Challenges of a Massage Private Practice

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.

Nice or Negligent

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.

Finding and Marketing Your Massage Niche

We therapists aren’t always marketing geniuses. Be that as it may, one of the major questions you have to ask yourself as a massage practitioner or center is: what do we specialize in? It is only then that you can find the right place—and the right customer—to market to.

To help you with this, here are a couple of things to consider as you think about your specialty. Is your strategy to create a spa-like atmosphere? A way to get away from it all? Or, are you partnering with physical therapists or doctors? Maybe you have an acupuncturist who refers clients to you?

At Dreamclinic in Seattle, the clinics that I founded and helped to  build, when we first started, our sweet spot was sports injuries and medical massage and we blended techniques such as deep tissue and sports massage. We knew that about ourselves, so we literally struck the word ‘relaxation’ from our marketing materials.  Some marketers thought that was a little radical, maybe even a tad drastic. Yes, that’s true, they told us  we were losing valuable clientele because we were not spa-ish. But we stuck to our guns and instead grew a great following of busy working professionals with an active lifestyle that appreciated our focus on the fundamentals.

Maybe you are concerned that, as a small business, you can’t afford to lose any clients. From my experience, focusing on our strengths has had the opposite effect: It has allowed the right clients to find us, and it has allowed us to provide the best service to our clients. What’s better than that?

So what is your niche? How can you find the perfect fit in the market for what you offer? Someone out there is looking for just that. Now go find them.

Finding and Keeping a Massage Office

Many therapists could benefit from the use of a massage office. Your own spot saves your back from wrangling tables at house calls. Your own spot also offers a great learning experience – how to develop skills to negotiate and keep an office, handle bills and make more income.
At some point in every massage therapist’s career the question comes up: Would you rather work for yourself or someone else? Would you rather handle the details to enjoy the freedom? Does it suit your style and your abilities? If it does not, are you interested in developing those skills?
Being able to answer those questions thoughtfully is just the start. I’ve pulled together some tips from a long career; some of it spent working for others and some for me.
Find the Time: Lots of therapists I worked with at spas and medical offices talked about getting their own place, but most never took their first steps. You have to plot out your time. Will you spend every Monday and Tuesday looking at places? What about collecting equipment and décor on the second-hand market? Will you be spending full retail for what you need?doorsign
Study up: There are lots of online resources, most free, where therapists share their stories and advice. Tap in. I also looked at consumer columns on such things as commercial leases, tax advantages of an office and how to use your noggin to determine if potential officemates and/or landlords will be a good fit.
Work up you own agreement. If you find a place to share or rent full-time, you will get your best deal from your own hand. Sure, lots of landlords have their own agreements, but those agreements often turn back on themselves and nullify the very things you want or need. If you can use a one-page, simple agreement of your own design, you are better off.
Know your noise: Massage needs peace and quiet. The most common complaint I have heard from people is that they didn’t know the neighbors would be noisy. Or their landlord rented to a noisy neighbor just to fill space. You need some quiet neighbors, like accountants, other wellness offices, etc. Restaurants, machine shops and daycare are going to drive you crazy. Get it in writing that you won’t be subject to excessive noise incompatible with your business.
Have one-year’s rent in the bank before you leap. If your office is going to cost $500 a month or $5,000, you need to know you can pay for it while you figure out your business. Don’t rely on your hands to make paying clients magically appear.
Have more than one income stream available: If you run ads on Google, have a good website and your cousin the chiropractor sends you clients, you might make it. Most people forget to figure in the cost of marketing and keeping good referral sources in place.
It is also a frequent and fatal mistake to assume that if you leave your employer, your clients will follow. Most won’t. And your employer has paid money to get those clients in the door and the clients may just like it there just fine. How do you handle that? Trust me, it will take about 5 minutes for your employer to find out you are telling clients about your new venture. Ethics applies in business and in massage. Read up on how to leave gracefully. You don’t want to be one of those therapists who have to go to work for someone else a year later because you venture failed or created a lawsuit.

Offense or Opportunity for Massage Therapists

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.

Advice from a Massage Therapist Superstar

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:

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.

