Massage Client Comfort

How to Make Massage Clients More Comfortable

Client comfort can make or break a massage experience. If a client is uncomfortable during a massage therapy session, they will not be eager to schedule another appointment or refer their friends. This is true even if the therapist uses good technical skills, is professional, offers affordable services, and helps the client with their problem. Client comfort is what ties it all together, and is something that all clients expect.

What does it mean to be comfortable? Being comfortable is the physical and mental state of being at ease. It is a feeling of security, and being free from stress and anxiety. Creating massage client comfort comes down to creating a calming physical environment that minimizes physical and sensory stressors, and enhances mental well-being.

This article looks at some specific things that professional massage therapists can do to make their clients as comfortable as possible. Increasing client comfort not only creates an amazing client experience, but it increases your likelihood of repeat business and referrals. And it can enhance each massage session to help clients reach their treatment goals.

Why is massage client comfort important?

Most massage clients will keep changing therapists until they find one that they want to stick with. The goal of this article is to look at different aspects of a typical massage that relate to client comfort, so that you can create a better client experience. You want to make sure that your clients keep coming back, and don’t feel the need to keep searching for another massage therapist. Increasing your amount of repeat customers and client referrals is the fastest way to grow a massage practice and ensure a consistent income.

Making sure that your clients are comfortable not only creates a better client experience, but it can improve client outcomes. A recent study in the Journal of Ergonomics examined the role of psychological and physiological processes in comfort perception. Comfort has traditionally been measured in research studies by assessing a participant’s autonomic nervous system activity when exposed to an environmental stressor such as noise, harsh lighting, vibrations, or uncomfortable air temperature. Increased activity of the sympathetic nervous system (SNS), and decreased activity of the parasympathetic nervous system (PSNS), are considered to be indicators of discomfort (stress response). By creating a comfortable massage experience, you are increasing the positive effects that your massage will have on the client. This applies whether your primary outcome is mental relaxation, or to create a physical benefit such as reducing pain or muscle tension.

Massage Client Comfort on table

Physical and psychological client comfort

A client’s level of comfort is influenced by physical and psychological stimuli. For example, a client’s psychological comfort will be influenced by how he or she feels. Does the client feel safe? Confident? Upset? A client’s physical comfort is influenced by external stimuli that they encounter before, during and after the massage. These stimuli affect one of more of the five senses:

  • Touch
  • Visual
  • Smell
  • Auditory
  • Taste (if providing food or drink)

The results of any physical and psychological stimuli that your client experiences will either support your therapeutic effect and progress towards treatment goals, or work against them.

Many massage clients, especially first time clients, can feel uncomfortable during their first appointment because they are anxious and don’t know what to expect. For a client to be comfortable while lying on a massage table, which is a pretty vulnerable position, they must have a sense of trust and confidence in the therapist. Massage therapists can increase their clients’ trust by demonstrating professionalism at all times. Components of professionalism that therapists should always demonstrate include competency, neatness in appearance, compassion, confidence, good communication skills (including body language), respect for others, reliability and integrity.

You can also establish client trust and confidence in you by building rapport with your clients. Techniques to build rapport include using good communication skills such as asking good questions and active listening. One of the most important things that you can do, especially with new clients, is listen to them and make sure they feel heard. Understand what brought the client in to see you. Then make sure that your massage session addresses their needs. All of the table warmers and bolsters in the world won’t make a client comfortable if the therapist is not providing treatment that focuses on the client’s problem. Developing your rapport building skills will not only enhance therapeutic relationships, but it will help you when it’s time to promote your massage practice.

It is also important to explain what to expect during their massage or bodywork session. This is especially important if they are a new client at your practice, have never had a massage before, or if they are trying a new service that you offer. Anxiety and hypervigilance tend to creep up a little for anyone who is in an unfamiliar place. This is why most people have a hard time sleeping when they are in a new place. So be sure to give all new clients a tour and orientation to your facilities.

Make sure you explain your draping policy to new clients, and provide clear instruction about how they are to prepare for the massage. For example, after a client assessment and before you step out of the room, say something like, “Undress to your comfort level and then lie face down on the table, under the sheet. You can place your clothes and jewelry [here]. I will wash my hands and be back in 2-3 minutes. I’ll knock before I enter. Do you have any questions before I step out of the room?”

Smooth transitions and position changes

One way to increase client comfort during the massage is to ensure smooth transitions. This means providing a smooth and seamless transition when changing strokes, such as when transitioning from petrissage to friction or tapotement. It also means making sure that your transitions from one area of the body to the next are seamless and logical. The point is to make all transitions predictable to avoid any drastic and jarring changes that could stimulate a startle response in the client. *Abruptly changing to a different stroke, rhythm, amount of pressure, or area of the body is not relaxing.

