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What's Normal – & Not Normal – During a Massage?

Dr. Elizabeth Yuko is the Health Editor at SheKnows. She is a bioethicist and writer specializing in sexual and reproductive health and the intersection of bioethics and popular culture. She is an adjunct professor of ethics at Fordham ...

Here's what to expect during a massage & what to do if something makes you uncomfortable

So far, a lot of the conversation around sexual assault and misconduct has centered on high-profile figures — primarily those in the entertainment industry and politics. But in reality, the problem runs far deeper than that and affects many people across almost every profession. The most recent example of this surfaced in an article from BuzzFeed over the weekend, which notes that nearly 200 women have reported sexual assaults as clients at Massage Envy — the first and largest chain of massage franchises in the United States.

This is wrong and disturbing on so many levels, including that when you go for a massage, you put yourself into a physically vulnerable position with a stranger — and you’re there to relax and let your guard down. These reports about Massage Envy raise a lot of questions regarding consent and what’s normal — and not normal — during a massage. If you aren’t used to massages — or even if you are but are working with someone new — it can sometimes be difficult to determine where the line should be drawn, especially when that line is a thin sheet covering your naked body.

Massages do come with health benefits, including helping with aches and pains and recovery after a tough workout — not to mention they can be incredibly relaxing. So instead of skipping your next appointment or avoiding this treatment on your next spa trip, here are a few guidelines to help you determine what’s normal during a massage (and what’s always inappropriate) and tips for communicating with your therapist.

What happens during a normal massage?

The most important part of a massage is the conversation you have with your therapist before the treatment starts. At this point, the therapist should go over exactly what the massage entails and ask you if there are areas you would like them to avoid or focus on.

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Communication is key regardless of whether you’re getting a massage as part of prescribed physical therapy or you’re simply there to relax, Kamillya Hunter, the owner and founder of Spa Analytics says. Before your first appointment with a new therapist, he or she should do a thorough intake, she adds, which involves asking about the client’s pain points and any injuries, medical treatments and medications they are taking. Next, a good therapist will walk the client through exactly what they plan to work on during the session and confirm they understood the client’s specific needs, Hunter adds.

“When a massage therapist asks if you'd like a full-body massage, in our minds we are going to massage all of the major muscle groups,” Stephanie Agakian, a licensed massage therapist and owner of Bodhi Body Studios, explains.

Another way to think about it is that a typical therapeutic massage will include all the parts of the body that a thong bikini does not cover, including legs, arms, back, butt, abdomen and face, says Kathleen Lisson, a board-certified massage therapist and author of Swollen, Bloated and Puffy.

Yes, gluteal muscles (butt) are frequently involved in a massage, as it may relieve common ailments like back pain or sciatica, Hunter explains. But again, if you’re not comfortable being touched there, you can speak up at any time and let your therapist know.

The communication should continue between you and the therapist throughout the massage. They should check in to make sure the pressure they’re using works for you, and to ensure you’re comfortable. In turn, you should feel free to speak up if something could improve your experience.

“You should feel comfortable enough to let your therapist know if something isn't right, whether that's the pressure they are using, you get too hot or too cold, you hate the music that's playing or you need more work done in an area,” Agakian says. “After all, massage therapists are body workers. We are not mind readers, and we take pride in our work. If something is off, we want to know about it.”

Whether you are entirely naked or partially clothed is up to you — and the establishment. Some massage therapists and franchises, including MassageJoy in the U.K., require clients to wear at least their underwear during a session according to the company’s owner Naz Ahm.

Even if you are completely undressed, the therapist should place a sheet over you, covering the areas of your body that are not currently being massaged with a sheet or blanket. This practice is called “draping,” and according to Hunter, franchises typically have a very strict draping policy. But she also points out that whether the sheet is wrapped tightly or loosely around your body is not an indicator of a good or bad massage.

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Of course, it’s important to note that not all people are comfortable with every type of touch — and that’s completely fine. This is where communication with your massage therapist comes in. Even if massaging a body part — let’s say your feet — is an entirely acceptable part of a massage, you may not enjoy having your feet touched. In that case, just tell your therapist and he or she will skip that area. If for some reason they don’t, you can call off the massage at any point.

“A trained therapist will know how to give a good massage even when a client does not want all of his/her body massaged,” Lisson says. “A big red flag is when the therapist is unable to or seems too rushed to have a conversation with you about your needs before the massage begins.” 

What is never OK during a massage?

If you are getting a massage for therapeutic or relaxing purposes, it is never acceptable for the therapist to touch the client’s genitals. That area is strictly off limits.

In most cases, a woman’s breast tissue is also avoided during a massage. There is one exception to this, though: Getting a breast massage after a mastectomy. But according to Agakian, before getting this type of treatment, the client needs a referral from a doctor and should ensure they are working with a therapist who has been trained in this specific type of massage. Hunter also notes that whether it’s legal to involve breasts in a massage can depend on the state, but even in places where it’s acceptable, it still may require written consent from the client.

It’s also important to note that the sexual misconduct happens both ways. According to Hunter, sexual assault happens even more frequently to the therapist than the clients.

Some establishments, like MassageJoy, have processes in place if a therapist faces an uncomfortable situation with a client, like if they refuse to leave their underwear on (complying with company policy) or make any other inappropriate requests, Ahm says. Remember that they are a person too and even though you are paying for a service, your therapist should not have their safety, well-being or boundaries violated either.

What to do if something inappropriate happens

First and foremost, know that either the therapist or the client can end a session at any time, whether it’s because of clear sexual misconduct or because one party feels uncomfortable. If that happens to the client, they can get dressed and immediately remove themselves from the situation.

It is also important to note that sexual misconduct is not something massage therapists, managers or even owners are necessarily equipped or trained to handle, Hunter says.

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“To say massage therapists, managers or owners should know how to handle situations such as these implies this is something common in the professional industry. It is not,” she adds.

So where should you report misconduct? It depends where it happens. If it occurs at a franchise or larger massage studio, Agakian recommends reporting it to the manager. Even if they aren’t the ones to handle the investigation, it’s important for them to know what is happening in their establishment.

If your therapist is self-employed, you can always report any sexual (or other) misconduct to the police or the state massage board.

Tips for a successful massage

It’s important to remember that not every massage therapist is the same. Like psychotherapists, sometimes it takes a few attempts to find the massage therapist that’s right for you. Not everyone likes the same type of style and pressure, so it makes sense to prefer working with some therapists over others.

Kristie Garduno, owner of Clients Kneaded Mobile Massage, suggests getting a recommendation from a friend or coworker if you’re looking for a new therapist as well as reading plenty of online reviews. But above all, she suggests finding a therapist that hears you.

“As long as the therapist pays attention, he/she can adjust every other variable,” she explains. “And of course, also find a therapist that you feel comfortable with. Massage is all about relaxing, so if you cannot get comfortable enough to relax, the time is wasted.”

Once you find a massage therapist you like, stick with them, Lisson says.

“My best advice for making massage a part of your wellness routine is to develop a relationship with a licensed/certified therapist that you can trust,” she adds. “Always seeing a different therapist increases your chances of getting a massage from a therapist with bad intentions.”

Like so many other parts of life, the moral of the massage story is that communication is crucial. If your massage therapist doesn’t initiate a conversation before the treatment starts, don’t be afraid to start it yourself. Be firm and clear about what you want and don’t want, and always remember that you can leave at any point, and above all — take care of yourself.

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