Answering common questions and concerns, and sharing best practices
Your First Massage
People have many reasons for not receiving massage. Sometimes it’s the stigma of massage being a luxury thing rich people do. Sometimes it’s discomfort with the idea of being touched by a stranger.
I’ve been practicing massage therapy for nearly twenty years, and I’ve come to understand many of the fears and concerns people have about massage come from movies, books, myths, and rumors.
Once people hear the truth, they are much more comfortable with the idea of having a massage. And that’s a really good thing because massage is essential healthcare. In fact, most of the rest of the world considers hands-on therapies to be essential healthcare.
So in this article, I’ll walk you through what to expect for your first massage appointment. A hopefully I can dispel some of the fears or concerns you might have about receiving a massage. I’ll also cover best practices so that even from your first massage, you can be a savvy massage consumer and avoid some newbie faux pas.
This is hardest to do, because you just don’t know what to expect for your first massage. This is where things can be bumpy for first timers. So here are a few things that you can do in preparation for your first massage that will really make you feel like a pro.
Give yourself enough time
We’re all busy, so it can be fairly normal to squeeze your massage appointment into your busy day. But your first massage appointment tends to be the longest, and especially when visiting a clinic like Catherine Nelson Massage Therapy, your first appointment will run longer than an hour.
Give yourself enough time to get to your appointment without being in a rush. And allow enough time at the end to hear what your therapist has to say and ask your questions without having to rush right out.
It is required that all patients be clean and odor free for their massage appointments. Unless you’re an athlete with a very specific training schedule, you’ll want to keep this policy in mind ahead of your massage appointment.
Also, avoid using strong perfumes, colognes, or heavily scented products before your massage. Even if they are pleasant scents, they will linger in the room for hours after you’ve left, and could very well bother someone with allergies or headaches.
If you’re a smoker, realize that your clothing smells like cigarette smoke. Even though you may not smell it, this scent, too, will linger in the room for hours and sometimes days. Plan your cigarettes around your appointment, and arrive to your appointment odor free.
It is not required that patients wear any specific kind of clothing to a massage appointment. Later, you and your therapist might make a specific plan about your next treatment, and you may plan to wear something specific, like workout shorts. However this will always be discussed with you. You’ll always have an opportunity to ask questions and be in agreement with this plan before the next appointment.
Most therapists make every effort to use only enough lotion or gel to achieve the needed glide, but it is possible some of the lubricant may transfer to your clothing. The lubricants I use are water soluble, and do typically wash out in the washer, but bear this in mind if you tend to wear very delicate fabrics.
Tipping is expected for most massage therapists. Massage is a service, so therapist wages are based on tips. There are exceptions. Some massage therapists expressly refuse tips, and this is often stated on their websites.
You are usually able to leave your tip on a card. However, therapists always appreciate cash tips, just like most other service providers. If you want to leave a cash tip but don’t typically carry cash, this will be a helpful insight so you can plan ahead.
Find the office
Be sure to leave yourself enough time to find the office. GPS is great, but often imprecise, especially in an office complex with lots of buildings, or in a multi-use building with lots of individual offices.
Nothing is more stressful than getting lost in a building maze trying to find your massage therapist’s office. The only thing you’ll be thinking about is that you only booked an hour and you’re wasting it trying to find the office!
So just give yourself extra time, plan to arrive 10-15 minutes early, and/or drive by the address on a day before the appointment and scope it out well in advance.
Read and complete paperwork
Every legitimate massage therapist will require new patients to fill out paperwork. Some do this via electronic forms, in which case you will have received an email and link to do so well before your appointment, most likely at the time of booking. So take the time to do that before your appointment so the therapist can review your information.
Most therapists still use paper forms, though, as I do, so you’ll need to come 10-15 minutes early to read and fill those out.
The therapist must have a chance to review this information before he or she can safely work on you. If you come early and do it before your scheduled appointment time, it won’t cut into your appointment and you’ll receive your full time on the table. If you come at your scheduled time and take 10-15 minutes to fill out your paperwork, the therapist still has to review them, so you’ll lose table time.
This kind of paperwork only needs to be completed every twelve months, roughly. So once this is done at the first massage appointment, you won’t need to worry about it again for quite some time.
