Most massage aficionados remember the trepidation that came with their first massage. What should I expect? Will I have to take off my clothes? How much do I tip?

For relative newcomers to massage, the prospect of those first visits and their unknowns can be unnerving. Here are some basic bodywork etiquette guidelines to help you get the most out of your session, create a healthy client-therapist relationship, and address some of those unknowns.

Punctuality = Full Session

There’s nothing worse than rushing into your massage appointment five minutes late. Not only is it nerve-racking, but it also eats into your valuable massage minutes. Do your best to be on time, and when possible, early. On-time clients start the massage more relaxed and focused, getting them that much closer to a place of healing calm.

When scheduling at a spa, most guests are asked to arrive early so they can prepare for their session and stow away belongings in the locker room. Arriving early enough also allows you time to enjoy the facility’s amenities, such as a steam room, before the scheduled service begins. New massage clients are also asked to arrive a bit early to fill out health history intake forms.

If you do get held up in traffic and arrive late to your appointment, the therapist will probably not be able to give you a full session. Plan on the session staying on schedule, even if you aren’t. Sometimes therapists will extend extra time if there are no appointments after yours, but don’t count on it. Respect your therapist’s time, call if you’re going to be late, and understand that your session must end on time, regardless of when you arrived.

When it comes to cancellations, most spas and private practitioners require a 24-hour notice to avoid fees. Outside of an emergency situation, last-minute cancellations or missed appointments usually result in paying a percentage, or all, of the scheduled massage fee. Your therapist earmarked that hour for you and likely turned away other clients who could have benefited from that time. Every situation is different, so check with your therapist about his or her specific cancellation policy, then honor it.

Honor Your Body

Some people have a hard time even considering massage because they are so unhappy with their body. Primarily a female issue, poor body image can be extremely damaging, leading to eating disorders in many cases and negatively affecting the way people live. While it’s hard to imagine that getting naked and lying on a massage table will make the situation any better for those dealing with self-esteem or body image issues, massage therapy and bodywork can do wonders.

According to bodyworker Merrill DeVito, massage helps integrate body and mind again, allowing clients to see things from different perspectives, bringing them back into awareness of their body, and showing them what it means to listen to their body. Bodywork can help mend the body-mind chasm that is created through self-hate, bringing the two pieces back together in a peaceful, healthy union.
Massage therapists and bodyworkers not only have advanced knowledge of tissues and structure, they also have a great appreciation for the human body as a whole, no matter its shape or size. “Massage therapists and bodyworkers don’t look at their clients as fat, thin, ugly, or beautiful, but rather see the person as a joy and a privilege with which to work,” says spa consultant Charles Wiltsie. Whether working with a 350-pound woman on the massage table or a 100-pound man, massage therapists see bodies as bodies.

Shower Up

While most guidelines recommend showering before your massage, it’s important to note that many therapists work with clients in less-than-hygienic conditions. Throughout the summer, you’ll find massage therapists at cycling events, road races, and even triathlons. A weary cyclist staggering into the massage therapy tent at the end of an exhausting day’s ride hardly smells like roses. For massage volunteers who work with the homeless population, judgment is not passed on those non-showered bodies either.

That said, if you find that your feet have endured a long sweaty day and you’re just about to go in for your massage, take a moment to stop in the restroom first and wipe them down. And, if you’re able to shower beforehand and wash away the grime and energy of the day’s events, do so.

Consider Confidentiality

Even though massage therapists aren’t medical doctors, nor are they held to the same doctor-patient privilege, they do hold their knowledge of you, your issues, and your sessions in confidence. If for some reason your therapist needs to confer with your primary or referring physician, he or she will have you fill out the proper release paperwork beforehand. That same confidence prevents therapists from talking with you about your friend’s recent stone massage or what your husband discussed during his last session. So, make it easier for all, and don’t ask.

