Massage Therapeutix

Relax. Renew. Rejuvenate.

Bodywork Etiquette

Most massage aficionados remember the trepidation that came with their first massage. What should I expect? Will I have to take off my clothes? How much do I tip?

For relative newcomers to massage, the prospect of those first visits and their unknowns can be unnerving. Here are some basic bodywork etiquette guidelines that will help you get the most out of your session, create a healthy client-therapist relationship and address some of those unknowns.

Punctuality = Full Session
There's nothing worse than rushing into your massage appointment five minutes late. Not only is it nerve-racking, but it also eats into your valuable massage minutes. Do your best to be on time, and when possible early. On-time clients start the massage more relaxed and focused, getting them that much more closer to a place of healing calm.

When scheduling at a spa, most guests are asked to arrive early do they can prepare for their session and stow away belongings in the locker room. Arriving early enough allows you time to enjoy the facilities amenities, such as a steam room, before the scheduled service begins. New massage clients are also asked to arrive a bit early to fill out health history intake forms.

If you do get held up in traffice and arrive late to your appointment, your therapist will probably not give you a full session. Plan on the session staying on schedule, even if you aren't. Sometimes therapists will extend extra time if there are no appointments after yours, but don't count on it. Respect your therapist's time, call if you're going to be late, and understand that your session much end on time, regardless of when you arrived.

When it comes to cancellations, most spas and practitioners require 24-hour notice to avoid fees. Outside of an emergency situation, last-minute cancellations or missed appointments usually result in paying a percentage, or all, of the scheduled massage fee. Your therapist earmarked that hour for you and likely turned away other clients who could have benefitted from that time. Every situation is different, so check with your therapist about his or her cancellation policy, then honor it.

Honor Your Body
Some people have a hard time even considering massage because they are so unhappy with their body. Primarily a female issue, poor body image can be extremely damaging, leading to eating disorders in many cases and negatively affecting the way people live. While it's hard to imagine that getting naked and lying on a massage table will make the situation any better for those dealing with self-esteem or body image issues, massage therapy and bodywork can do wonders.

According to bodyworker Merrill DeVito, massage helps integrate the body and mind again, allowing clients to see things from different perspectives, bringing them back into awareness of their body, and showing them what it means to listen to their body. Bodywork can help mend the body-mind chasm that is created through self-hate, bringing the two pieces back together in a peaceful, healthy union.

Massage therapists and bodyworkers not only have advanced knowledge of tissues and structure, they also have a great appreciation for the human body as a whole, no matter its shape or size. "Massage therapists don't see their clients as fat, thin, ugly, or beautiful, but rather see the person as a joy and a privilege with which to work," says spa consultant Charles Wiltsie. Whether working with a 350-pound woman or a 100-pound man, massage therapists see bodies as bodies.

Shower Up
While most guidelines recommend showering before your massage, it's important to note that many therapists work with clients in less-than-hygenic conditions. Throughout the summer, you'll find massage therapists at cycling events, road races, and even triathlons. A weary cyclist staggering into the massage therapy tent at the end of an exhausting day's ride ride hardly smells like roses. For massage volunteers who work with the homeless population, judgment is not passed on those non-showered bodies wither.

That said, if you find that your feet have endured a long sweaty day and you're just about to go in for your massage, take a moment to stop in the restroom first and wipe them down. And, if you're able to shower beforehand and wash away the grime and energy of the day's events, do so.

Consider Confidentiality
Even though massage therapists aren't medical doctors, nor are they held to the same doctor-patient privilege, they do hold their knowledge of you, your issues, and your sessions in confidence. If for some reason, your therapist needs to confer with your primary or referring physician, he or she will have you fill out the proper release paperwork beforehand. That same confidence prevents therapists from talking with you about your friend's recent stone massage or what your husband discussed during his last session. So make it easier for all, and don't ask.

