These potential clients may be trying to size up you and your spa. Offer a quick tour.

If they like you and your spa, but are reluctant to make an appointment, offer a special. What’s a special?

• I can do a half-hour massage for the regular price and if you like it you can extend it to a full hour at a discount of $10.
• I can offer you a half-hour massage for a $10 discount and if you want to extend to an hour the discount will be $15.

If you are already booked and waiting on a client, offer a specific appointment option:

• I can schedule you today at 3 p.m. for a deep tissue session. We can do an hour or 90 minutes…?

Are you way too busy today? Offer advice on getting an appointment at another time.

• I can usually get people in with a few days notice. What about this time later this week?

Showing potential clients around, answering a few questions and being friendly can turn the walk-in prospect into a client. Try it. It works!

After all, the walk-in client is there because they want a massage.

I found one therapist purely by chance who really knows how to do meridian and nerve-based massages, something my low back appreciates greatly. So I was surprised when I got into the shower one day a few hours after my massage and found large, red welts on my back, suggesting that I had teenage cystic acne.

In the mirror I saw big, red and itchy bumps all over my back, especially on the lines of the sideline meridians. I had either had a reaction to the massage oil or somehow some sort of bacteria had been introduced into the skin during the massage.

I thought, probably like many clients, that I should simply not visit this therapist again. Something had been dirty, the oil, the bottle, the hands, something. I had showered just before the massage, so I did not think it was my skin. Oh well.

Then perhaps, like some clients, I though about the affection I had developed for this particular therapist. I liked her style and her results. I decided to see her again and tell her about my reaction.

Once we were alone in the massage room, I explained that I had some sort of reaction to the massage and had been nursing the bumps with arnica and witch hazel. I showed her the pattern on my back. She looked stunned.

“But I always wash my hands, and I make sure the linens are clean and fresh.” she said. I pointed at the oil bottle. “Do you wash it? Wipe it? Does anyone else use it?”

Hmm. That was possible, she said.

As massage therapists we see a lot of people and often use the same bottles and oils on each client. Can someone have sensitive skin? Sure. But what if it was the oil layer on the outside of the bottle? What if the oil itself was contaminated with bacteria?

No sure answers there. But here are the basics of keeping clean between massages and during successive massages in a busy practice or clinic.

• Always wash hands after and before a session. Washing hands at the end of a session is a half-measure. You will handle materials, perhaps dirty linens, doorknobs, credit card machines, etc. before your next massage. Wash hands again before you start.
• Wash the exterior of your oil bottle as well, especially if someone else is using your room and supplies on your days off. Slick bottles can transfer bacteria to all of your clients that day and beyond. I wash oil bottle every day and use anti-bacterial wet wipes to clean bottles between clients.
• Never stack linens for more than one client. Some therapists think they have found a great way to avoid scrambling for linens by putting five or six settings on the table. Well, no certain infections, such as scabies, can be passed from one sheet to another. You don’t want to be explaining your timesaving system to an inspector from the health department.
• Hand washing is done with warm to hot water and soap and requires rubbing both hands together for at least 15 seconds. Rinsing, one-handed washings, or other half-measures don’t count. Over the years I have learned to follow-up my hand washing with a cold-water rinse. Good for my poor paws.
• When using a jar or tub of massage cream, use a clean or disposable spatula to scoop from the jar. If you stick your fingers in the jar, you are cross-contaminating any bacteria to your whole client book for that day and as long as you use that jar. Cover the jar in between scoops. Better yet, use oil with a pump or flip-top.
• Use cleaning cloths with hot water and a cleanser or anti-bacterial wet wipes on common surfaces such as towel warmers, crock pots, essential oil bottles, anything in the room that might be touched by oily hands. If you only clean when it is slow, or you rely on a cleaning crew for these details, you may be spreading bacteria and other germs.
  • Some massages start with a foot massage, either because of the client’s symptoms, wishes or the therapist’s training. Tell your client as you finish their feet you are going to wash your hands and will be back in a moment. Some people have fungal infections, bacteria, etc., or go barefoot, and your foot massage can spread skin infections to other areas of the body.

Better safe than sorry. By the way, I decided to stick with my therapist, largely because she was concerned and eager to learn how to prevent more skin reactions. Just like a client, I appreciated her attitude and its promise for future reaction-free massages. Cleanliness fills your book.

Therapist: What is our goal today?

Client: I’d like to have the right side of my body removed.

Therapist: That would make you a leftist. Sure you want to do that in Reagan country?

Therapist: You seem a little tense.

Client: I’ve had a tough week at work.

Therapist: It is Tuesday…

Client: Thanks for coming over to my house. I have some dinner if you haven’t eaten yet.

Therapist: I have to warn you. If you feed me I come back…

Client: Do you believe in colonic irrigation for migraines?

Therapist: I think that depends on where your head is…

Client: What about coffee enemas?

Therapist: Depends, too, on whether they are iced or hot…

Therapist: Any idea why your neck hurts at work?