Use the bathroom
It’s always a good idea to empty your bladder before your massage.
After receiving work, your body will jump into a sort of detox mode, and you’ll often need to urinate after the massage. Starting with an empty bladder will allow you to be more comfortable for the duration of the appointment.
There’s really nothing worse than being distracted and miserable for the last part of your massage because you have to pee really bad.
So arrive with enough time to use the bathroom before your therapist comes to get you from the lobby.
Review medical history
In order to ensure it is safe for you to receive a massage your therapist needs to review your medical history paperwork and then discuss it with you. When your therapist takes you into the treatment room, you’ll be invited to sit down with your therapist and talk for the first few minutes. (Not every therapist does it this way, but this is my policy.)
During this conversation, your therapist will ask you some questions, and you’ll be able to tell your story. I want to make sure all of my patients have enough time to be heard and ask all their questions, so I build this time into our appointments. This way, patients can still receive their full time on the table without feeling stressed or shorted.
Identify complaints and treatment goals
During the initial conversation, part of what your therapist will ask is about what brought you in. What pain or issue are you wanting to work on? And what are your goals for treatment?
After hearing your story, your therapist will likely suggest goals for your consideration, and you’re welcome to accept or reject those as things you want to achieve.
This part of the conversation is really important, as this is where your treatment plan begins. Based on the information you provide, your therapist will build a customized treatment plan to help you get where you want to go in your health and wellness.
Again, not every therapist does this, but for the skilled professional, this is a must. If your therapist doesn’t take time for this, or doesn’t ask you any questions, you need to find a new therapist.
Part of the initial conversation is learning what your expectations are for the appointment and for treatment in general.
If you just want a full-body massage for relaxation, your therapist needs to know that.
Otherwise, if you say you’ve been having headaches, your therapist may suggest a very focused treatment designed to treat headaches. In which case, you would likely be disappointed with the appointment, not having received what you wanted.
I always want to make sure I’m on the same page as you, and that I’m giving patients treatment plans that are realistic, and in timeframes that are realistic.
Be sure to be honest with your therapist about your expectations, and feel free to ask clarifying questions if you receive information back that you weren’t expecting.
Suggest session focus
After hearing from you during that initial conversation, your therapist will make suggestions about how to spend the time during that appointment. Perhaps it’s a full-body massage, or perhaps it’s very focused, technical work to the low back and hips for low back pain. You should always know what kind of work your therapist will do during each and every session, and where your therapist will be working. And you must agree to it.
If you want something else from the session that day, this is where you can let your therapist know, and the two of you will finalize the plan before the therapist leaves for you to get undressed and on the table.
Discuss areas to work and how to disrobe
Before the therapist leaves the room, you should know exactly where he or she will be working, and how much clothing you should take off to receive that work. If part of the plan is to receive glute work (work to the back of the hip), will that work be done with gliding strokes on the skin or through the sheet? Do you need to take your underwear off? Are you uncomfortable taking your underwear off?
These questions should all be answered with your say-so and agreement before the therapist leaves the room. I will always walk you through this and seek your agreement. If you are receiving care somewhere else, you will likely need to initiate the conversation and clarify with the therapist. Do that before getting on the table.
Know that you have ultimate say. If you don’t want work on a certain part of your body, that’s the final word, and the therapist has no room to argue. Your therapist may ask some questions and offer some additional information for clarity, but that is not the same as pushing or bullying you. Never let a therapist push or bully you into something that makes you uncomfortable. If that’s happening, you may consider just walking out, depending on the intensity of the situation.
And never, ever tolerate a therapist touching you somewhere you’ve said you don’t want to be touched. You’re in control at all times. You have the power to ask the therapist to stop. You have the power to end the session.
Dressing and undressing
After your initial consultation, the therapist will leave the room for you to undress in privacy. You will use this time to undress to your comfort level based on the plan you and your therapist have just made.
There are often hooks for you to hang up your clothes, or there is a chair in the room. Most people use the chair for their clothing, and this is perfectly acceptable.
When you’re undressed, you will get on the table between the two sheets and cover yourself fully, as best you’re able. Sometimes it can be a struggle to get the sheet in place, and that’s okay. The therapist will straighten the sheets when he or she comes back into the room.