When considering smooth transitions and the natural and logical flow of the massage session, also consider the client’s position changes. Normally it is ideal to minimize the number of times that the client has to turn over. This is an effort for the client and can pull them out of a state of relaxation. Turning over on a narrow massage table can also be very difficult for an elderly client, and painful for a client with back or shoulder pain. That being said, there are times when a position change is welcomed. For example, a client that gets increased sinus pressure when lying in prone may look forward to turning over. Massage therapists should create their massage plan for the individual session after discussing with the client about their current needs.

Aromatherapy massage essential oils

Learning your individual client’s preferences

The more you know and cater to your client’s individual preferences, the more comfortable your clients will be. Understanding these preferences turns a cookie cutter massage service into a customized client experience. This makes it more likely that you will help them meet their treatment goals and exceed your clients’ expectation (and get repeat business!).

The best place to start learning about a new client’s preferences is during the intake process of their first appointment. You can add questions about specific preferences right on the massage intake form. Or you can create a separate form that asks questions about client preferences. The second option here may be better because most intake forms are pretty full already, and you could use a separate form as a survey to give to current clients as well.

You may also want to ask certain questions verbally during their intake process or first session. Verbally asking a client about their preferences will do more to build connection and rapport than just having them fill out a form, which can feel a little cold and corporate. Asking questions verbally gives you an opportunity to dig deeper into their answers if needed. Just be sure to document their responses so you will remember them for their future visits. You can also combine these approaches by having the client complete a written form, and then talk about their responses. This will ensure that you don’t forget to ask something important. Choose the method that works best for your practice.

Some of these questions can be open-ended, which means that you would just leave some space for them to write in their response. For other questions, it is better to ask a close-ended question. This would be a yes/no, or a list of items to select from. Remember that these are questions about preferences related to comfort and enjoyment. Questions about safety and health issues such as allergies and fragrance sensitivity should already be on the client intake form or medical history form. A few of the most important preferences that you’ll want to ask about include:

  • Have you had a professional massage before? yes no
  • How long has it been since your last massage? ______________________
  • Please, tell me about your best and worst massage experiences. ________
  • Preferred amount of pressure (light, medium, firm)
  • Are you able to lie comfortably on your back and stomach? yes no
  • Do you prefer massage oil or lotion? (circle one)
  • Would you like the table warmer on? yes no
  • Would you like a blanket during your massage? yes no
  • Do you like to listen to music during a massage? yes no
    If so, what kind? _______________________________________________
  • Do you prefer scented or unscented oil/lotion? (circle one)
  • Do you have favorite essential oils scents? yes no
    If so, please list: _______________________________________________

If you do not plan on offering something, then it’s best to not ask about it. For example, if you only use massage cream or lotion, and do not want to use oil, then skip the question about this preference. Or you may need to use oil for the type of massage that you offer. If a client asks for an essential oil that you don’t have, you may want to consider getting it for their next appointment. It’s a small price to pay and may help you to win a long-term client.

Take your client’s preferences seriously. A particular preference may seem trivial to you, but it may be a big deal to your client!

In addition to asking new clients about their massage preferences before their first appointment, it is also helpful to follow-up during and after their appointment too. These are opportunities to confirm the client’s previous responses, and show that their preferences are important to you. A client that has not had a professional massage before is often just guessing about what they like. They may have thought they wanted heavy pressure, but actually prefer light or medium. Also, what the client considers to be light, medium or firm pressure may be different from your perception. A brief exit survey after a new client’s first appointment will help you make their next appointment even better.

Portable massage table with blue fitted sheet

Start by getting a quality massage table

With the exception of a massage therapist’s hands, forearms, elbows and the knowledge to skillfully use them, a high quality table is a massage therapist’s most important tool. What should you look for in a quality massage table?

  • Good padding. This feature of a massage table is the most relevant in a discussion of client comfort. A quality table will have thick padding that supports the client’s weight without having them “bottom out”, as the cushion compresses.
  • Functional. In other words, your massage table should fit its intended use. It may be that you need a lightweight table that fits easily in your car and is easy to transport. Or maybe you need a larger table that is strong enough to support additional weight when providing ashiatsu massage. Or maybe you need a lift table or a tilt table for the type(s) of treatments you plan on offering. Choosing the right type of massage table for your practice is important.
  • Versatile. Most therapists offer more than one type of massage and work with clients of all sizes and shapes. A good table will be adjustable and versatile to meet all these needs.
  • Safe.The table needs to have a high enough “working weight” so that it can be used safely. Most quality massage tables have a working weight of 500-600 pounds.
  • Easy to adjust. The height of a massage table needs to be easily adjusted. If it is a hassle, then you may not adjust it when you need to. This will effect your ergonomics which will result in more fatigue and a greater risk of injury to you.
  • Quiet. A comfortable massage table is one that is silent. No squeaking or creaking during the massage. An electric lift table should also be quiet as it is being raised and lowered.

