Massage Therapy FAQs 1


Let’s look behind the closed doors of the often misunderstood profession of Massage Therapy. After all, it’s been practiced for more than 3,500 years and as the world’s population continues to become older, the business and employment opportunities abound. Patrons of the art of massage come in many colors, use many different languages and practice their own particular cultural traditions. Therefore, therapists who’s native culture is not USA, will most likely lean toward their own cultural background. Most of the dialogue presented here is basically “instructional” or “tutorial” and is presented in an English language level that will easily translate into the native language of the reader.

Briefly, to avoid a lot of embarrassing questions that may not get asked or even answered, there is a “session” prior to the massage that should be first considered and exercised. That is, PREPARING FOR THE MASSAGE. The following article will describe the most popular massage styles and offer general answers to some of the most often asked questions about Massage Therapy and what to expect during “your” personal session.


Aromatherapy technically is NOT a massage technique. It is the “aroma” or “odor” of certain specialized plant-oils. These oils are extracted from its host plant, sometimes mixed with other aroma oils to create a unique blend of “essential oils” that when exposed to the open air tend to help the massage client(s) relax by inhaling the essence of the oils.

Assuming that you, the client, are somewhat new to receiving a “commercial massage” I would first suggest you go to a reputable spa or clinic; OR make an appointment with a “free-lance” massage therapist who has a squeaky clean reputation, for your introduction to what ever “style” of massage you seek or what may be recommended for your particular medical condition. Most questions can be answered over the telephone.

Before you decide on a spa, or for that matter, before you decide to schedule a massage therapy session, I suggest you first learn of the different types or styles of massage techniques that are most popular among clients. Next most important to learn is the background and local reputation of the spa, hotel, salon, clinic, parlor or a private “free-lance” massage therapist.

A “free-lance” massage therapist is a person who performs personal body massage services, but, who is NOT an employee, rather, the therapist is “self-employed”, generally operates as a “mobile” or “portable” massage service where the therapist goes to YOUR location, home, office or rental to perform the service. Some “free-lance” therapists operate their enterprise within their own home-studio, while others go to your location along with all the necessary materials and equipment. Most massage therapists are certified and in many USA jurisdictions therapists may also be required to procure a Massage Therapist License.  

Based on some of what you just read, I suggest that prior to your “first” massage you should do a little homework. You don’t want to set an appointment at a “parlor” that you just spotted on the street around the corner from two other parlors and a beer garden. Your best bet is to engage the services of a SPA, HOTEL, or other facility within a structured setting that can assure privacy, security and flexibility and the services of a licensed and certified massage therapist.

While the fee at a luxury Spa or Hotel Salon may be greater than the place next door to the tattoo parlor, you’ll have a pretty good idea what a massage should “feel like”, what techniques are best for YOUR situation, and you’ll have learned what is expected of you as a client and what you can expect of your massage therapist. Stopping in at a sleazie massage parlor somewhere near the airport, bus depot or train station is likely to be just one of the parlors in the same neighborhood — several in fact. These places are all too often “rip-off” stations. Don’t get caught up in these tourist traps.


Should I tip the therapist? Am I supposed to be nude? Do I say anything if the pressure’s not deep enough? I’m self-conscious about having had a mastectomy…What if you’re self-conscious about your body?

Here are some answers to a dozen or so very common massage questions you really want to ask, but may be too embarrassed to actually ask.

1) Am I supposed to tip?
If you get a private massage at a spa or hotel, a 15% to 20% tip is standard if you were pleased with the services. In a clinic setting: 10% to 15%, and for a therapist who provides the massage service at your office, home, rental or other location, consider the travel distance for the therapist, travel time and other expenses. An “OUT-CALL” (aka: free-lance) massage therapist who goes TO the client must carry everything needed that might be otherwise located on the shelves of a salon, spa or massage studio. Tipping an Out-Call therapist should be in the 15% to 20% range.

On the other hand, there are no real ground rules or norms when it comes to massage in a medical setting. Some massage therapists and massage associations I asked said tipping is NOT appropriate in a medical setting. Most likely, the “tip” is already incorporated in the “service fee”.

