Massage for Aging Clients
Caring for elderly clients requires the massage therapist to have a keen awareness, not only of the characteristics unique to the client but also of the various members of the client’s care team.
With the rise of video demonstrations in digital campaigns throughout the massage therapy profession, I have become increasingly aware that many practitioners forget the basics that must be in place to deliver their best work. By “best work,” I’m not only referring to what provides therapeutic value to clients; equally important are healthy stroke application methods that support the therapist’s body.

I’ve seen videos of techniques that would likely feel good to the client and maybe even deliver some therapeutic benefit (although in some cases, it appears the goal is to deliver something unique and impressive). But often missing is an appreciation for simple, effective strokes and body awareness when applying them. This is concerning because skillful body mechanics are arguably the most important aspect of career longevity.
One recent video I watched was particularly concerning because the instructor marketing a technique taught in their course used compromising body positions. Most notably, their shoulders, upper back, and mid back provided strength for the strokes. What I saw motivated me to write this article with a clear call to action—tune in to and use your true power! Every stroke you apply must have the force of your feet, legs, and core behind it.
Spend time training yourself on what “bad” feels like so when you unconsciously go there, your brain signals you to adjust.
There are many aspects to skillful body mechanics. The focus here is on using core power to build a healthy, powerful stroke. Then, I outline what not to do with your body as you apply strokes. Lastly, I encourage you to experiment with both correct and incorrect positioning so you can feel the difference between a powerful stroke and a stroke that causes strain.
While the positioning of your core (hips, pelvis, abdomen, and back—specifically, the pelvic floor, gluteal muscles, erector spinae, diaphragm, and abdominal muscles) is your primary guidepost in a healthy stroke, it’s important to recognize that your legs and feet are what put your core in motion. Here are some key guidelines:
Now that we have covered healthy guidelines, let’s learn from the flip side by highlighting what not to do when applying a stroke.
When you work in any of these incorrect positions, your upper body is burdened with doing all the work. If you need to walk along the side of the table for a longer stroke that connects multiple body parts, do not alternately place one foot in front of the other. Instead, once you have pushed your weight from the back foot to the front foot, step your back foot forward to return underneath you and start again.
A lot can be learned by recognizing what causes strain. It’s impactful to consciously place your body in these unhealthy positions and become present with the sensations. All too often, we are so focused on the client that we forget ourselves. Spend time training yourself on what “bad” feels like so when you unconsciously go there, your brain signals you to adjust.
Practice with a partner outside of a professional client session. Start with the first bullet point listed in the “What Not to Do” section: Perform the incorrect approach, then perform the correct approach using the previous stroke guidelines.
Your power as a practitioner won’t come from delivering unique and impressive techniques. It will come from delivering quality work that is as healthy for you as it is for the client. As an instructor, it’s my duty to equip you with approaches that help you thrive rather than suffer.
This work, though incredibly rewarding, is undoubtedly demanding on our bodies. These core skills will serve your longevity. Take the time to reinforce them with mindful practice.
Try the following exercise to put your body into a powerful, fluid position.
Caring for elderly clients requires the massage therapist to have a keen awareness, not only of the characteristics unique to the client but also of the various members of the client’s care team.
This variation of your massage stance can reduce discomfort, help conserve strength, and use your movement and body weight most efficiently during a session.
When focusing on stretching a target muscle, sometimes other muscles in the group need to be considered for the session to be effective.
Balance challenges vary in form and cause. We can support clients’ sense of stability with the “settle, adapt, refine” model by addressing key regions of the body.