” resulting in pain reduction, detoxification of body tissues by eliminating the build-up of toxins as a result of the effects of medication.

• LD Therapy Stimulates fluid circulation.

• LD Therapy stimulates the immune system and helps to prevent post-surgical infections.
• LD Therapy Improves skin regeneration, accelerated wound healing with fewer complications.

What exactly is Electro-Sound Lymphatic Drainage?

Electro-Sound Lymphatic Drainage is a one hour accelerated method of cleansing and detoxifying the lymphatic system. In a congested lymphatic system, lymph is thick, sticky, stagnant, laden with toxins and unable to circulate and eliminate waste. Lymph congestion and toxicity reduce the electrostatic field of the proteins in the interstitial fluids and contribute to thickening and clumping of lymph. Breaking down congested lymph fluid is painlessly achieved in a two-step process using the XP2.

STEP 1 – While the client rests comfortably on a massage table, we increase electrostatic tension and stimulate lymphatic drainage, by using the XP2 a state of the art high-frequency electro-sound lymphatic

drainage instrumentation. The operating systems of the XP2 are hand-blown glass bulbs containing rare noble gases (argon, xenon, and krypton); it is the combination of these gases that devitalizes bacteria, viruses, etc.

The electric charges stimulate, re-polarize and re-establish ideal frequency and energy of individual cells& tissues and decongest the entire lymphatic system; producing a mild heating effect, increasing circulation, activating lymph, breaking up blockages, detoxifying, and enhancing immunity.

Each session is the equivalent of eight to ten manual lymphatic drainage sessions. As lymph is effortlessly moved through lymphatic pathways the patient is left feeling calm, rejuvenated, with none of the soreness that results from squeezing which is required in manual lymphatic massage.

STEP 2 – Lymph (fat& cellulite) is directed manually along the limbs and torso (always in the direction of the ducts) with two probes of a micro current stimulator on the XP2, delivering a frequency-specific signal. This stimulates the lymphatic system and increases circulation, proper elimination, detoxification, cell nourishment, and boosts the immune system.

Fact:According to research 80% of overweight women have a sluggish lymphatic system.A congested lymphatic system is directly connected to the formation of cellulite because backed up fluid “sticks” to thefat cells. Getting the lymphatic system running smoothly again is the key to easy weight loss and feeling great.