Our field of massage lives between two worlds. Historically, or at least over the last hundred years, massage was supposedly something that affluent people, primarily of the female gender, would allow themselves as a way of destressing and ‘getting away from it all. But massage is also increasingly recommended by doctors in situations where there is muscle injury, perhaps after a car accident or if there’s been surgery. So, luxury or legitimate treatment: which is it?

Sometimes, because I live in the world of massage and have embraced it so fully, I forget what the general perception is. When I am reminded, I’m always surprised how little the medical applications of massage are understood generally. So, for that reason I’m going to share them here—not because you don’t know them, but just as a reminder to continue to educate your clients.

Massage is, in addition to anything else, directly impactful to the musculoskeletal tissues of the body which include the muscles, ligaments, tendons, as well as the fascia that surrounds the muscle groups.

• In the case of a micro-trauma, where part of the muscle, tendon, or ligament is torn, commonly called a sprain or a strain, the muscles surrounding the area might be very tense, compensating for the injured tissue. You could use some friction to help elongate the compensating muscles back into shape.
• If there is a knot, you may find that trigger point work is super-useful.
• Chronic adhesions that are tough and feel ropey benefit from cross-fiber friction techniques. While those aren’t gentle or relaxing, they are effective. If there’s anything that’ll get your muscle restored to full action, good old cross-fiber friction will.
• Sometimes we use heat and ice, or hydrotherapy, and sometimes we’ll do stretches, either active or passive, and all of that is part of the work we do when we’re applying massage as a medical technique.

If I could, I’d like to make a clone of myself and go visit every surgeon in the country and ask them: “Did you operate on this person? Did your work create some scar tissue? Do you know that scar tissue can possibly be preventing full range of motion? Given how well it can improve outcomes, why haven’t you recommended massage to all your post-operative patients?” I know it sounds crazy, but that’s what I’d do. Why? Because massage is one of the absolute best methods for removing scar tissue and allowing patients a full recovery.

As a massage therapist, one of the most important considerations is to keep your client comfortable and relaxed. An integral part of that is the temperature of the room. In the Pacific Northwest, I would venture to say that the majority of temperature issues are not that your client is too warm, but rather that they’d like to be warmer. Being warm, of course, has the additional benefit of relaxing your client, which in turn helps to relax their muscles.

If your client expresses that they would like to be warmer, don’t take that as an affront. Everyone’s body temperature has a different thermostat. Here are some simple solutions to make sure your client is comfortable and the temperature is to their liking:

• Blankets: The easiest one is to keep some blankets on hand, ones you can place over your client as needed.
• Table warmer: Another good idea is to have a table warmer beneath the sheets that you can turn on for them.
• Grain packs: Pillows stuffed with rice, buckwheat, or another grain can be microwaved and applied to your client’s body give a soothing, warm heat.
• Space heater: In general, you want make sure that the actual air temperature in the room is at least at 70 degrees. A space heater can be perfect for that, especially in older or larger buildings where you can’t adjust the thermostat easily. Turn it on before your first client is there. Today there are many makes and models that work quietly and are energy efficient.

If your client is cold during the massage, simply turn to one of these options during the session for additional heat. I promise they’ll thank you later, and the reward will likely be a repeat customer and a referral.

When I finished massage school, back in the early 2000’s, my classmates and I shared a lot of enthusiasm to graduate, start working, and build a successful practice. Similarly, today, a lot of people graduate hoping to build a private practice—for many obvious reasons. Let’s compare the realities of the pros and cons of private practice. On the plus side:

• Individuality: Private practice allows you to create a space that’s a perfect reflection of who you are. You can decorate in your style, or use your favorite essential oils.
• Control: You can control your schedule, your appointments, even whom you do or do not take on as a client.
• Finances: Simply put, you get to keep all the money, without having to share a cut of it with an employer.

These are all tempting reasons to start your own private practice. What people tend to forget about are the more difficult aspects of building your own private practice—the reasons why about 80% of therapists eventually end up working for someone else:

• Extra work: When you’re working in private practice, typically you need to add an average of one hour of other work for every hour of massage in order to take care of accounting, maintenance, and other aspects of managing your business. This means that your twenty clients add an additional twenty hours of work per week. Instead of earning that $60, $80 or $100 per hour, you are likely earning half of that.
• Isolation: Private practice can be lonely. When a wonderfully skilled, experienced therapist applies at Dreamclinic, they frequently say they want to be a part of a larger community. They want to exchange skills and interact with peers. “It’s amazing how the solitude can eat away at you,” they say.
• Marketing: Promoting a business is not easy. If it were, everybody would start their own business. Initially, many practitioners expect every friend and family member to become a client of theirs. Six months later, they realize that that’s translated into approximately three appointments and that they need to turn to advertising and other forms of marketing to build their clientele, which can be tough between the competition and the additional skills needed to do it well.

