Unique and specific techniques, like myofascial release, can greatly enhance the therapeutic benefit of your work on your clients, but when using them, it’s important to consider, and appropriately set, the client’s expectations for the session. Myofascial release is a wonderful way to create space for muscles to relax. Tension in muscles can sometimes be caused by the layer of membrane, called fascia, that surrounds the muscle group, which can be adhesed or dehydrated, preventing the muscles from moving freely.

If you have someone with an old sports injury or who has recently undergone surgery, or just somebody where it feels like their muscles are bound up and barely have any room to move, that’s a good indication that the top layer of the musculoskeletal system may need some stretching to give the muscles room to expand. So, myofascial can be a wonderful way to start a massage to make sure that the rest of the work will have the most beneficial impact.

One time, though, I had a massage therapist who started using myofascial release on me as the very first technique in our massage session and proceeded to do it for close to 30 minutes, which was a full half of the session. I found that very unusual because myofascial usually doesn’t involve any oil or lotion, and most of the time, someone’s applying oil or lotion within the first few minutes of a session.

If someone comes in and their main complaint is stress or a busy life, and they’d really just love to have an hour to relax into a nice Swedish experience, they’re going think it’s weird that for half their massage there isn’t even any oil or lotion being used and you’re just pulling on the top layer of their skin. It’s about the context, and it’s about your intent as well as your client’s goals. It’s important to remember that if you’re going to start off and do a lot of myofascial work, which might be the right thing to do, you need to be sure to tell your client why. Consider the typical experience your client may have had before in massage, and clearly dialogue through it.

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We all need to be listened to, but sometimes, that need can actually obscure communications. Take care not to be misled when a client gets carried away responding to your intake questions. Massage sessions typically begin with a question from the therapist to the client along the lines of “What would you like to work on today?” or “What brings you in today?” or one of my favorites, “Are there any parts of your body that hurt?”

Sometimes, though, people can get caught up in their stories. Everyone loves an invitation to talk about him or herself, particularly from their massage therapist.  Asking them how they are doing or checking in on any pain or discomfort shows them that their needs matter to you, which is vital to building a strong rapport with your clients that will bring them back again and again. Plus, it’s vital for you to know where to focus your work.

Occasionally, though, you’re going to get an earful of just why that toe or shoulder or knee hurts—in tedious and gruesome detail. From there, you might assume that this person’s primary area of concern is absolutely killing them and think that you’re going to need to spend a good hour of massage just trying to make it feel better. That would be a reasonable assumption, based on the amount of detail that they went into and the time they spent talking about it. It’s tricky, though, because sometimes people simply like to talk about their pain and problems, but they don’t mean to be saying that they only want work there. They might actually be looking for more of a generalized massage, or even a full-body Swedish.

Don’t be fooled by these inadvertent miscommunications. Always ask, “So do you want to do specific treatment work to help your problem area get better, or would you like more of a full-body massage?” Add this question to your intake, and you might be very surprised how often someone was just caught up in the story but actually wants you to do more of a generalized massage session.

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Body modesty is always an issue, given that our clients quite literally bare all when they are in our care.  This can lead to a question for some therapists around the matter of whether a typical massage session should include work on the glutes (a.k.a. the muscles of your hiney).’

This group, which includes Gluteus Maximus, Gluteus Medius, and Gluteus Minimus, are actually some of the hardest-working muscles in the body. They connect all the work that the legs do, and they also connect to the lower back muscles. For those of us who are sitting a lot, or even people who are athletic and run, the whole hip area can often use a good working over, and the glutes certainly benefit tremendously from massage.

Unfortunately, with the proliferation of franchised chains and spas, therapists are often instructed to skip working directly on the glutes, so as to avoid even the possibility of an awkward situation, especially if there is a gender issue involved, such as a male therapist working on a female client, or vice versa.  When such a major muscle group like the glutes is not even a consideration, it often means that the client won’t get the full therapeutic benefit of the session.

If you are ever concerned about your work on someone’s glutes being misinterpreted as anything inappropriate, rather than avoiding the area, simply converse with the client. Explain that these are very hard-working muscles that would benefit from this work, and ask the client if it would be ok to work on the gluteal area. Sometimes the client will say that they don’t need any work there, and sometimes they’ll greatly appreciate it. Either way, asking is better than just skipping. If you are still uneasy about working in that regions, ways to carefully respect someone’s modesty when working on their glutes could include:

• Starting out working through the sheet or blanket, with just a gentle tracing around the greater trochanter
• Using a shiatsu-style rocking technique through the sheet or blanket
• Still working through a sheet or a blanket and applying pressure or twisting action with your knuckles

When working directly on the skin, taking care to use careful draping, crossing the sheet over their glutes and tucking it securely under their leg and torso.

Most importantly, remember that what the client receives from the massage in the end is your intent. If your intent is purely therapeutic, even if the client is a little shy in the beginning, by the end of the massage, they will know that the only thing that you ever meant to do was to help them feel better.

