The Reality of Massage Therapy Today

This blog ended up to be a lot longer than I wanted it to be, but it was hard to shorten it. Enjoy a longer read!

The perception of massage

Whether you see me or another massage therapist, we all go through similar situations. Some more on one situation and others with other situations. Whatever the case, I feel it may be important to let everyone know what we deal with. A lot of this happens more with business owners, but even for massage therapists that are employed the challenges are still very similar.

Some people, when they hear the word massage they automatically envision a spa setting. Where everything is so relaxing you can almost fall asleep. For some places that is true, however, there are so many different kinds of therapists it does not end with spa-like massages. Don’t think spa-like massages are not beneficial, because they are. 

In my instance, I am a medical massage therapist. I help with pain relief, pain management, vertigo, mental disorders and more. I am focused on providing people with a better quality of life as opposed to the spa-like massages, which are a focus on relaxation. All massage therapists have a specific focus or specialty.

Other people think massage has a sexual innuendo. I have had clients tell their friends about me and they would ask if I offered “happy endings” and if I didn’t offer that they were not interested. I get emails, phone calls, and text messages all the time about it too. I even had someone ask me in person at my office for the first time, not too long ago!

One email I got, several years ago, asked me all the right questions about what I offered and what I could help with. This potential client sounded excited that I would be able to help with some of his issues. His last question was, “shoes on or off?” My first thought was of someone taking their clothes completely off then putting their socks and shoes back on and climbing onto my massage table. What a weird process, but to each their own. So I told him that he can do whatever makes him feel comfortable. I won’t be able to massage their feet, but if that is the goal and it gives them comfort that this will help reach that goal? Then, by all means, go ahead and do that. 

His reply was “no, I meant you.” Oh heeeeeeellll no. I replied “this conversation is over.” He emailed me a couple of times after that apologizing for disrespecting me and offending me. I just ignored them and left it be. For those who didn’t catch on, This person, most likely, had a foot fetish and wanted to ‘see’ my feet during the massage.

I have had people also push my boundaries with clothing or lack thereof. I got a text from a guy asking to book a massage. Before we settled on a date and time, he had a question before we got too far into the booking process. He asked if it was ok to have his underwear on instead of having the top sheet on. This may sound gross to a lot of people, but it is common for people to not want the sheet on because it is too hot. The issue is it is illegal for massage therapists to see clients completely naked. 

My response to that was, as long as he has his boxers or briefs on, I won’t mind. Then he says that the underwear he will be using is ‘so very very small’... his exact words. I replied “so there is a chance things may slide out into view?” To that he said yes. I told him that if there is a chance then he is practically naked and I will not be booking his appointment. End of story. He kept texting me, but I stopped reading.

Late cancellation/no show policy

It is not a big deal when one person does it and that is kind of what goes through the minds of a lot of clients. I was there, I know. What is not known is how many clients will late cancel or no show once it starts. As we all know, a lot of things happen in 3s. Death is one of them. Well late cancellations and no shows are another one. My worst week, in this sense, I had 6 to 8 of them. 

Let’s think about how we get paid. In my case, I get paid by clients directly and my goal is to be completely booked and if I didn’t have my policy I wouldn’t be by the time the day ends. However, I give ‘oopsies’ to people who do it for the first time or by circumstance, because unforeseen emergencies happen. Interestingly, that happens in 3s as well.

Massage therapists who are contractors, it is the same concept with them. Employed massage therapists get it the worst. They get paid an hourly wage, but only for the hours they are actually massaging. So employees in Massage Envy, for example, are only getting, give or take, $18 an hour if the clients actually show up to their appointments. If I remember correctly, they are still getting paid in between clients, but it is minimum wage.

You would think, since they are working with such a big company, they are not missing out on one late cancellation or no show. Corporate is not, but the employee is. Then on top of that, again, when one no show or late cancellation happens, multiple will happen within that week. Sometimes, that will happen week by week. If that is the case, how much less did they get paid compared to their anticipation at the beginning of the month?

I am fortunate, my clients are understanding and are willing to pay for what they missed. Unless they are in an emergency or an unforeseen circumstance happened, then I always offer an oopsie. BUT, keep in mind, this also happens in sets as well. I appreciate my clients for being the way they are, so I don’t mind it. Sometimes it is painful, but my clients are worth it.

I have heard stories from other massage therapists and I have never gotten treated so horribly. That is why I appreciate my clients so much. Off the top of my head, I can recall one story where a client called 5 minutes before their appointment to reschedule to another day. Since it was not within the 24 hour policy, the therapist asked the client how they wanted to pay for the missed appointment.

Mind you, she was rescheduling because she absolutely had to schedule lunch with a friend or something like that, which was nothing close to an emergency situation. The client said “but I am not there for the service.” They kept going back and forth and the client got angry that she was being charged for a service she didn’t get. Needless to say, she is no longer a client.