Client: Yes. She is in the office across from me and is not going anywhere soon.

Therapist: Have you tried any other treatments for your back pain?

Client: None that worked. That’s why I’m here.

Client: Whom do you go to for massages?

Therapist: I have very patient, somewhat deaf therapist friends whom I try not to wear out. And sometimes I play Russian Roulette by going undercover at a local spa or clinic.

Client: Has anyone ever told you that you are funny?

Therapist: Yes, and funny-looking, too!

The head is supported by these many muscles, embedded with many layers, often adhesed, and near the source of many functions from sleep to mood to respiration.

Headaches emerge from these groups, as do disorders such as head-forward posture, and as some suspect even problems such as chronic fatigue.

So what do many of us do when we approach the root of these many complex problems? We effluerage upward, in the direction of the cranial vault and away from the shoulders.

Let me make a case that we are drawing our hands in the wrong direction. Take a look at the accompanying picture from Wikipedia. See all the muscular origins? The SCMs, the traps, the cervical erectors?

The upward effluerage comes from the general direction of Swedish massage, which is in the direction of the heart, following venous flow.

But at the shoulders, we are no longer drawing toward the heart, but away from it. This draws thumbs and hands into the great space at the under-cranium, the place where those headaches and balanced-head issues hide.

With congestion disorders from headaches to fibromyalgia, we may do much good for our clients by drawing down from the hairline toward the mid-trapezius.

Try drawing congestion away from the source, toward the crux of the trapezius. You might be surprised by the results.

Talk to the client first, not during a session. Get enough information to know what the client seeks, whether they want a complete massage or spot work, and if they have medical conditions that should not be massaged. This communication takes only a few seconds. A good massage therapist always has time to communicate.

Know Contra-indications: A client with a cold or kidney infection can develop much more serious infections if massaged. A good massage therapist knows the reasons not to massage and how to explain that so the client doesn’t get angry.

Practice Universal Precautions: Protect your clients and yourself. If you don’t know what universal precautions are, you are not practicing safely. Good massage therapists know how to practice without spreading disease – or going overboard and putting on gloves when there is no rational need.

Pressure: The point of an effluerage is to soothe, not startle. Pressure with a first effluerage should be mild and stay the same all the way up. Therapists who start light on less sensitive areas and then suddenly drill sensitive tissue at the end of an effleurage could be called grinders. Not a good rep.

Timing: Twenty minutes on the feet because you like foot massage is not a good opening if the client wants a full body treatment. A person with a headache usually wants their head rubbed first.

Encouragement: We don’t fix, we soothe. A positive word goes a long way in helping people feel better.

Goals: What you want to practice that day may not be what the client wants. They may just want to fall asleep. Check-in. Ask before doing unusual techniques For example: whiplash clients can be very afraid of having someone traction their neck by suddenly lifting their head with a towel. If they don’t understand or agree, they will tense up.

Oh heavens. I have had massage trainees stare at the floor. Roll eyes in a complete circle looking everywhere but at the client. Worst, a brief nanosecond of eye contact followed by staring over the head.

How would you feel to be greeted these ways? Would you go into a room, take your clothes off and figure everything is going to be fine?

Yes, sometime before massage therapists become overnight successes because of their fabulous hands, they need to learn the art of eye contact. Yet for many of the massage community, we’re introverts, looking for a quiet place to work in harmony. We didn’t think about developing eye contact because we are not social divas, by and large.

That first day of looking a stranger in the eye can bring out insecurity for a walk right across your face.

Here is the really bad news. When you cannot look someone in the eye they don’t see shy and humble. They see sneaky, dishonest, and even incompetent. Fear or loathing. Aloofness. Distance. Not the first impression anyone would want to make with a client, ever. The last impression a therapist wants is a wrong one.

With two or more trainees, it is fairly easy to practice greetings with each other. You do not know each other, but you are in this life raft together. We will go over it about a dozen times, and toss out those little things in our expressions and eyes that say the opposite of the greeting we speak.

It takes some doing especially when the new trainee is solo. One of my solo newbies was getting great feedback on her massage, but her surveys indicated that her greetings were getting in the way. The telling question – would you request this person again – was not going her way. If the survey says the massage was great, what to do?

We had a talk over mocha bobas, a drink invented by people who want to make me feel old.

It went something like this:

How are things going?

Great! I love my job!

Fantastic. How are you doing with building your client list?

I’m getting some people back. Not as many as I thought I would. It seems to take time.

Is there anything that you think would help you?

The dreaded open-ended question. A pause. This is the most uncomfortable time. But this new therapist was intelligent and gifted. She knew what I was asking.

I think I need more help with greetings.

Let’s practice now. Go up to the barista and ask for something more. Look her in the eye. Greet her like a client. See if you can connect with just your eye contact.

She tried it, and came back.

That was tough. I felt like I was staring at her, invading her space. It was very uncomfortable. I don’t like it.

