What is Involved in a Massage Session?

Before one schedules a message session, it is best to know what is involved.  You might be asking questions like…  What really happens in a session?  What types or lubricants are used?  Oils?  Lotion?  Do I have to get undressed?  Completely?  Will I be covered at all?  How much better will it make me feel?

Well, let's start at the beginning.  Once you've made the decision to have a massage session, selected a therapist, and made an appointment, you're ready for some relaxation and healing.  The first suggestion is to show up for your appointment about 10 minutes early as there will probably be some forms to fill out. 

Most clinical massage therapists (CMTs) keep client records, which include contact information, health information, and session notes.  Because some people have health conditions that could pop up at any time (asthma, heart conditions), basic contact information including an emergency contact is kept.  This includes a client's birth date as (whether we like to admit it or not) age does have some bearing on what we can receive in massage movements and pressure. 

Whether there is a form that is filled out, or questions asked by the therapist, health information is something that is necessary for the therapist to have.  There are many health problems that could change what the therapist is allowed to do (rashes, fibromyalgia, swelling).  There are some health problems that could make it so that the therapist would not be able to work at all (bronchitis, cancer). Problems with the body that can be made better with massage movements can be referred to as 'Indications'.  This means that 'massage is indicated' as a means to help relieve the problem.  Problems with the body that are made worse with massage movements -and this can be sometimes determined by what stage an injury is in- are referred to as 'Contraindications'.  This means that massage is 'contraindicated' as it can make the problem worse.  Something else to be concerned with is if you have anything contagious, like a cold, or fungus spot.  In this case, the therapist can not work on you as they could become ill.  Once that happens, they could then pass it on to others.  It is necessary to be completely open and honest when giving health information as this protects you, the client, and in some cases the therapist. 

At this point, you're ready for your bodywork.  Now remember, this is a professional session with a licensed massage therapist.  It is completely about healthcare and non-sexual. 

For the purpose of the session, the therapist will ask you to get undressed and get on the massage table.  At this point, they will leave the room and come back a few minutes later.  Once the therapist has left, you should get undressed to your comfort level.  This varies from person to person.  Many people feel comfortable removing everything.  This is what usually works best for the therapist as it allows them to reach all muscle groups easily and treat the body as a whole unit.  For those that are not comfortable, they usually leave their underwear on.  Some women will leave their bra on, but that needs to be unhooked and worked around to properly massage the back.  Massage can be given to a completely clothed person, but it is hard on the therapist's hands, and they can not do the quality work most people need while working through clothes.  If the client is having problems with their lower back, the therapist will have to work in that area to address the problem.  That may require the client to be completely undressed so the therapist can work deep into the low back and buttocks (the gluteal muscles, or glutes).  (In truth, the back includes the buttocks, and often this area needs to be worked as it connects many muscle groups.  A therapist can work through underwear by doing compression movements only, but this is never as good as direct hands-on movements.)

Once you have undressed to whatever level you decide on, you should get on the massage table in whatever position the therapist wants you in (either face up or face down).  There will be either a sheet or towel to cover with.  If you are asked to lay face down, the drape (the towel or sheet that was left for you to cover yourself with) should be covering (at least minimally) your backside.  If you have a full sheet, then completely cover yourself.

Most states have laws against a therapist massaging a nude, uncovered subject.  Most therapists are uncomfortable with this anyway, which is why there are proper draping techniques.  With proper draping, a therapist will uncover each area they work on as they come to it, and a subject's genitals are never exposed.  If the subject is a woman, her breasts are never exposed except in rare circumstances.  (There are legitimate breast massage techniques that are used when actual need requires them and usually the therapist will ask for a doctor’s note.)  The buttocks are exposed one cheek at a time as they are worked.  The entire backside is never undraped. 

For the session the therapist will use some sort of lubricant, usually an oil or lotion specifically developed for massage.  It will probably have some type of scent to help the subject relax.  This is where you need to have been completely honest on the medical information form.  Some people are allergic to different scents.  Scents can range from floral to citrus to herbal.  Make sure you ask the therapist what scent they are using to make sure you won't have an allergic reaction.  Some therapists will have a selection of scents to choose from.  Some will also have unscented oil and lotion in case none of the scents will work.