If a used massage tables or even a new table needs more cushioning, this can be easily fixed by adding a table pad or memory foam topper. Do yourself a favor and skip the cheap egg crate foam. The extra cost of a good pad is insignificant compared to the benefits of keeping your clients comfortable. Make sure that it fits your table well too. Be sure to cover it with a table cover that can be sanitized between clients. Plus, the oil, sweat and smells will ruin the pad quickly if it isn’t covered. However, if you provide mobile massage services, lugging around an extra table pad and warmer is probably not worth it. Especially if you have to carry your massage equipment very far or up steps (and you don’t want to make two trips!).

Get the best face cradle you can (and adjust it correctly)

One of the most important accessories that a massage therapist needs, in addition to a good table, is a good face cradle and cushion. The face is one of the most sensitive areas of the body. If the client’s face and neck are not comfortable, they will have to adjust their position periodically to relieve the pressure. This takes away from the relaxing massage that you are providing.

A good face cradle will evenly support the client’s head while in prone without creating pressure points on their forehead, cheeks or jaw. The average human head weighs about 11 pounds, so the face cradle must provide secure and comfortable support or else the client’s neck muscles will tighten up. A good face cradle should also be able to tilt up and down, and be elevated or lowered (cervical protraction & retraction). It is ideal to be able to quickly and easily make fine adjustments while the client has their face on the face rest. The cradle frame and the adjustment knobs should feel sturdy and not flimsy.

*Keep in mind that a face cradle made by one manufacturer may not fit the holes in a table made by a different manufacturer. So be sure to take some measurements, read the product description, or ask the supplier about compatibility.

A correctly adjusted face cradle positions the client’s cervical spine in a neutral and comfortable position. Too much extension can compress the suboccipital region and make it difficult to access the posterior neck muscles. Too much flexion will be uncomfortable too. The cushion needs to be soft but supportive. You can always add a fleece, memory foam, gel or other type of face cradle pad for additional cushioning. Just make sure it is able to easily be cleaned between clients.

Provide comfortable positioning and good limb support

Bolsters and pillows are commonly used table accessories to provide extra cushioning and support. They take stress off the joints, and relieve pressure and stress points to further increase client comfort. Bolsters come in different shapes and sizes. Examples include: round and half-round leg bolsters, cervical bolster for supine and side-lying, angle or wedge bolster, breast pad, arm supports, rectangular bolster, and more. These cushions come in different lengths, sizes and densities.

The most commonly used bolster in massage therapy is the round or half-round bolster to use under the client’s knees when supine. This relieves pressure on the back, sacrum, knees, and heels. It also reduces tension in the leg muscles and behind the knees, and improves circulation in the lower legs. This bolster is repositioned to be under the client’s ankles when in prone to relieve pressure at the ankles, knees and feet. Personally, I like the half-round better than the full-round bolster for the legs because for the same height, the half-round provides a greater contact area to disperse the weight of the legs better. Other common examples of how pillows and bolsters may be used during massage include:

  • Pillow under the chest for clients with a large abdomen (prone)
  • Pillow under the abdomen or pelvic region for clients with lumbar stenosis (prone)
  • T-wedge to relieve pressure at the breast area (prone)
  • Cervical pillow or towel roll to support the C-spine (supine)

The bolster should always either have a washable fabric cover, or be placed under the fitted sheet on the table. Cold vinyl against the skin is not very comfortable! *Even though the bolster doesn’t touch the client’s skin, it needs to have a cleanable surface and be sanitized between clients, just like the table. Fabric is not an effective barrier for sweat, smells, and germs.

Make sure to select the right size bolster for your client. A smaller diameter bolster will typically be more comfortable to a shorter client, but it is always a good idea to get feedback and document it for future sessions. It’s also a good idea to have a few different types and sizes of bolsters on hand so that you can accommodate various body types, sizes and preferences.

Arm rests are available for most massage tables. Therapists can attach a front arm shelf or sling at the head of the table, under the face rest, to provide clients with an option of where to put their arms while in prone. There are also bolsters that attach to the sides of the table to extend its width and support larger client’s arms in prone or in supine.