If you’re not sure, don’t be afraid to ask if tipping is customary. You can call ahead to ask if you don’t want to do it face to face.

If tipping isn’t the norm, you can always show your appreciation by referring friends, family and co-workers to the massage therapist.

2) Am I supposed to take off my underwear?
Many people prefer to keep their panties or briefs on during a massage, while others prefer to be completely nude. It’s up to you, the client.

If your problem areas are your lower back, hips, buttocks, or groin, tight-fitting underwear can sometimes get in the way of massage work, but a thong for women or bikini-briefs for men should do the trick. The “smaller” the thong or brief the less likely the garment will be affected by massage lubricants and oils. Best bet: overall, nude is better.

In North America, if you do remove your underwear, the general protocol is that the licensed massage therapist must ensure that you are always properly covered by a sheet or towel. Only the area being massaged will be uncovered.

This tends to imply that the “sheet or towel cover” isn’t used if you’re wearing underwear. Not so. Often as not, the therapist will cover most if not all while massaging the target body part remains uncovered. Most often, moving the cover-sheet (or towel) from place to place can consume more time “re-arranging the cover” than actual body massaging activity. Therefore, do not expect to be completely “covered” 100% of the time except for the small area the therapist is working on.

If you’re in a “private room”, as opposed to a communal dormitory setting, you likely will be in a closed-door room, or at least behind obscure cloth drapes, similar to hospital rooms.

3) What if I realize I’ve drooled?
Many people fall into a peaceful slumber during the massage but when they wake up, they notice a pool of drool on the pillow or massage table. This is very common but no less embarrassing. It often happens when people are being massaged while lying face down on the massage table.

Don’t be afraid to ask the massage therapist for a tissue or moist facial towel, similar to the towels shown in the photo. If you already know you “might” fall asleep and drool…  ask for the extra fresh but dry towel at the start.

4) Will the therapist be there when I undress?
In North America, the massage therapist should leave the room so that you can remove your clothing and lie on the massage table (usually face down) under the top sheet.

If the massage is conducted in a spa, salon or private massage facility, a brief shower is usually required prior to the actual massage activity.

Don’t rush or worry that the massage therapist will walk in on you — the massage therapist always knocks and asks if you are ready before entering the massage room.

5) Should I talk during the massage?
Although some people prefer to talk throughout the massage, don’t feel like you “must” make idle conversation with the massage therapist. After all, you’re having a treatment, you’re not at a cocktail party or a sit-down comedy! Feel free to close your eyes and relax or snooze if you like, which is what most people do.


Deep tissue massage and sports massage are just some of the types of massage that require more feedback from the client. The massage therapist often works on deeper layers of muscle and will want to ensure that the pressure is not uncomfortable yet effective to the intended therapy.

Be sure to speak up if:

  • the room is too hot or too cold
  • the fan is blowing cold air around
  • you experience pain
  • you have any questions related to the massage
  • there’s anything you forgot to mention during the consultation


6) What if I get an erection?
Some men refuse to get a massage because they worry that they’ll get an erection. Or they get the massage but are unable to relax during the massage because of this fear.

But there is no reason to be embarrassed. It’s perfectly normal for men to get an erection during a non-sexual, therapeutic massage. Besides, therapists and massage technicians who have been doing massage activity for any length of time will have encountered and will have seen, up close, just about every kind of body picture you can imagine short of going to the local morgue. For an erection, the therapist will normally ignore the condition and avoid the immediate area, OR, applying a cube of ICE will usually send things back to normal.

A gentle touch administered to any area of the body can activate the parasympathetic nervous system and cause a partial or full erection. Your massage therapist (male or female) understands this and will generally ignore it.

If you’re still worried, you may wish to wear a men’s bikini bathing suit, during the massage, which provides more support than boxers, or wear the well known sports item called a “JockeyStrap” under the shorts.

7) How do I know if it’s a legitimate clinic, spa or therapist?
Although you might think massage parlors that openly offer sensual or erotic massage may look obviously seedy, it can sometimes be difficult to spot these places.

