Working as a massage therapist in a busy chiropractic office, as well as owning my own mobile medical massage practice, I see a wide variety of clients.

My clients range from ages 5 to 95 and come from all walks of life. I love seeing the beautiful progression of our bodies from infant to elderly, and helping people of all ages experience the healing benefits of massage therapy.

There is one demographic, however, that I notice does not always receive the same attention in many practices: teenagers. In this article, I’ll discuss the benefits and special considerations for working with teen clients.

I personally love to work on teens, because by helping them to take an active role in their health, I inspire the next generation of loyal massage clients. I find that my teen clients have lots of questions and love to learn about how their muscles, nerves and skeletal system all work together in harmony in daily life.

My slogan is “Education gets results,” and I believe that by helping educate younger clients on anatomy, muscle function, stretching and the importance of self-care, we as therapists can have a profoundly positive effect on the next generation.

Drama and Change

There are many benefits to adding teen clients to your practice. The teen years are a period of dramatic physical growth and change for most. From a learning perspective, you will get to experience firsthand how bodies change through the teen years, common imbalances, and what you can do to aid in healthy development.

The teenage developmental years include some of the most extreme physical changes that humans experience in our lives. Physical growth and hormonal changes are incredibly taxing on the body and mind, and massage therapy is an excellent tool to assist in healthy physical growth and to ease the stress that teens find themselves under.

One of the most dramatic and visually apparent reasons for young adults to receive regular massage therapy is that notorious teen growth spurt. Pubescent hormones trigger the skeletal system to grow rapidly until full mature size is reached. In males, this can mean an increase in height of up to 4 inches a year and up to 3 inches a year in females.

Rapid bone growth generally is first seen in the hands and feet, followed by the forearms and shins, and lastly the spine. Males can expect a broadening of the chest and shoulders, while women generally experience widening of the pelvis.

Because the skeletal system grows at such a rapid rate, muscles and their tendinous attachments are placed under heavy stress, unable to match the rate of skeletal growth. Inflexibility and associated pain (often referred to as growing pains) are common complaints I see in my teen clients.

Rapid growth of the tibia and fibula can lead to shin-splint-like symptoms and stress on the tibial tuberosity, the anchor point of the large patellar tendon. Teens who experience rapid growth spurts can expect to have a mildly exaggerated bony anchoring point at the tibial tuberosity as a response to the stress placed on the tendon during this time.

Because of this rapid skeletal growth and the inability of the muscles and tendons to grow at the same rate, the skeleton often does not receive adequate support from muscles, which can cause difficulty in coordination and injury. I use my massage to coach teens on body awareness, proprioception and injury prevention.

Muscular Dysfunction

There are many unique environmental factors that also contribute to muscular dysfunction in the teen years. If you have ever had to carry a backpack full of heavy textbooks, you may have experienced the aches and pains yourself!

Unfortunately, the average teen’s backpack weighs 18 pounds, and can weigh up to a whopping 30 pounds. This is an incredibly heavy burden to carry for hours per day, especially when slung carelessly over one shoulder, as seems to be the universal style for most students. This causes unnecessary strain on the rotator cuff, neck, trapezius and spine as the body compensates for the unbalanced load, leading to neck, shoulder, low-back and spinal pain.

As a therapist, you can educate your clients on proper body mechanics, and coach them to purchase an ergonomically correct backpack with a hip belt.

Another accessory almost no teen will be caught without is a phone. Excessive phone use leads to forward head posture, which places incredible strain on the cervical spine and supporting muscles. Phone use, along with the burden of typing and writing homework and notes, can also lead to forearm, hand and wrist injuries.

Most teens I work on have excessive forearm and thumb tension.

This is a great time to teach preventive stretches for these areas, to help prevent injury later in life.

I had one memorable case in which a 17-year-old boy named Jake* and his mother came to me for treatment for his chronic neck and upper-back pain. His mother told me she was frustrated that nothing had seemed to help Jake, and she was concerned that her son was having so much pain at a young age. Jake was also an athlete on his high school basketball team, and the pain was affecting his ability to play.