While you should follow your bliss and listen to your heart, make sure you head into your private practice with your eyes wide open. Also, realize that if you find it challenging to be on your own, whether that’s from not getting enough clients or struggling to find enough free time outside of your private practice, don’t feel bad. This is a common challenge that others deal with as well, some of whom find ways around it and some of whom end up choosing to work for a good employer.

One of the biggest obstacles that comes up when you’re trying to build a client base—whether working for someone else, or in your own private practice—is building the habit of simply asking clients to come back to see you. Just about every therapist knows that it is supposed to be good business practice, but the average therapist isn’t comfortable even asking a client to reschedule. They state that doing so feels “pushy” or “salesy.”

Let’s take a moment to talk about this dichotomy. What is really happening? Are we really being pushy? Are we really being salesy? Or are we, instead, being considerate and doing the client a favor? Think back to your last dental appointment. When you were asked: “Can we follow up with you for your next appointment?” you likely happily agreed.

You see, there are many situations when you, as a consumer, actually appreciate a reminder—especially if you know you tend to get overly busy, or, like me, forget to put things on your schedule. What about your hairstylist? Or your personal trainer? Most service providers will offer to call or email with a reminder about your appointment. By and large, those are welcome—as long as we have a relationship with the provider.

Remember that when we don’t offer to make it easy to rebook a service, not only do we not get credit for being considerate, but it can actually come across as uncaring or even negligent. I realize it’s difficult to break the mental mindset that you are “making a sale,” as opposed to offering a genuine service.

It is a necessity for massage therapists to break this false association with being “salesy” and realize that once clients have actually tried and love your massage, they know that it’s beneficial for their health and will welcome your invitation to be a return customer.

Do you ever get asked to give massage when you’re at a party or other event? I suppose I’m a reasonably social person because I do, inevitably, find myself at some kind of a function or evening reception at least once a week, sometimes two to three times a week.

It is not unusual for there to be somebody in the group there at the event who eventually discovers that massage is my chosen field. As the conversation goes further, the person I’m speaking to, be it a man or a woman (more often a man), starts grabbing at their shoulders or pointing to their neck or back, letting me know how much that body area would love a massage—not sometime, but right now. Not theoretically, but immediately.

What to do about it? My first reaction may be something close to resentment. I find myself wondering, “Doesn’t this person understand that I’m here for the event and not necessarily looking to work at a party where I’m a guest like everyone else?” After all, you don’t ask a doctor to go perform a surgery at a social event, or a hair stylist to start giving haircuts for free wherever they go. And yet, that is exactly what people are doing when they start hinting that they could use a little shoulder rub right there on the spot.

However, instead of my automatic response of being offended, I’ve learned to develop a new reaction, one that turns this kind of situation from offense to opportunity. I smile and chuckle lightly to make the person feel okay about it, and then I palpate the area and I say, “Wow, it does seem like you have some serious tension there!” or something like, “oh my gosh! What a big knot you have there in your shoulder!” By working with this person instead of fighting against their impulse, not only do I leave them feeling heard and accepted instead of rejected, but I create the space to turn this into an opportunity for us both.

After asking when they last had a massage, I affirm their sense that some bodywork is needed, saying something like, “Well, you know, it does seem like you could really use some massage. I’d love to work with you.” If we don’t happen to live or work near each other, I suggest a clinic in their area. In the end, by showing compassion and steering this person to actually receive good bodywork, I get a lot further than by being offended and righteous. So, the next time someone’s being tactless and not respecting your massage profession, just remember it’s your call: was offense or opportunity.

When I first started practicing massage, I enjoyed something of a meteoric success. My practice went from zero clients to fully busy within three months. I didn’t really think much about it back then, ten or twelve years ago, but these days, I get asked what I did, and so I thought I’d share.

Some of the things I did when I was practicing full time are things you can read about in other articles here on the Findtouch blog. Things like:

• Setting a safe space for clients 
• Listening carefully to what they want
• Palpating before massage 
• Checking in gently during the massage 
• Providing self-care tips and useful feedback afterwards 

These are all things that we’ve heard about, again and again. In addition to those, here are a couple other things that I did, that may or may not be unique, but were certainly effective:

• Educate & empower: Having discovered early on that clients love to focus on and talk about their own bodies, I found that clients are super-excited and feel empowered when they better understand how their body works. So, at the end of each session, I would make a copy of the relevant page from a wonderful book with pictures of different muscles and give it to them. That way, I could show them the particular muscle that was involved and exactly where their injury was.
• Stay close: Whenever I interacted with my clients, I made a point of not doing it while standing across a desk from them or at any kind of distance, but while either sitting or standing side-by-side to reinforce the fact that I was there with them and to break down any distance between us.
• Seek feedback: I’d ask, “What did you like about the session? Is there anything that I could have done differently, or better?” While questions like that made me feel vulnerable and left me concerned at first whether my clients would think I was not fully skilled, I quickly discovered that those questions were received really, really well. In fact, it actually endeared me to my clients in that they not only honestly shared any areas for improvement, but also appreciated the fact that I cared to ask and sought to improve.