Of course, one generally will not employ investigative techniques to determine if the clinic or therapists are on the “up-and-up”. In this event, you, the client will have to rely on your own “gut feelings”, information obtained from personal friends and other clues that can be obtained by a simple visit. If the spa or clinic “just happens” to be located in an area that is “less-than-up-and-up” you will most likely observe an equally undesirable area surrounding the questionable spa, clinic or “parlor”. Your best bet is to avoid these questionable establishments.

Another interesting means of “checking ‘em out” is telephone the salon, spa or parlor to learn what they “say on the phone” regarding their procedures. Second thing to do is call the local police department to inquire about any recent complaints filed regarding the specific facility or therapist you are researching.

A “visit” may simply be a “drive-by” look-see. If you spot “questionable clientage” milling about the “clinic”, you may have a place that specializes in services not necessarily connected to the ethical massage therapy techniques but more for the $$ it brings into the business. Another clue is: “how many other clinics/massage parlors are there within a couple blocks?” More than two should raise a red flag. The location happens to be within a short distance to a military base, or other higher concentration of potential clients… bus depots, train stations, airports and similar locations are key real estate for “massage parlors”.

If you’re trying a new clinic, spa or therapist, it’s a good idea to call first and ask these questions:

  • Do you offer therapeutic massage?
  • Do you offer erotic or sensual massage?  (only if this is what you’re looking for)
  • Is the massage therapist certified or licensed? (which does not attest to their “skill level” nor ethics. A license by the local city to operate the business, or a school certificate of completion of massage techniques does not mean the technician/therapist is an accomplished massage therapist with good technique and morals combined and a clean reputation.)
  • Do you require a health questionnaire of your clients?

8) The pressure isn’t deep enough, but I don’t want to insult the therapist’s technique. What should I do?
Communicate openly with the massage therapist. Keep in mind however that it’s a myth that massage therapy has to hurt to be effective. The popular phrase of “no pain, no gain” does not fit the ultimate purpose of massage therapy.

Some of the most effective types of massage therapy are gentle and do not involve deep pressure or pain. In fact, too much pressure can cause bruising and muscles to seize up. Here is a good rule of thumb — on a scale of one to 10 where “one” is no pain and 10 is extremely painful, the pressure should always be six (6) or less. 

9) I’m self-conscious about a certain part of my body and don’t want the therapist to see me. What can I do?
People are self-conscious for various reasons. Some of the more common concerns are:

• I’m overweight. Way too much cellulite.
• I have excessive hair growth on my body.
• I have several tattoos that may offend others.
• I’ve got acne on my face or back.
• My feet are ugly.
• I have scars.

Being self-conscious should never keep you from seeking health care, whether it’s visiting your doctor or seeing a massage therapist. If you’re self-conscious about a certain part of your body, you can ask the massage therapist to avoid that area. Or, you can opt for a therapy that is done through clothing, such as shiatsu or Thai massage. Because no massage oil or lotion is used, you can remain fully clothed during the session. You can even bring your own comfortable clothes to wear. Just remember to provide complete and accurate information on your health history form, so that the massage therapist is aware of any precautions or contraindications.

10) I’d rather see a female therapist. Should I request this?
Some men don’t feel comfortable having a massage by a male massage therapist. It may be due to outdated social and media stereotypes of the profession or the fear of getting an erection during the massage.

Erections are a common physiological response that happens when the parasympathetic nervous system is activated by touch anywhere on the body… especially a wide variety of certain erogenous zones that can trigger a partial or full erection. This is a normal, natural, physical reaction to the stimulation and is not considered an open, active perverted attempt to engage the therapist or client in an amorous setting. The therapist will generally ignore the event and usually will avoid the activity that brings on the erections.

As a matter of fact, female clients are not immune from the “erection” anomaly described for male clients. Women who may become sexually aroused during the massage therapy session generally do not “show” their condition as visually obvious as a male counterpart. However, women who experience breast sensitivity resulting in “nipple erections” may have the massage therapist avoid the technique and body area that caused the arousal. 

There are many other visual signs of sexual arousal during a massage session that the therapist may or may not actually see on the female body. Some of these clues are swelling of the genitalia and redness. Similar coloring of her facial cheeks and some reddening of the lower abdomen just above the pubic region. Slight swelling of the mons pubis is a more difficult “clue” to spot but its flesh temperature will be elevated. Another clue is ”shivering” but not from being cold!