Massage Heals Whiplash

Massage at the Top of the Spine

People who have suffered whiplash are a good number of the clients in massage therapists’ practices. They seek relief from neck and shoulder pain, tension headaches, migraines and fatigue.
Massage does wonders for sore muscles of the neck and shoulder even years after a whiplash. It opens fused muscles, improves circulation of blood and lymph, and helps muscles re-learn movement.
Usually people with whiplash have been around to many different doctors and therapists. Often they have gone as far as they can with them and have decided to try massage to reduce symptoms.
And here is where the massage therapist can shine. Depending on whether the whiplash was from the rear, front, sides or diagonal directions, massage can open up clogs of adhesed muscles and return their natural movement.
Most have thick fibrous bands starting at the occipital ridge and ligamentum nuchae, and simple Swedish strokes – softly drawing away from the occiput and gliding back – can draw down the congestion.
Light to medium trigger point work on taut bands of the trapezius, splenii, scm’s and scalenes will further restore motion.
What I find, however, is that many clients tell me massage therapists shy away from their occiputwhiplash zones, even though this relatively simple work will bring much relief.
The whiplash survivor is not a china doll, but someone who needs the relief of massage.
Sometimes we are used to massaging the thick muscles of the shoulder area but clients start to cringe when we move up to the neck. It is a natural reflex to dig in to hardened tissue of the neck in order to loosen it. Actually, the opposite works much better. When I check the neck I soften my hands and do more soft molding strokes. I want the defenses to drop, not increase. When hands are soft, the tissue responds by allowing you to massage more deeply, but with gentleness.
Another common reflex is starting a stroke lightly and adding pressure as it proceeds. In effect, it is a grinding motion and a very unpleasant sensation to the client.
Instead, use the same medium pressure throughout the stroke. Go back and start the stroke again with slightly more pressure, repeating and adding slightly to the pressure with each glide, taking care not to depress the vertebrae. At the end of four to six strokes, the tissue will have been opened and drained. Success!
Drawing away from the congestion and doing light pressure techniques on the neck and upper shoulders will bring a great deal of relief without having to get into more complex techniques best left to intensive workshops. There is no reason to be afraid of making these areas worse. Your hands can’t go from 40 miles per hour to zero in one second!
A few who have had severe whiplash – and survived – they are the tough clients. Their symptoms are more serious – vertigo, sleep disruptions, fascia that forms nooses and restrictive loops over the years of compensating for severe imbalance.
I like to think I have great massage skills for all these folks, but I am cautious. Have neurologists or osteopaths with experience in these dysfunctions evaluated their injuries? Are they stuck or hyper-mobile? Have they had an increase in symptoms from additional injuries?

Lunch Leaving a Lingering Odor for Massage Clients

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.

Breathe New Life into Your Massage Practice

130218_organ_donation-highres_aotwOn 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.

Massage Goals and Baskets

Hey, it’s the time of year most massage therapists try to take a few days off, before the deluge of Christmas gift certificates and post-holiday injuries start piling up on the books.
I like to practice something with therapist employees and therapist friends. It’s something that shouldn’t be so rare but we often forget to do it. It’s the where-am-I-going-in-the-next-year game.
Yes, goals.
This shouldn’t be that hard, but I find many people in this field don’t set goals because they are bummed out if they don’t meet them. But goals are just that – something you shoot for in basketball. The number of attempts does not count; it’s the baskets.
So we will benefit from having personal goals, professional goals, income goals, housing goals, fitness and massage goals. Who’s up for some thinking ahead?
With employee massage therapists, I’ve met some resistance because when people are struggling, their gaze drops from the horizon. But this is the best time to set goals, little to large, because scoring will develop confidence. Forget the attempts and count the baskets!basket
Try setting small goals. One of my favorite therapists complained that she felt like she did the same massage all day. Well, that will drive anyone crazy. We talked and she said she wanted to learn some new moves.
Well, there are great ways to do that. Classes, sure, but how much do you retain with just short practice sessions during class? Take the class with a friend and practice that night and the next day. Retention of techniques goes up tremendously. Plus you get some work on your own tired body.
I wish classes had refreshers in a few weeks so people could go over what they learned and see the amount that has stuck or been lost. When I do classes or training, I offer that.
The less expensive way to learn is to trade with another massage therapist. Now I’ve had people come and get massages from me solely to copy techniques later, and they do not do very well. The missing step here is to tell the person you want to learn and practice some of the moves done on you. That takes feeling the technique, as well as getting off the table to really see what is being done with a test-body. Sound like school? Yes.
But at some clinics/spas those Tuesday morning schedules are a great opportunity to hold practices – if others are willing to share. Sometimes you just need to find the right people. In my experience, therapists who “steal” moves from the prone position do a poor and ineffective copy of the original. And those who say they want to learn do much, much better.