Suppose that is the only way to get your coffee, or anything else in your life that you want. Can you make eye contact? Can you practice enough in the next week to get comfortable with it?

Yes, it was an assignment. When we met for coffee the next week, her discomfort was less, her confidence more. We can still both be shy, I said, we just have to learn how to connect with our eyes and our hands.

Or is it? There are some relatively simple and low-tech ways to keep track of things so you can keep up with your bills and keep the IRS happy as well.

Most massage therapists are independent contractors, so they need to do something to keep practice and financial records in a way that they can create with the least pain. Simple systems can help with preservation of sanity.

Here’s some “practical” advice:

Smart phone apps offer easy client minding and bookkeeping systems. But one of the problems with these apps is that when a therapist gets busy, these get neglected.

A week, a month, a year later, these apps only tell you what you have told it.

The calendar is simplest scheduling/bookkeeping system has long been used by salons. Whether paper or on your phone, note the client, phone, duration and amount. Add each day’s amounts and hours up, then total each week. No, it won’t dissolve into an easy spreadsheet. But it will keep you in the know.

Some therapists will keep their client notes and info on a separate file in the phone. More complicated but it keeps the notes separate from the financial records, which is better for client privacy.

Expenses often are another forgotten aspect of the massage therapist’s business. Again, the calendar can help. Make note of where you drive for mileage, how many sheets you wash.

For the completely absent-minded, the most elemental system for expenses is a resealable plastic bag. Receipts go in there right away. If the receipts are electronic, they go into another notes file in your phone.

Massage is, after all one-on-one. We are stars or idiots one hour at a time, and we often don’t take much credit for our clients’ successes or failures. Is a massage therapist a facilitator or a game-changer? Do we really know?

I’m reminded of the times I thought I had no clue what I was doing, only to have the client hop off the table and give me a compliment and a big tip.

But I also remember that once on vacation – after one particularly hideous massage from someone who thought they were fantastic – that I said thank you and left a tip anyway. I made a mental note of the therapist’s name in case I ever happened to go to this resort again so I could get someone else.

How we measure ourselves and our effectiveness in massage therapy is something of an emerging issue. In a practice that is more art than science, can we really measure ourselves?

People have often received treatments for medical conditions that have no proof or promise – but the treatments are tried in the belief that they may relieve suffering or repair the underlying condition. That is the art of medicine.

Can we also preserve the art of massage while some therapists attempt to move into the medical – and the reimbursed – field?

A recent post by long-time and very respected massage instructor Noel Norwick of Los Angeles asked the question on Facebook.

His question on medicalmassage@groups.facebook.com group referred to a study. It found that soothing talk – reassurance – worked just as well as physical therapy treatment after whiplash. Here’s the link: http://www.bodyinmind.org/treating-whiplash

It appears to say that treatment versus soothing talk have the same results. My comment was that it might say much about the quality or delivery of treatment instead of its effectiveness in the right hands.

Would that be the case if reassuring talk were compared to massage? I think not. Hope not. But let us ask this question another way – if we could offer nothing hands-on, would we offer reassuring speech? Isn’t that sometimes the de facto treatment for stress disorders – even though many of us would propose that massage would be much better?

App companies are going whole hog into personal service. Rides, house-cleaning, errands, baby-sitters, pet-sitters, and yes, massage therapists. Where is it heading? For a big thumping collision as we struggle to define ourselves, our employers and our clients….

Oh yes, big questions. It’s going to be a bumpy ride. Hang on.

Are app companies employers? Are service providers employees or clients? Are clients users or beneficiaries? Who cares? Massage therapists care because the answers to those questions will determine how much money we make, how much we pay in taxes and how free we are to make decisions in our professional lives.

Here’s how it shakes out: Google is an advertising service that provides therapists with a way for people seeking their services to find a provider – and leaves the rest of the transaction up to the therapists and clients.

The app services are vetting providers, setting prices, presentation, times and even setting tips. The amount of control they have means they appear to be employers, not middlemen. If a therapist wants to provide more or charge more, they are not able to.

A therapist is not an independent provider of service when someone else sets the price and pay. If a therapist is not independent, then basic labor laws about employees apply.

The bottom line for therapists is that it is all about control. Control of prices, providers and policies such as tipping makes apps employers. That means the app gets to pay a lot more money in taxes for Social Security, payroll, disability, etc. that would otherwise be paid by the therapists.

There’s been some talk that the new services may yield a new classification of worker – the dependent contractor. That’s where the therapist would be a service provider who would pay less in taxes in exchange for less control. But will the apps pay the taxes? And pay for the benefits? Stay tuned.

In the interim, the people who may be the biggest targets are small businesses who have called their employees independent contractors to avoid higher costs. If the apps can’t have independent contractors, then spas and clinics can’t either. That will make major changes in the way multiple-therapist businesses operate.

Meanwhile, a massage therapist’s best bet remains Google or the other online search providers. People looking for a massage can find you in an efficient way. If they do not want your services, or don’t want to pay your price, they will find someone else who better matches their needs.