To add to this subject, many people show up to their appointments late. I used to have quite a few but I stuck to my policy and they didn’t complain, because they knew what they were getting themselves into. Now I may have an occasional late client but it is unintentional and does not happen often. I have heard this is one of the big issues a lot of massage therapists have. Thank goodness I do not. But I did have my fair share of those.

My first one was someone who always took the last booking. The first time he came in, he was 15 minutes late and he claimed he was late because he couldn’t find me. It happened a lot so I didn’t put it against him and still did a whole hour. However, I told him that he knows where my office is now, so I will not extend it next time. 

The 2nd time he walked in he was only 5 minutes late, so I didn’t mind covering that, but this time, when I was coming to a finish, he asked me to crack his back and neck. That is not within my scope of practice so I strongly told him no. He argued, but not for long. The third time, he was a half hour late. I wanted to leave my office at a decent time, so I told him before we started that I needed to be out by a certain time. 

So I proceeded with the massage and stopped it at a half hour mark, with no extension at all, which was talked about so there was no surprise. After the payment, he talked my ear off, I reminded him of the time, but he kept me verbally hostage. A half hour went by and he says, see? You could have done the full hour. I didn’t let him rebook with me.

This guy also tried to not pay me my rate! I told him for the first massage it was $60, but after that it was $75. He kept only bringing $60, so that was another reason I ‘fired’ him.

Scope of practice

Since this topic is part of the last story, this is a perfect subject to bring up next. Since we are licensed professionals, it is illegal for us to cross into other professional scopes of practices. Because we are licensed we should know better in the eyes of RLD (Regulation and Licensing Department). 

What we get pushed into a lot is “crack my back real quick while you are there”. It doesn’t seem like a big deal. Since we are massaging this person’s back and they probably have their spouse push an out of socket rib back into place regularly. But if something happens by accident and this client gets rushed to the hospital we are in big trouble. 

What this comes down to is that we are trained to massage people and that is our only job. We are not caretakers who help take client’s clothes off and/or help them onto the massage table. We are not chiropractors. We are not physical trainers who help people understand how to strengthen our clients. We are not counselors or psychologists who talk our client’s through problems. 

Actually, that is the only boundary I am loose on. Most of our pain comes from situations that cause emotional distress which connects to body pain. So it helps me understand why they are going through certain pain areas and talking about it can help me guide my client’s through it.

Main point here is, if we have to do more than what we are paid to do, technically there is a problem.

Massage pressure

Every massage therapist has a different level of strength. Some can practically break a bone and others specialize in light massages because they lack that strength. Thanks to corporate massage companies and spas they have drilled into people’s heads that deep tissue can help get through all layers of muscle. Yes, that is true. What they don’t tell you is, it does not take that much pressure to achieve deep tissue. 

I used to often get people coming in for the first time asking for deep tissue and I have to clarify exactly what it is they are asking for: Deep tissue? Or deep pressure? Every single time, I find people can take more pressure in some areas and less pressure in others. So I tell people right off the bat, I will do what I feel is best according to your physical and verbal feedback. 

The problem here is some people will ask for more pressure, then more pressure, then more pressure, and on and on. Without the thought that it may ruin our careers. Massage therapists are prone to having arthritis in our hands. If we take care of ourselves through strengthening, stretching, acupuncture, massage, from another therapist of course, etc, we can last a long time. 

The biggest problem is a lot of massage therapists do not know their own limit or how to tell their clients they cannot go any deeper. Well, I am sure you, my clients, know I have no problem telling you what I can and cannot do. I am not shy! The other thing is not many of them will take the extra care for themselves, because they are too busy taking care of their clients. The average lifespan in the business as a massage therapist is 5 years. I have heard of people lasting only 3. 

If you love your massage therapist, make sure they are taking care of themselves! We need a lot of TLC, too! 

Hygiene

I don’t mind clients coming in after work as long as they don’t smell or are covered in dirt and what not. I think every massage therapist is different with this, because I have met one who states in the policy that they have to take a shower before their appointment. 

I have clients who are older and have a hard time bathing and so they may have some exfoliation happening during a massage. Which, again, I am not worried about, because I get it. I am not going to deny them pain relief from something I can potentially help them achieve. More range of motion to be able to reach behind their back or bend down to scrub their legs. I do not mind at all!

However, if you are young (in your 30s) and I am practically scraping your dead skin off as you bitch about how I am not going deep enough or not getting the right pressure? You can go F yourself and never come back. Yes… This has happened. And no, I didn’t have to say anything, because I was not what he was looking for. Thank goodness!!!

I had another guy come in with athlete’s foot. I asked him why one foot was smooth and the other was rough. He had no idea why and thought that was weird. 5 minutes later he shouts I remember now! I have been battling athlete’s foot for several days! I excused myself out of the room, washed my hands and went back in. I told him that I had just started massaging his leg when he ‘remembered’ so I have to avoid that area so now it will only be an upper body massage. I couldn’t believe it! I could have massaged his face and said, “Oh! I’m so sorry! I totally forgot how contagious athlete’s foot is!” Just kidding, I would never!