While you’ve been getting undressed, your therapist has been washing his or her hands. He or she will knock and ask if you’re ready before coming in. With your okay, the therapist will come back into the room, adjust the light setting if needed, place pillows and bolsters to help ensure you’re comfortable, straighten the linens, and begin the massage.
At the conclusion of the session, the therapist will close the session and end the work. He or she will likely give you instructions, and you should follow those. Most often the instructions will be to crack the room door once you’re dressed. This indicates to the therapist that you’re fully dressed so the therapist can come back into the room. However, some therapists may ask you to meet them in the lobby or hallway once you’re finished dressing.
Something to keep in mind
Keep in mind that the therapist most likely has an appointment after yours. The therapist will need to wrap up with you, reset the room, and be ready for the next person. It can be slow going when getting up after having a massage because you’re so relaxed and kind of sleepy, but it’s really helpful if you can get dressed quickly and open the door so the therapist can keep moving.
For my appointments, I spend five to ten minutes after each session explaining what I found, what I did in the session, what we need to work on next, if we’re on track to our original goals, and what the patient needs to do at home. I also make sure to answer questions. Generally, people do not feel rushed. However, during this time, I am often resetting the table, tidying the room, or otherwise preparing for the next appointment, so the sooner I can get into the room, the better.
“Table time” is an industry term for the amount of time a patient spends on the table receiving work. In a typical 60-minute appointment, the patient receives 50 minutes of table time. Occasionally, you find therapists who have less common appointment structures, like a 75-minute appointment instead of a 60-minute, in which case the patient may have a full 60 minutes on the table.
My scheduled table time for a 60-minute appointment is 50-55 minutes, and this is done in a 75-minute time slot. The ten minutes before and the ten minutes after the table time go to conversation, so patients have plenty of time to be heard and never rushed.
It’s the law
It is state law here in Colorado that every massage patient be fully and professionally draped at all times while receiving professional massage and bodywork. Under no circumstances may a patient receive massage or bodywork while nude with no drape.
This being true, every massage therapist should be using a sheet and either a towel or a blanket to keep you covered while you receive the massage work. As each area of the body is worked, that single area of the body will be uncovered (draped) in a neat and professional way, ensuring there is no flashing, slipping, or gaping.
Draping is where most massage therapists struggle. It’s poorly taught in school, there are too few reputable resources, and it’s regarded with little importance. However, I am very strict about draping protocols. After teaching proper draping for many years now, I am quite proficient in secure draping.
You should never be surprised
The areas where you will receive work must be agreed upon before you get on the table, as discussed above. So you will know if your glutes (back of the hip) will be uncovered or not, or if your pecs (the upper portion of the chest) will be uncovered or not, and you will have agreed to that work. Nothing that happens during the massage should be a surprise to you, and you should never feel uncomfortable.
You’re in charge
With that being said, if you agreed to something but feel uncomfortable in the moment, say so. Perhaps you thought you would feel okay with having your glutes worked on, but in the moment feel very uncomfortable. Just say so. The therapist will respect your right to change your mind, and move on.
If your therapist refuses to move on, tries to pressure you to receive the work anyway, or shames you, you need a new therapist. You have the right to end the appointment right there. Either way, don’t book with that person again. If that person works in an organization with supervision, report that behavior to the manager or owner immediately.
During your massage, the rule of thumb is that only one body area is exposed at a time. There are a couple of exceptions, but those are for technical, specific work and should be explained to you ahead of time. If your therapist is exposing more than one area of your body at a time, it is likely due to poor training, and may be an indication you’d be better served by another therapist. It could also be nefarious, in which case I strongly caution you to ask, in the moment, why more than one area of your body is undraped. And if you feel uncomfortable, end the appointment.
After the hands-on portion of your appointment, your therapist will review his or her findings and present you with a customized treatment plan. (If your therapist doesn’t do this, find a new one.)
I always plan for this time in each appointment. It’s your body, and some of the pains and problems patients come in with are ones they’ve been dealing with for a long time. Maybe that’s you, maybe you’ve had a problem for a really long time, and you’ve tried to find help in lots of places without much success. I really want you to know what I found, what the problem is, and, most importantly, how I can fix it.
