Many years ago, when I was teaching intro students massage, I said that I would repeatedly repeat, hoping to burn it into the students' brains as they formed their own personal massage style. I would say, “The only way you can mess up is if you don’t drape properly or work too deep, too fast!” The saying wasn’t entirely true. There are several ways therapists can “mess up,” but I think poor draping and working too deep are at the top of the list! Both can result in the client feeling like the therapist isn’t focused on their comfort and safety. Those two things, client comfort and safety, are the absolute most important factors of any good therapy.
The draping part is easy. Just pay attention and make sure the client is always covered. If you don’t know how to drape properly, many resources can teach you how to do it. Palpating at an appropriate level is more complex. It requires good communication between the therapist and the client and mindful palpation by the therapist. How “deep” is too deep can change depending on where you are on a client’s body and from client to client. The therapist has to gauge their pressure at any given second, and then they have to determine whether they need to lighten up or hang out to give the tissue time to accommodate. Palpation is a skill, and it can take quite a while to refine.
One factor that results in therapists working too deep is that they can become overly goal-focused instead of client-focused. This can cause them to overwork tissue because they “have to” get a knot out right now! This loss of patience and awareness puts the therapist’s need to “get it out” above the client’s need to feel safe and comfortable. It isn’t a fair trade as the client's likelihood of leaving feeling sore and bruised can be drastically increased, not to mention overworking tissue takes time away from other areas that also need attention.
Poor communication can also lend itself to massage work being too deep for the client’s comfort. Many clients don’t know how to tell the therapist to lighten up. They instead “grin and bear it,” thinking that the therapist knows best. The therapist’s job is to check in with the client to see if the pressure is comfortable. Instead of asking closed-ended questions that can be answered with a “yes” or “no” response, ask open-ended questions that give you good feedback. So ask, “Should I lighten up, go deeper, or stay at this pressure?” instead of questions like “Is the pressure good?”
Staying aware of how my body feels helps me find the “just right” pressure regardless of who or what part of the body I am working. If I can feel the joint pressure above the tool I am using; I can use that information to either adjust my position or pressure. For example, if I am using my elbow to apply pressure to a client’s glute muscles and I feel pressure in my shoulder, I may either have poor body mechanics that are not allowing the pressure to disperse through my body, or I may be pressing too hard into the client’s tissue. If the client’s tissue allows me to sink in, then there is no reason for there to be excess pressure shifting into my body.
Providing massage to clients is a privilege. Some choose massage for help with conditions that cause them pain and discomfort, others come for relaxation and stress relief, and others come just because it feels nice. Understanding your clients’ needs helps you tailor the therapy session to be as beneficial as it can be for them. That said, good communication is key on those occasions where you feel something would really benefit the client, but it ventures outside their expectation.