Some women also prefer a female massage therapist because they say they feel more comfortable, secure and much less vulnerable.

This doesn’t just apply to massage therapy. A University of Michigan study found that 43 percent of women preferred a female doctor for a colonoscopy. Of these women, 87 percent said they would be willing to wait more than 30 days to get an appointment with a female colonoscopist, and 14 percent would be willing to pay more for being attended by a female.

Unfortunately, men who choose to become massage therapists are often unprepared for the discrimination they face. When clients request female over male therapists, spas and clinics stop hiring males, no matter how skilled they are. It is also noted that female therapists often garner $100 (+) per hour plus travel and other expenses, where, the male therapist would be lucky to get $40 per hour NOT including travel costs if any.

That’s why I believe it’s important to challenge your preconceptions. Here are some tips to help you:

  • If you see other practitioners in the clinic or spa, ask if you could meet the therapist before you book the appointment. Of course, if your booking does not involve a clinic or spa, use your best judgment during the interview with your therapist prior to committing to a confirmed appointment.
  • If this is your “first” massage session, consider booking a massage at a health club, a spa or a clinic, where there’s usually a higher percentage of male and female clientele, staff and the atmosphere is likely to be more “business like” with more “formal” attitudes by both client and staff members alike.
  • You may wish to start with an active form of massage, such as deep tissue or sports massage or a type of massage that is done fully clothed, such as shiatsu or Thai massage.

11) Erotic or Sensual Massage
This is a difficult subject to expound on given the sexually charged nature of the massage session.

In fact, therapeutic body massage techniques “can” include every part of the body… including erogenous zones (body parts or “zones” that can be sexually charged by simple touching or application of massage or stimulation techniques.) A very common, simple “feel good” massage usually involves the Swedish techniques. Smoothing, hands gliding across various parts of the nude body can and usually does invoke sexual stimuli to various body parts resulting in, at minimum, a mild degree of sexual arousal.

Given that the participants in the massage therapy session are consenting adults, it must be assumed that the agreed upon erotic massage session could lead to an unintended sexual encounter or an unlawful outcome of the massage treatment session. This is a condition that the therapist must evaluate very carefully to avoid legal issues.

Generally speaking, an erotic massage will involve techniques that are intended to sexually arouse the client to some level… often, but not always, concluding in an orgasm. Interaction between the therapist and client is highly likely. Here there must be a distinct consent to continue with this kind of engagement. For the legal aspects, it is suggested that the “massage session” be officially terminated. The two consenting adults can then pursue what ever course of action agreed upon where no compensation (money or other monetary value) is offered, asked for, given or accepted.

Be sure to agree with your therapist on “what” is being offered ”first” before booking the appointment.

12) Legal aspects –
There’s an old lawyer’s “saying” that tends to tell the entire story:

  • “… if it ain’t on paper, it didn’t happen.”

That simply means, unless there’s a valid “contract”, “client release”, “consent and agreement”, a witnessed verbal agreement or ”legal document” signed by participating parties. Either party to the activity could be held legally liable for any litigation that may arise.

However, should the client & therapist seek the best protection possible, I would advise them to employ valid consent forms/documents for each session. When in doubt, do a signed contract. If something beyond recognized ”massage therapy techniques” is to come into play, stop the massage therapy session, settle up on any fees. After that has been accomplished you may choose to engage your massage therapist/technician in other matters… like dinner, a movie theater, chocolate, light wine, more chocolate… well, you get the point!

Bill Ford, Founder

For a brief description of 10 or 12 most popular massage “styles” or “types” used throughout the United States and other parts of the world, CLICK HERE to review our Massage FAQs 2.
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About Bill Ford, Founder

Born in the late 30s - you do the math. Lots of life experiences in numerous endevors but not an expert in any that I know of. I'm a fan of challenging projects. When I'm told it can't be done I go ahead and do it anyway. This web site is one of 'em. How long will this web site last? Hard to say. Depends on how long I live. Film at Eleven. --bf
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