If this part gets skipped, you’re getting robbed of a significant part of the value of massage care.
As noted above, it is your body and your health care. You should have time to ask all your questions, be clear on everything your therapist has presented to you, and fully understand the treatment plan. If you’re receiving care somewhere that does not allow time for you to ask questions or your therapist can’t provide you with answers, you need to find a new therapist.
I build this time into the appointment so you don’t have to feel rushed, and I take a lot of care with the information and education I provide to my patients. I always want you to understand what’s going on and why the things I suggest will actually help you.
What you do at home is usually way more important than the work you’re receiving from your therapist. However, those home care activities should be targeted to your specific issue and should complement the work you’ve received from your massage therapist.
Part of my exit interview is your homework. I will usually give you a couple of stretches to do, as well as other things like a water-intake goal and perhaps magnesium supplementation. I’ll help you understand why I’m making those specific recommendations, and then re-evaluate them after each treatment so you’re always on track and making progress with each treatment.
Part of the treatment plan is scheduling your next appointment. In order to capitalize on the treatment you’re receiving and make the most of it, really regular appointments are important, especially in the beginning.
Your therapist should explain to you the frequency of treatments as part of the treatment plan. (If your therapist can’t do this, find a new one.) And it’s really smart to schedule those out for the next couple of weeks to be sure you have time on your therapist’s schedule. For my, planning is key. It is extremely difficult for me to accommodate last-minute bookings, and I almost never have same-day appointments.
Be prepared to schedule your next appointment at the time of your first one. (The exception, of course, is if you’ve realized you’re seeing a therapist that doesn’t serve you well and it’s time to find a new one.)
Things That Make People Uncomfortable
There is a persistent misconception of male massage therapists. Having worked in medicine for a very long time, I can recall the stigma that used to surround male nurses. For a time, not that long ago, it was extremely difficult for male nurses coming into the field. Fortunately, that has passed. I hope that the stigma around male massage therapists will go by the wayside, too, but I’m afraid that’s a ways a way.
There are two primary concerns with male therapists:
1. Deep Pressure
The idea is that male therapists use more pressure than female therapists. For those who want more pressure, they want a male therapist because they think that will get them deeper work. And for those who don’t like deep work, they want to stay away from male therapists because they think males always work deeper than females.
The reality is, this simply isn’t true. And, actually, usually it’s totally the opposite.
Little boys are raised hearing things like, “be gentle,” “don’t hurt her,” “you’re stronger/bigger than him,” while little girls are never told such things. Now there are biological factors that play into this, in that males have greater bone density, greater muscle mass, and tend to be heavier than females. Granted, there are always exceptions, but this is the rule.
So male therapists definitely can work deeper than females, but they typically don’t, because they are afraid of hurting the people they’re working on. Female therapists almost never hold back for fear of hurting people, and therefore almost always work more deeply from the beginning.
So an insider tip for anyone looking for deep work is to find a female therapist who specializes in deep tissue. It will likely be the deepest work you’ve ever had.
But that means that anyone looking for lighter work need not fear receiving work from a male therapists. A male therapist will not generally start with very deep pressure.
2. Sexual Inappropriateness
I’ll be the first to acknowledge that there are lots of stories about male therapists sexually abusing their clients, but the truth is it’s uncommon. The reason we hear about those stories is because they’re unusual. Things that happen all the time aren’t sensational enough to make the news.
There are things you can do to screen potential therapists before booking an appointment to ensure the one you’ve chosen is legitimate and professional. There are also telltale signs to look for that will show you red flags if someone is suspicious.
Assuming a male therapist will look at you inappropriately, talk to you inappropriately, treat you inappropriately, or touch you inappropriately, just because he is a male, is fear-based thinking.
Male therapists and professionalism
Male therapists have an enormous stigma to overcome the moment they go into practice. It’s so big we’re talking about it here in this article. Male therapists have to work ten times harder to present themselves and behave professionally, so they almost always are more professional than female therapists.
Male therapists also tend to treat their careers (and their patient care) more like a career and less relationally. By that I mean female therapists can be a little wishywashy, less reliable, and more friendly (take more liberty) with scheduling, pricing, and treatment. Men tend to have firm, predictable pricing, scheduling, and care.