I’m not sure which of these practices contributed most to my success, or why, but all together they created the effect of very quickly filling up my massage room with loyal and returning clients who referred others at a brisk pace.

What’d you have for lunch? Was it a burger? Lasagna? Perhaps it was a delicious taco—a spicy Mexican treat with lots and lots of delicious onions? Mmm… Sounds good, but that was your lunch break. Now, you’re about to see a client. Are they going to experience your fine, effective massage technique, or are they going to experience the fragrance of your recently consumed lunch? It’s all about context. Onions smell great at the dinner table, but not so good on the massage table.

We’ve talked about the importance of making sure that you eat enough, so, you can remember that a hearty lunch is a good, good thing. It’ll give you the energy to give your afternoon clients solid, quality work and to feel great while doing it. It’s important, though, to make sure that your lunch stays on your lunch break.

Part of your preparation, not just after lunch, but before each session, needs to include a quick hygiene check—part of which could be a quick tooth-brushing or popping a mint into your mouth.  Maybe you prefer to use a mouthwash. Whichever breath-freshening method works for you, make sure you take a moment for it before each new client.

After ensuring the room is the right temperature, the music is the right style for your client, the atmosphere is professional and you’ve discussed a clear massage plan; it is important that you don’t let your next session be dominated by the smell of garlic or onions from your recent, delicious, scrumptious meal. Minor details such as this can lead to an unpleasant experience to the client and potentially them not re-booking with you.

On occasion, I’ve run into licensed massage therapists who have experienced boredom with their massage practice and had decided to move on to a different career. I know this happens for some, but, for myself, I honestly can’t imagine ever getting bored with the practice of massage.

There are just so many wonderful, pertinent, and directly useful techniques that I can imagine a lifetime of learning. So, here are some of the things that I found that have really expanded and renewed my practice whenever I was beginning to feel stale in the past:

• Trigger Point Work: This is an awesome, tremendously effective technique for loosening stubborn areas of chronic spasm.
• Structural Integration and Myofascial Release: Classes on these were invaluable in teaching me how to create space for muscles in the first place, in case they had no room to expand before they could be worked on.
• Thai Massage & Yoga: Incorporating elements of these have made for great additions to my practice.
• Nutrition: I’ve seen others who have taken classes on this to integrate into their massage practice. Do you know the effects that additional Magnesium or Potassium can have for your clients’ muscles?
• Energy work (Craniosacral, & Reiki): Others I know have also integrated these into their practice to great effect.
• Learn & Grow: In Washington State, we have a requirement for twenty-four hours of continuing education every couple of years, and that’s great. If your state doesn’t have a similar requirement, go take a continuing education class anyway. And if that twenty-four hours doesn’t satisfy your curiosity, double it, triple it. You’ll see. Just keep learning and keep getting better, and you’ll never be bored.

While we are primarily massage therapists, we’re also health practitioners or wellness practitioners. Really, as far as that goes, the field is still so young. There is a tremendous amount of information and knowledge to be brought in, and we are in the perfect place to do that because of the intimate and trusting relationship that we get to build with our best clients.

There are so many tools and also such a fulfilling achievement in helping alleviate other’s pain that boredom is merely a state of mind you can avoid in your practice.

With that introspective time of year right around the corner, your clients likely have their New Year’s Resolutions on their minds. Those resolutions can include everything from flossing more to working harder to seeing more of the world. New resolve to eat a healthier diet or to exercise regularly is somehow easier to summon as the calendar flips. As massage therapists, we’re in a unique position to support our clients in these efforts.

So many aspects of well-being come together on the massage table: stiffness & aches are worked out; old toxins are dislodged from their hiding places; and stress & tension melt away. What better way to buoy up one’s efforts at increased health & well-being?

This is a wonderful time for you to offer to be an ongoing source of support and encouragement for your clients as they live into the new year and their newly chosen good habits. By booking them for a regular massage appointment, you can help them hold the space for those resolutions. Follow these easy steps to engage with your clients about their goals for the new year:

1. Inquire – Find out whether your client has resolutions in mind that include their health and well-being by asking and listening. Even if they haven’t made specific goals, a statement like “Ugh, I know I need to take better care of my body!” reveals their underlying desire to do something.
2. Invite – Tell them you’d love to be a source of ongoing support as they make these positive changes and that you’d be happy to book a regular appointment for them so they know that they have at least that one good thing for themselves set.
3. Ask – Ask if it’s ok to give them some encouragement through a call, a text, or an email if you haven’t heard from then for a while in the new year.
4. Follow up – Keep a list of the clients interested in ongoing massage care being part of their lives, check it against your calendar regularly, and reach out to anyone you haven’t heard from in a month and a half, or so.

How clients choose to improve their well-being is as unique as each person choosing. Whatever your clients choose, you can be there with them in the coming year.