I have had smelly people on my table, but it was just their natural odor and I knew that for a fact. I wasn’t going to shame them for that and I was not going to deny them of pain relief because of something they have no control over. 

This brings me to the last subject…

Communication

Communication is so important on the massage table. I was only able to know about the body odors thanks to my clients’ honest communication.  A perfect example is a time at massage school, where an instructor was showing my class a technique on me and he had a really painful spot in my right hip. He stayed there for a minute and told the class it was starting to release tension, which I was able to feel too, but then he let go as he said that it was completely released. I didn’t feel like I got the satisfaction of feeling it completely go away. That is the time I found that the client and the massage therapist may feel similar things, but not all the time.

I have been told numerous times by other therapists that I should have more faith in what I feel. How would I know what my client is actually feeling if I didn’t ask the questions though? A lot of you may know this about me, but if you are some that fall asleep during a massage, I will rely only on what my hands feel. However, I do believe that when I am asking my questions, it leaves the client even more rejuvenated than if I didn’t.

Most importantly, though, the communication cannot just be from me. I have strong hands and I don’t always know if I am putting too much pressure or too lightly. I do what I feel is needed, but I am human and I am not always right. From the years I have worked on my clients, I have realized that when I make sure my client’s pain level is not overbearing, say a 5 pain level, their body reacts so much better, quicker, and it lasts longer. 

I communicate this to all of my clients, but a lot of the time they will still bear the pressure. I will usually notice that my client may be uncomfortable and will ask if the pressure is ok. So many times, their response is that they can handle it. Fact is, I don’t want them to be able to handle it. That usually means they will try to take it until it is too much. At that point, they may be tensing up in the area or tensing up somewhere else and that is counterproductive. The perfect spot is where the client isn’t concentrating on staying relaxed, but able to stay relaxed comfortably. 

I had a client who saw me for a couple of years before he sent his wife to me. When I was about to start the massage, she said “please don’t hurt me.” I asked her why would I do that? Then she told me she had noticed a bruise on her husband’s shoulder once and asked where that came from. He had no idea, but guessed it happened during a massage and said, “Cat can be really sadistic sometimes.” 

I burst out laughing, “he said what?!” and proceeded to tell her he should have told me I was going too deep. My intentions are never to hurt. No pain no gain is a real thing in the gym, especially for weight lifters, but not here in my massage room. It’s more like no pain MORE gain. So I asked her to please let me know if it is too much. 

In conclusion:

Being a massage therapist is not for the weak. We have to be strong with our boundaries and really stick to our integrity or we will be taken advantage of. On the flip side, we also have to be compassionate and understanding for those who cannot speak up for themselves. 

Massage is such an important alternative medicine today. So many of us come and go so quickly because we cannot take the abuse to our profession or the abuse towards our physical well being. There is also a lot of paperwork involved if we work closely with insurance and some therapists can’t handle that on top of all the other stuff mentioned above. 

One last story, when I started my business, it was scary. I started at $40 for an hour massage, but  I quickly realized I deserved better than that and bumped it up to $75 an hour about a week after I opened my practice in April of 2016. 

Setting a price on my profession was a huge deal. What was I worth??? My knowledge, training, and license I had worked so hard for, how much was all of that worth to me? I started at $40 because I only had experience through massage school. I had to do over 600 hours of massages in school + the clinical massages people outside of the school could book. However, I went straight into a 4 month medical massage course as soon as I graduated from massage school and the kind of knowledge I got from that gave me the confidence to boost my rate up to $75 and at that moment knew I was worth it.

I have had lots happen, but there was one text I got from a guy who was asking about my expertise and how much I charged. We discussed my expertise and as soon as I told him my price his reaction, in text, was “Oh hell no!” Exact words. It didn’t hurt my feelings, but if I got this kind of text about the time I boosted up my rate, I would have started doubting my decision to boost my rate up and doubted my worth. 

It didn’t hurt my feelings because his perception of massage value is not my problem. That just tells me he is not the client I need. However, not many people or therapists are like me who have extremely thick skin.

Massage therapists need support to be able to do what we do, but also need support to stay open and grow. Not saying you have to support all of them. Just saying when you find your forever massage therapist, understand what they go through, support them, and have some compassion. Especially when you late cancel or no show or when you need more help than what the therapist is being paid for. I bring these two, three situations up because these happen more often than others.

Especially with clients who go through insurance and the treatments are not out of pocket. It is not a financial requirement. “It’s free so it is not a big deal if I show up or not.” However, it is a big deal for the massage therapist. That is an hour they are not getting paid and, for some therapists, that one massage could have been what paid a utility bill. 

Side note:

Not all massage therapists are good people either. There is a lot to say about that as well. I may or may not write a newsletter on that, but it can be a big topic to cover. Be careful who you choose! Trust your intuition, if someone feels off… LEAVE.

There are much more we struggle with, but these are things that are client involved. People don’t usually know they are doing anything wrong until someone shines a light on it. Some have no idea what we go through at all because they are so respectful in the first place they expect that others are the same way.