That isn’t to say that male therapists are less friendly or sociable, but it will be much more like visiting the doctor than visiting your hairstylist.
When a therapist–male or female–is working on a patient, there aren’t sexual thoughts or looks happening to that patient. Not to impersonalize the care, but bodies generally look the same, and a therapist will just see a body needing work.
The mentally unhealthy
A person working as a massage therapist regularly having sexual thoughts about patients is a person with a mental or emotional problem. This is unhealthy, and unnatural. And this is not a person who is a massage therapist. This is a person who has chosen massage as a way to fulfill unhealthy fantasies.
The reality is, every profession has these unhealthy, unstable people, and blaming an entire industry or an entire portion of an entire industry will really limit your ability to find a qualified, talented, knowledgable therapist who is professional and trustworthy.
These unhealthy, mentally ill people can be male or female. And there are always signs, so learn what those are and look for them. Vet your therapist of choice before booking an appointment. Or stick with clinics that are reputable, like Catherine Nelson Massage Therapy and others.
Work to the glutes or pecs
This can be the number-one reason why people don’t receive massage therapy. The glutes are the area of the back of the hip. Anatomically speaking, you don’t have a “butt,” you have glutes. But this is a sensitive area, and many people don’t want to be touched here.
The pecs (pectoral muscles) are the front chest muscles, and both males and females have these muscles. When a therapist works the pecs, he or she will generally work an area the width of three fingers down from the clavicle (the collar bone). The chest remains fully draped, and the breast is not exposed.
It is okay to not want work to these areas. Other areas people don’t like touched are the feet, face, and head. Massage work can be done without touching any of these areas, and you always have the final say on whether you want work to these areas or not.
It’s all connected
It is important to understand how those areas play into your particular issue, though, so your therapist will explain those factors to you. It’s also important to understand what work to those areas actually looks like.
For the glutes, some techniques are done over the sheet, in which case you can easily keep your underwear on. For other techniques, gliding strokes directly on the skin would be used, which would mean your underwear would need to be removed. However, those gliding strokes may not be necessary every time, so perhaps your treatment begins without those, and for the first one, two, or three appointments, the therapist works other areas and any work to the glutes is done over the sheet.
If gliding strokes are to be used, the leg is exposed and the sheet drawn up in a proper drape. To drape the glute, the glute is exposed and the sheet is securely tucked without flashing or gaping. The so-called “butt crack” is never exposed, and the sheet is not tucked into the butt crack.
The same thing is true for the pecs. Many techniques can be done over the sheet. If gliding stokes are to use used, the arm is uncovered and the upper portion of the chest is exposed, then with the arm on the outside of the sheet, the sheet is securely tucked under the torso to prevent flashing, gaping, or slipping.
These are worthwhile conversations to have with your therapist before deciding whether or not to have a massage. Massage is so incredibly beneficial to our health, I would really encourage you not to miss out entirely because you would prefer not to have work in one specific area.
When I was in school almost twenty years ago, only about one out of every four Americans had ever had a massage. Today, it’s about one out of every three. So if you’ve never had a massage, you’re in good company, but you’re missing out on a host of health benefits.
It can certainly be intimidating to think of letting a perfect stranger touch you while you’re undressed, and I’ll be the first to acknowledge that receiving bodywork of any kind is an extremely vulnerable experience. This is something I spend a great deal of time discussing with my students because it is such a big deal.
But knowing what to expect before you go can take a lot of the fear and worry out of the experience. This article covers most of the things I’ve heard from people over the years, and addresses the top questions and concerns.
If there is something I haven’t covered here, feel free to email me. I’d also encourage you to explore the my YouTube channel, as I’ve answered many questions there already.
The more you know as the consumer, the more you will benefit from the service. It will allow you to ask better questions, seek better sources, and be better prepared for your appointments.
Never forget that you are in control of the session at all times. Your therapist is there to guide you and educate you. Just like anyone else who works for you, if you receive bad care, bad service, or bad answers, fire that person and find someone new. Your health is too important to miss out on such a beneficial service because of a bad therapist or bad information.