Massage Therapists: How Adaptable Are You?

A massage therapist works on a client's neck area.

By Mary Kathleen Rose

Consider this. You have a new client who comes into your massage therapy practice. In the course of the intake interview, the client gives an overview of their medical history. They also state their reasons for wanting bodywork. So far, so good.

As you begin to instruct the client to get on the massage table, they ask you a question or make a request: “Do I have to take my clothes off?” or “I don’t want my face in that cradle thing.” How do you respond? Do you have a routine you always use, or are you willing to listen to what the client wants and adapt your protocols and techniques to their preferences?

As a longtime massage therapist, I have worked with a broad range of clientele who have many individual needs and concerns. My practice has been in private studio, spa, home care, hospice, and medical settings. I started out with a good, well-rounded massage education, and I consistently took continuing education classes in various areas of interest. But as my practice shifted more to working with elderly people and those in medical settings, I saw that all my education could not prepare me for everything. 

Adapting For Your Clients—Two Simple Questions to Ask

Some of my greatest lessons came by learning on the job. I learned that communication with the client is key to understanding their needs. I learned that two key questions are critical in determining how I will work with the client.

The first seems so simple, and it is: “How are you?” Asking this question lets the client tell you why they have come, addressing the pain or discomfort in their bodies. Asking this question seems so basic, but it lets clients know you care about who they are and how they are feeling in the moment.

The second question is “How can I help you?” Simple enough, right? But so much is contained in that query. I am not saying, “What can I do to you?” which can imply I have a pre-planned agenda. Rather, which of my skills, techniques, and approaches can I adapt to your specific, individual needs?

Every session requires the therapist to adapt to the needs of the client—from basic things like creating a safe and comfortable setting and ambience to respecting the client’s needs and preferences, all while honoring safe and appropriate ethical boundaries.

Adapting to the client’s needs does not mean you can practice something you are not trained in or legally allowed to do. It does mean pulling from your resources of knowledge, techniques, and approaches to ensure a safe, appropriate, and effective session that enhances the well-being of the client.

For me, this process of discovery makes every session a new adventure, an opportunity to learn and share the art and science of hands-on healing.

Adaptability Is What Makes You Most Effective

I am also a regular massage client (as I believe all massage therapists should be) and I value the adaptability of the therapist I visit as they respect my needs and preferences. Filling out a medical intake form will be helpful to the therapist, but it is not a substitute for direct verbal communication with me. And, having reached the status and age of “older client,” I have needs that are different from when I was a younger client.

As a client, I know it is important to state my concerns and preferences, just as I’ve asked of my clients. But I have too often been surprised when a therapist responds to me by saying something like:

“Oh, but I have to use lotion or oil to get into your muscles.” 

“But I need you to be in the prone position to work on your back.”

“I have to use this deep thumb pressure, because you are so tight.”

Recently, I stopped into an inviting and lovely clinic that specializes in on-site acupressure massage. They had stations with on-site chairs, recliners for foot massage, and tables for full-body sessions. Because they specialize in acupressure, clients are fully clothed. I wanted some work on my shoulders and upper back. I checked in at the front desk, and a polite male therapist took me over to the on-site chairs and asked me to sit down on one of them. I asked him if I could sit in a regular chair, as I saw one nearby.

He looked confused and started to tell me I needed to be on the forward-inclining massage chair so he could work. I said, “No, that is not comfortable for me. I cannot breathe easily with my face in that cradle. I just need to sit up straight for you to work on my shoulders.” He was at a loss of how to proceed, so I pointed to the regular chair and said to him, “Sit down. I’ll show you what I need.” Befuddled, he glanced over at his manager, an older woman who was quietly smiling.

He sat down, and I demonstrated a minute or so of what I wanted and needed. Then he got up and I sat down on the chair. Hesitantly at first, he put his hands on my shoulders. It felt good to notice the warmth of his hands sink into my trapezius muscles, which were so in need of some calming pressure. I gestured a “thumbs up” to him, and he proceeded with more assurance in his touch. He was good about checking in with me regarding pressure. Soon, I took a deep breath and found myself smiling as I settled into relaxation for the next 20 minutes.

Afterward, I thanked him, especially acknowledging his willingness to adapt to my needs. He smiled and thanked me too. “I think I learned something today,” he said. I replied, “I’ll be back.”

author bio

Mary Kathleen Rose is the author of Comfort Touch Nurturing Acupressure for the Elderly, the Ill, and Anyone in Need of a Caring Touch (Wild Rose, 2020). She can be reached at

Related Content

• Listen: “The Significance of Motor Points with Mary Kathleen Rose” 

• Read: “Comfort Touch: Nurturing Acupressure for the Elderly and the Ill,” by Mary Kathleen Rose 




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