Keep the client at a comfortable temperature

Massage 101 teaches us that we must keep the client at a temperature that is comfortable to them. This will help them to relax on the table and is conducive to producing a therapeutic effect with your massage or bodywork. Their preferred temperature may change from visit to visit, or during a single massage session. A client coming into your massage office when it is especially hot or cold outside may take some time to adjust to the temperature in the massage treatment room.

It is ideal to be able to quickly adjust the temperature for a client on the table without changing the temperature of the entire room. This can usually be accomplished by adding or removing a blanket, or by adjusting the table warmer. The extra weight from a blanket, even a light one, also contributes to client comfort because it can make them feel more secure. A strategically placed fan can also be helpful. Sometimes it is just a certain area that the client complains of being hot or cold. Cold feet for example, can be warmed with additional covering, large heated stones (near the feet), or a hot pack. Friction massage technique can generate heat quickly, but only temporarily and in a small area of the body (it is not practical to attempt to use friction to heat the entire body).

Some massage modalities such as hot packs, cold packs, hot stone massage, and ice massage may require you to make further adjustments to keep the client at an overall comfortable temperature. Just make sure to periodically ask the client about their comfort and make sure that they know that you appreciate their feedback. And even though client comfort is important, you still need to be able to work comfortably, especially if you provide multiple massages per day.

Use smooth and soft massage sheets

Nice, clean massage sheets are an important component of a client’s massage experience. A good sheet set will enhance client comfort and provide a secure physical boundary. Massage therapists have many options to choose from including flannel, cotton-poly blend, 100% cotton, and microfiber. Microfiber sheets have a smooth and silky texture, are durable, resist stains, and are a popular choice. They are also more compact so you can fit more in your washer, and they dry faster than flannel. But each material has its pros and cons. Quality massage sheets need to have several characteristics including:

  • Durability to withstand frequent washing without breaking down or pilling
  • Should resist oil stains and not retain smells (wash within 24 hours of use)
  • Should be smooth, soft and comfortable to the touch
  • Thick enough to provide some warmth

The bottom fitted sheet needs to fit securely on your table without coming loose when the client turns over. A sheet set that is designed for a massage table will fit more snugly, especially if you have a wider table or use a table pad. But if it is too tight, you may have trouble sliding the bolster under the bottom sheet. The top sheet needs to stay securely in place as you adjust the draping.

Make sure your massage room smells great

How your massage office smells is one of the first things that your clients will notice when they walk in. Creating an office and treatment room that smells great starts with making it as clean as possible to remove the source of any offending odors. This can be as simple as wiping down surfaces between clients and removing trash from the break room daily. Or you may need to address a bigger problems like old/dirty carpeting or mold and mildew issues. Some natural cleaning products such as baking soda or vinegar help to neutralize odors.

Once your office is thoroughly cleaned, you can enhance your clients’ experience even more by using their favorite scents. This can be delivered through the use of essential oils, candles, or other methods. An essential oil mist diffuser can quickly create a pleasing aroma throughout a room. There are several other ways to deliver essential oil scents without a diffuser:

  • A few drops on a cotton ball or tissue, placed near the head of the table or air vent
  • A spray bottle with water and small amount of essential oils
  • A diffuser necklace attached under the face rest
  • A reed diffuser
  • A tea light essential oil warmer, or an electric EO warmer

*Tip: try not to overdo it with the scents. It is ideal to deliver the scents in a way that can be removed easily, since the next client may not like that scent.

Massage therapists must also be mindful of how their hands smell before massaging the client’s face. This is especially important if you have been using aromatherapy massage oil for the rest of the body, or if you just finished working on the client’s feet!

Make sure the face cradle and head of the table is cleaned thoroughly between clients. This is not only for sanitation reasons, but to remove any smells from the previous client (e.g. cigarette smoke smells), since this is the area that the next client is most likely to pick up on scents. *Tip: if you use a rolling stool, don’t keep it under the client’s face rest when you’re not using it. People don’t want their face to be inches from where someone sits during a massage!

*The sense of smell is more closely linked to memory than any of our other senses. So make sure to give your clients a pleasant smelling experience to remember.

Design a visually appealing ambience

Designing an attractive massage room that is inviting and calming is a great way to help make your clients comfortable. It is important to carefully select your furnishings, lighting and decorative touches to create an ambience that appeals to your clientele and enhances your treatment sessions. Neutral, earthy tones tend to be the most relaxing. Materials such as fabrics, wood, wicker and stone will create a warm and natural vibe. While modern design elements such as metal and glass create a colder atmosphere, similar to a stressful office building.