While I spoke to her and filled out paperwork, I noticed Jake was looking down at his phone the entire time, with extreme forward head posture and exaggerated curvature of the cervical and thoracic spine. I asked roughly how much time he spent per day in this position and he estimated almost four hours.

In our session, I focused on demonstrating a healthy range of movement for his neck and showing him areas of tension. I worked on relaxing the overstressed muscles of his posterior neck and thoracic spine, and bringing length into the tight muscles of his chest and anterior neck. Afterward, I coached him on proper body mechanics and the importance of stretching to prevent muscular dysfunction.

When we ended our session and came back to the waiting room, his mother gasped and said, “Jake! You’ve grown three inches taller in an hour!” His posture had been so poor that she had no idea how tall he was. I’m happy to say that Jake is now pain-free and a faithful massage client.

Emotional Stress

The teenage years are physically challenging, and can also be incredibly stressful from an emotional and social standpoint. Many of my teen clients will express that they are uncomfortable with how their bodies are developing and harbor a deep fear that their body is not normal somehow.

I find that a massage session is an excellent time to help teens build body confidence. I take the time during our sessions and consultation to stress the amazing beauty, function and complexity of the human body and to reassure my clients that such concerns are perfectly normal.

Massage therapy is also an excellent way to teach teens about safe, consensual touch and about setting boundaries for themselves. I encourage my teen clients to stay in communication with me during our sessions, and to let me know what they are feeling in regard to pressure and comfort at any given moment.

I stress that this is their time, their body, their boundaries, and I am here only to assist them in healing and relaxing. Communication is our strongest tool as therapists; its value cannot be underestimated.

Special Considerations

There are some special considerations to take into account when taking on teen clients. Intake paperwork will vary based on your local laws and personal preference, but all children under the age of 18 are required to have parent or guardian consent prior to receiving massage.

Each of my initial sessions consists of intake forms and consent to treatment, a consultation and evaluation, a written and signed detailed description of the services to be rendered, and a follow-up contact the next day. Your initial consultation is a great time to offer a complimentary postural and scoliosis screening.

I always offer the option to the parent or guardian to be present in the room during our session. Some parents like to be present to ask questions during their child’s treatment, while others prefer to give privacy. Likewise, some very shy teens are more comfortable with their parents present, while others prefer the privacy of a solo session.

Be prepared to be flexible with your techniques as well, as some teens may not feel comfortable fully disrobing for their sessions. Modalities can be modified for even the fully clothed client with very little effort, and my clients’ comfort, trust and relaxation is of the utmost importance.

Build a Teen Clientele

You can attract teenage clients to your practice and introduce them to the valuable benefits of massage therapy. Targeting parents is often the most direct way of bringing in a younger clientele. Contacting the PTA or Facebook group for families at your local high school can be a great tactic. Offer to give complimentary chair massages and have a brief sales pitch with educational materials or brochures prepared at the group’s meetings. This is one of the most effective methods I have found to build a teen clientele.

To target teens directly, you can also contact high schools in your area and offer to speak in health or gym class about the benefits of massage therapy. I spoke at a local high school to three separate classes, during which I gave a live demonstration of a fully clothed sports massage with assisted stretching. The response was overwhelmingly positive, with a lot of questions asked, and the participants were interested and engaged.

It can also be beneficial to establish a referral partnership with local physicians or sports clubs in the area. I also advertise a military, police and student discount of 20% off. A small discount like this will have very little impact on your take-home earnings, yet helps show appreciation for your clientele.

The Next Generation

The most important thing to remember is working on teen clients provides you an unparalleled opportunity to spread awareness of massage as a preventive and complementary therapy. By establishing a safe, trusting relationship with your clients and educating them on the importance of caring for their amazing bodies, you create the next generation of healthy, happy massage therapy fans.

* Client’s name has been changed.

About the Author

Rachel Peterson, LMT, is a practicing massage therapist, specializing in therapeutic, rehabilitation and medical massage therapy. She graduated from the Arizona School of Massage Therapy in 2014, after which she opened her own practice. She is a strong advocate for teaching healthy touch and educating people about their bodies, and how to heal themselves for lifelong results.

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