Oil is the most common lubricant that is used, however lotion may be available for those that are allergic to, or dislike oils.  Creams are available too, but not used or offered as often as oil or lotion.  Lotion is made by combining oil with water, and then mixing in other ingredients (cocoa butter, essential oils for scent, vitamins).  Some that are allergic to oil, may find that some lotions still cause them to have a reaction.  There are specific brands of hypoallergenic lotions available.  If you have problems with oil, you might want to discuss this with the therapist when making the appointment.  (There are types of massage that do not use lubricant like Shiatsu or advanced Lomi Lomi.  Some of these may be effective with your current problems, but some may not.  Again, ask the therapist.) 

During the session, the therapist will work the body, bending, pushing, pulling, and manipulating the skin and muscles to correct problems and make one feel better.  This will include long strokes, short strokes, medium pressure, light pressure, heavy pressure.  The therapist can use their hands, forearms, and elbows to deliver the necessary strokes.  Generally, in a session, the entire back side of the body is worked.  The front side is worked with the exception of the genitals, or (women only) the breasts. 

During the session, as a client, you have certain rights.  If there is something you are uncomfortable with, you should mention it.  If the pressure is too hard, you need to let the therapist know.  If the pressure is too light, you should let the therapist know.  By all means if you are being hurt, you need to let them know. 

At the same time, understand that depending on the problem, you may require deep work, and this may hurt.  The therapist may be able to ease off, but you may not get the healing you need, and it may take longer to heal.  If it hurts too much, then you need to tell them to go easy. 

There may be legitimate moves that make you feel uncomfortable.  If this is the case, you should let the therapist know.  You should then discuss it with them, and if you are not comfortable with these moves, the therapist will change to something else.

The key is that you have total control over what happens in a session.    Don't ever forget that. 

If all has progressed as it should, at the end of the session you should feel better.  Depending on how deeply the work was done, you may be sore from the original injury or you may be sore from the work.  In a perfect world, you would have a session and come away feeling great, and that does happen a good deal of the time.  But with injuries, it may not feel good afterwards.  But no matter how you feel, the session will make you better, and help speed up recovery. 

In the case of massage for relaxation only, you will go away feeling relaxed and de-stressed.  You will always feel better after a session.

WHY MASSAGE?

• It's a great way to give someone an experience of being totally taken care of and free of any responsibilities.
• It's good for your body. Any book on therapeutic massage will list a number of positive, documented effects that massage has on the body and mind.
• It feels good.

  TERMINOLOGY

• Effleurage: A smooth, gliding stroke during which the whole hand is in contact with the body, following the body's contours. Effleurage is a great way to begin and end massage on a particular area.
• Petrissage: A kneading, lifting stroke. Try to keep the palm of the hand in contact with the body along with the fingers. Be rhythmic, and alternate hands.
• Friction: A direct, focused, compressing stroke. Thumbs, possibly braced, work well for this stroke. Be careful not to exert pressure with your fingernails if you have long fingernails. Circular motions work well. This stroke should be preceded by effleurage and/or petrissage.
• In massage schools, four other types of strokes are taught: Vibration consists of shaking and/or vibrating motions, Gymnastics consist of moving body parts (such as arms) through their ranges of motion, Tapotement consists of rhythmic and soft "pounding" strokes, and Nerve Strokes are light strokes over a part of the body which precede leaving it for another part.

HOW TO STAY COMFORTABLE WHILE GIVING A MASSAGE

• If you're using a table, don't lean over it - keeping your back relatively upright is best.
• Lean into the person you're massaging for deep strokes, rather than depending on upper arm strength.
• Keep your shoulders down.
• Keep your knees slightly bent and fluid for long gliding strokes.

BASIC MASSAGE TECHNIQUES

• Maintain contact with your partner and take your time.
• Be sure the room is warm enough for the person you're massaging.
• Put oils/lotions in your hand first, to be sure they are warm.
• Start with light and general strokes before doing deep and direct work on any given area.
• Repeated, slow strokes are relaxing. Fast, light strokes can be invigorating.
• Deep, draining strokes on arms and legs should be done towards the heart rather than away from it.
• Offer the receiving partner a glass of water afterwards. For a variety of reasons, water is especially valuable to the body after a massage.
• Massaging severely vericose veins deeply and directly is probably a bad idea. With other conditions use common sense, getting a doctor's opinion if necessary.

Additional Topics:

• Intro to Massage • Massage Modalities • Massage School Notes • Ethics • Anatomy & Kinesiology • The Muscles • Massage Sequences • Aromatherapy • Acupressure • Swedish Massage • Deep Tissue Massage • Alignment Therapy • Pathology • Reflexology Massage • Trigger Point Therapy • Trigger Charts •