Get It Your Way

If there’s one thing that will make your massage both more enjoyable and more beneficial, it’s communicating with your therapist. If the room is too warm, if the bolster under your legs isn’t in the right spot, if the music is driving you batty—whatever the issue—let your therapist know right away so you can get back to the business of enjoying your massage. “By all means, you should speak up about anything that diminishes your enjoyment of, or ability to focus on, your session,” says Nina McIntosh, massage ethics expert and author of The Educated Heart. Wiltsie agrees. “Communication is key to getting your needs met,” he says. Clients must take the lead and let therapists know if a particular treatment or something else within the session is making them uncomfortable.

Your therapist will occasionally check in with you during your session, checking on pressure and making sure you’re doing okay. Be sure and let the therapist know if you’re not feeling well, if that spot on your calf is too tender, or even if you can’t hold your need for a bathroom break any longer.

Sobriety, Please

In resort settings, it can be especially hard to step away from icy margaritas on the beach to make that afternoon spa appointment. But the last thing you want is to be “tipsy” on the massage table. There are several downsides to being under the influence during a massage, the most important being how alcohol plays havoc with the body’s systems. Combine that with the increased circulation from massage and you have increased absorption rates, potentially making you nauseous or outright “losing-my-cookies” sick. That’s no fun and a waste of good massage time and money. In fact, many massage therapists will refuse to work on clients who are intoxicated. Leave the alcohol for another time. Water, before and after a therapeutic massage, is what the body really wants.

Nope, Won’t Find That Here

It’s unfortunate that massage therapists even have to address this subject, but they do. So the answer to late-night callers is, “No, we don’t give happy endings. No, you may not pleasure yourself. Therapeutic massage has nothing to do with sex.”
If a misinformed client somehow ends up in the massage room of a professional therapist and asks for something other than therapeutic massage, they will be asked to leave. Flirting, inappropriate touching, and sexual innuendos will not be tolerated. Keep the relationship professional and above board and your therapist will be a valuable member of your healthcare team.

You’re Human

The body can have a lot of responses to therapeutic massage. While avoiding food at least one hour before your massage will help, there’s still the chance that you’ll have tummy gurgles or even pass gas. It’s okay. As the body relaxes and systems get moving, the body can play all kinds of tricks. Your therapist has seen it all, yet sees well beyond those kinds of issues.

For men, there’s even a possibility that massage will cause an erection—a common response to nervous system activation. “It rarely occurs, but if it does, don’t panic,” says massage therapist and author Robert Chute. “Therapists know that this is a physiological reaction and will treat the situation accordingly.” He says the therapist might try to redirect your attention with a shift in the focus of the work, maybe altering pressure or moving to a different area of the body. Don’t worry, Chute says, “Your unintended erection, and any embarrassment, will soon pass.”

Time To Wake Up

While your therapist would like nothing more than to let you slumber after your massage, other massage clients will be arriving soon and the room must be readied for them. So when your therapist ends the massage and says, “Our session is over. Take your time getting up,” they are really saying, “Take your time getting up, but please don’t take a nap.”

They are also reminding you to take a moment as you come back to the here and now. Carefully sit up, allowing your body enough time to readjust. Go too fast and your body will knock you for a dizzying loop. Also, be careful not to slip getting off the massage table, especially if your therapist used oil on your feet.

Tipping Tips

When it comes to gratuities, most experts say it’s ultimately the client’s decision whether or not to tip. Like in other service industries, providing a tip is usually done in response to excellent service. In considering this, it’s important to note that many therapists who work in spas earn only a small percentage of what you’ve paid for their services. For these therapists, tips are an important part of their income. According to CNNMoney.com, the tipping norm for massage and bodywork services is 15–20 percent. Tips, however, are usually not accepted for massage performed in a medical environment.

Unsure what to do? Ask if tipping is customary and what is the policy. This is especially important when booking at spas, according to the Day Spa Association, as tips might already be included in the service price. Be sure to get clarification on fees and services at the time of booking.