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Have you ever had a client who walks into the massage room with you and won’t even look up? They’re like a dark, stormy cloud. You can tell that something’s going on, but you don’t know what it is. Maybe they’re upset. Maybe they’re mad. Maybe they’re mad at someone else. Maybe they’re mad at you.

So, what do you do?  It can be tempting to try to ignore that dark cloud, go right through the intake questions, and get the client onto the table as quickly as possible. Really, though, that’s not best thing to do. The massage experience is much more than just the techniques we use. It’s also about demonstrating that your practice is a place where their needs are seen and met. One of the reasons that people come in for massage is that they might be going through some stressfully unpleasant situations in their life. The best practice is to openly and caringly connect with and acknowledge what you are seeing in front of you by asking the client something like:

“How are you doing today?”

“What’s been going on with you?”

Those “how” or “what” kinds of questions can get a client to open up. If they don’t seem receptive to that, try a simpler yes-or-no question:

“Are you having a tough day?”

“Is everything ok?”

Even if you don’t get a big low-down, just the fact that you asked shows the client that you are an attentive, considerate person who notices and responds to their emotional state. That leads to a much more positive and connected session where you’ll be able to get better results for them, because now they can trust that you are not only a skilled massage therapist, but also a genuinely caring human being to whom their needs matter.

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Massage is for more than just the muscles. The skin, the fascia, and the lymphatic system are all affected, as well. Even the “boney landmarks” of the body—the knees, elbows, and the little knobs around the ankles benefit from, and can contribute to, a satisfying and relaxing massage experience. During a recent massage session, the therapist was working along the muscles of my lower leg. As he moved skillfully upwards, he jumped right over my knee and proceeded to glide along my quads.

“Whoa! Whoa, whoa, whoa. Hold on, Buddy,” I said. “What about my knees? You just skipped right over them.” I then gave him a little reminder about the basics of muscle anatomy. Where the ends of the muscles attach to the bones with the tendons, there are these little points called Golgi tendon organs. Stimulating these Golgi tendon organs actually triggers the relaxation response in the muscles.

When you take the time to trace with your fingers around someone’s knee, elbow, or the malleolus of their ankle, it can actually be one of the most delicious, relaxing components of any massage. If you are just starting as a massage therapist, or if you’ve been practicing for years, and you find that you have developed a tendency to skip these parts and work mainly in the belly of the muscles, think again. Give those boney landmarks just as much attention, and your clients will be delighted.

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Clients come to us in all kinds of states, and that can lead to not just potentially awkward situations, but sincere opportunities for you, as a massage therapist, to earn deeper trust from your clients by showing professional empathy and concern while maintaining a responsive, high level of care.  Impatience on the part of the client is one such chance. You know what I mean: while you’re asking them questions about whether there are any areas of their body where they are experiencing pain or discomfort and would like some extra focus, they are literally tapping their fingers on their knee, sighing aloud, and saying with their body language, “Skip all this talk. Let’s just get on the massage table.”

So, what do you do?  We massage therapists are wired to please.  So, many of us will sense the frustration and cut the intake short to go ahead and meet the client’s unspoken wish by getting them right onto the table.  A more effective approach would be to continue to hold to your intention to provide the best session by continuing with a thorough intake, while also taking a moment to directly address the client’s impatience.  Try asking something like, “I see you tapping your fingers. Are you concerned about us getting enough time on the table?” You can then reassure them, “Please don’t worry. We’re still going to get the full 60 (or 90) minutes.”  Stand firm in your intention and show them how it serves them by adding, “It is important for me to ask you a few more questions because it helps me give you the massage that best meets your needs.”

While the natural temptation may be to just succumb to the client’s impatient energy and rush them right onto the table, when you politely and professionally share your intention to understand their goals better, it will earn you their trust. They will come to respect your practice as a place where their needs matter and are attended to, which increases the likelihood that they will seek your services again.

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Now, we all know massage, itself, calms the nervous system through the power of our tactile sense, the sense of touch. Many massage therapists also use aromatherapy, applying or diffusing essential oils, because smell can be another way to help shift somebody into a healthier state. But what about sound? Music involves yet another sense, the auditory sense. It’s important to know that while, for some of us, it’s just pleasant background noise, there are others who are incredibly sensitive to music. It can have a big positive or, unfortunately, negative impact on their experience. Taking a quick moment to ask your client if they like the music can make a big difference, but when and how can you do that? One thing that has worked well for me, when practicing with clients, is to have different music options readily available. I find that if I turn on a track as I leave the room after we’re done with the intake, it allows the client to listen to the music while they are getting undressed and are on the table waiting for me to return. When I come back, I can very simply ask,

“How do you like the music selection? Will that work for you?”

Three out of four times, they will say that it’s fine, but once in a while, a client will say, “Thanks for asking. Actually, do you have something different?” or “I don’t really like vocals.” I can then simply switch to another track. Even for those clients who are not sensitive to music, this asking demonstrates care and concern for the quality of their experience, which is an important part of building their sense of your massage room as a place where their needs and preferences matter, leading to a more trusting client-therapist relationship.

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