Lighting also makes a huge difference in a room’s ambience. “Warmer” light colors contain more red, orange and yellow tones. These tend to enhance relaxation more than “cooler” light colors which emit more blue light frequencies which stimulate alertness. Some clients may prefer the room to be darker or lighter than normal. So it’s a good idea to have adjustable lighting. You can accomplish this with either a dimmer switch, or by having multiple lamps. A small towel can also be placed over the client’s eyes when in supine if they are particularly light-sensitive (e.g. suffering from migraine).

Try to avoid fluorescent lights, whether in the tubes or compact fluorescent lamps (CFLs). Although energy efficient, they contain toxic materials (mercury and phosphor), they emit harmful UV light, they flicker and can produce an audible buzz or hum, and can irritate light-sensitive people. The blue light in fluorescent and LED lighting can also produce phytotoxic effects. A better alternative is an incandescent light bulb which produces light that is the closest to natural sunlight. Try to avoid overhead lighting too, which will be in the client’s eyes when supine.

An ideal massage room should be large enough for the therapist to move around all sides fo the table freely, and provide the client with a seating area and plenty of room to get dressed. A room that is cluttered or too small may make some clients feel claustrophobic.

Create a relaxing auditory experience

Having a quiet space is important when you’re trying to create a tranquil and relaxing experience. The sense of hearing is especially important for a massage client lying down with their eyes closed. Creating a completely soundproof room is usually cost prohibitive and unnecessary. But minimizing outside noises, and drowning out unpleasant sounds can dramatically improve a massage experience.

The best place to start is by selecting your office space carefully. If your massage room is in a gym and you share a wall with the weight room, then all of the noise reduction strategies in the world won’t eliminate the sound of clanging plates. Same thing with setting up your office on a busy road. This is great for marketing, but it creates some additional challenges when trying to create a quiet treatment room.

If you’ve already established a good massage office, there are some strategies to help reduce any distracting noises without breaking the bank. Some of these strategies are easier to implement if you own the office space or have a long-term lease and an agreeable landlord. Here are a few cheap and quick strategies that most therapists should be able to implement:

  • Seal the gaps around any doors and windows to reduce exterior noise
  • Post a Quiet Please” sign or two to make sure people remember to be considerate
  • Add sound absorbing panels, curtains, furniture or area rugs to reduce echos
  • Drown out distracting sounds with music, a fan, or a white noise machine

Some clients are uncomfortable with silence and prefer chatting while on the table. For these clients, let the client lead the conversation. Try to stay on any appropriate topic that the client is interested in talking about, and avoid steering the topic back to yourself. Other clients prefer silence.

Ensure an overall feeling of cleanliness and professionalism

No matter what type of massage or bodywork you provide, your clients expect your entire office and treatment room to be sparkling clean, relaxing and professional. The overall feeling that a client gets when walking into a massage business and then into the massage room has a big impact on their impression of your business.

A massage room should look, smell and feel clean. I don’t mean it should have a lingering smell of disinfectant, or a spray bottle of cleaner left out. But it should be obvious that it was cleaned thoroughly before the client enters. This is especially important these days since people are more conscious (some are even fearful) of germs. Let the client know that you wash your hands before every massage too. For most of us, receiving a massage from someone while wondering if their hands are clean is not a relaxing experience.

This will benefit you as well. Spending several hours per day in a nice environment will increase your own comfort and work enjoyment. And a happy and comfortable therapist is more likely to create an awesome client experience than a therapist who does not enjoy their work setting.

Increasing client comfort before and after the massage

The client experience begins when the client arrives at your business and ends when they leave. The time before and after the actual massage also contributes to the client’s comfort and experience with you. In fact, research shows that people primarily remember the beginning and the end of an event due to the serial position effects such as the primacy bias and the recency bias.

The primacy bias is the tendency to remember the first piece of information that we encounter better than the information that follows. This also applies to our memory of events in life, such as an experience at a massage business. This is the why ‘first impressions’ are so important. The recency bias is the reason why people tend to remember what has happened most recently, or at the end of an event. By making sure that the massage session and checkout experience is remarkable, you will increase the chances that the client leaves on a positive note. This also improves your chance of getting a favorable review and repeat business.

Tips to increase client comfort before the massage:

  • Make your waiting room as relaxing as possible
  • Have a streamlined intake process
  • Demonstrate confidence when introducing yourself and during client assessment
  • Provide a convenient place for the client to place their belongings
  • Give each client a good orientation to the office

Tips for maximizing client comfort after the massage:

  • Provide the client with a comfortable place to get dressed
  • If you have a large office, make sure the way back to the front desk is easy to find
  • Give clear client education or instruction for self-care if needed (e.g. stretches, exercises)
  • Have a frictionless checkout process
  • Offer some available treatment times for their next appointment

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