Get It Your Way
If there's one thing that will make your massage more enjoyable and more beneficial, it's communicating with your therapist. If the room is too warm, if the bolster under your legs isn't in the right spot, if the music is driving you batty--whatever the issue--let your therapist know right away so that you can get back to the business of enjoying your massage. "By all means, you should speak up about anything that diminishes your enjoyment of, or ability to focus on, your session," says Nina McIntosh, massage ethics expert and author of The Educated Heart. Wiltsie agrees. "Communication is the key to getting your needs met," he says. Clients must take the lead and let therapists know if a particular treatment or something else within the session is making them uncomfortable.

Your therapist will occasionally check in with you during your session, checking on pressure and making sure you're doing okay. Be sure and let the therapist know it you're not feeling well, if that spot on your calf is too tender, or even if you can't hold your need for a bathroom break any longer.

Sobriety, Please In resort settings, it can be especially hard to step away from icy margaritas on the beach to make that afternoon spa appointment. But the last thing you want is to be "tipsy" on the massage table. There are several downsides to being under the influence during a massage, the most important being how alcohol plays havoc with the body's systems. Combine that with the increased circulation from massage and you have increased absorption rates, potentially making you nauseous or outright "losing-my-cookies" sick. That's no fun and a waste of good massage time and money. In fact, many massage therapists will refuse to work on clients who are intoxicated. Leave the alcohol for another time. Water, before and after a therapeutic massage, is what the body really needs.

Nope, Won't Find That Here
It's unfortunate that massage therapist even have to address this subject, but they do. So the answer to late night callers is, "No, we don't give happy endings. No, you may not pleasure yourself. Therapeutic massage has nothing to with sex."

If a misinformed client somehow ends up in the massage room of a professional therapist and asks for something other than a therapeutic massage, they will be asked to leave. Flirting, inappropriate touching, and sexual innuendos will not be tolerated. Keep the relationship professional and above board and your therapist will be a valuable member of your healthcare team.

You're Human
The body can have a lot of responses to therapeutic massage. While avoiding food at least one hour before your massage will help, there's still a chance you'll have tummy gurgles or even pass gas. It's okay. Ad the body systems get moving, the body can play all kinds of tricks. Your therapist has seen it all, yet sees beyond those kinds of issues.

For men, there's even a possibility that massage will cause an erection--a common response to nervous system activation. "It rarely occurs, but if it does, don't panic," says massage therapist and author Robert Chute. "Therapist know that this is a physiological reaction and will try to treat the situation accordingly. He says the therapist might try to redirect your attention with a shift in the focus of the work, or maybe altering pressure or moving to a different area of the body. Don't worry, Chute says, "Your unintended erection, and any embarrassment, will soon pass."

Time to Wake Up
While your therapist would like nothing more than to let you slumber after your massage, other massage clients will be arriving soon and the room must be readied for them. So when your therapist ends the massage and says, "Our session is over. Take your time getting up," they are really saying, "Take your time getting up, but please don't take a nap."

They are also reminding you to take a moment as you come back to the here and now. Carefully sit up, allowing your body enough time to readjust. Go too fast and your body will know you for a dizzying loop. Also, be careful not to slip getting off the massage table, especially if your therapist used oil on your feet.

Tipping Tips
When it comes to gratuities, most experts say it's ultimately the client's decision whether or not to tip. Like in other service industries, providing a tip is usually in response to providing excellent service. In considering this, it's important to note that many therapist who work in spas earn only a small percentage of what you've paid for their services. For these therapists, tips are an important part of their income. According to, the tipping norm for massage is 15-20 percent. Tips, however, are usually not accepted in a medical environment.

Unsure what to do? Ask if tipping is customary and what is the policy. This is especially important when booking at spas, according to the Day Spa Association, as tips might already be included in the service price. Be sure to get clarification on fees and services at the time of booking.

By Karrie Osborn, Body Sense, Autumn/Winter 2008