Three common problems often confront beginning and advanced therapists. First, many therapists fall into a rut by performing the same routine on every client. The second is not accurately listening to what the client needs. The third is not being in a neutral, healing space during the session. By avoiding these three pitfalls, therapists can go from good to great!

Vary your session to suit your client
One of the common occurrences for massage therapists is getting into the habit of performing the same routine on every client. Even therapists who have studied multiple modalities often have a tendency to perform the same routine, especially if the client offers no specific ailments to be addressed. Every client deserves a treatment that is designed to suit him or her specifically. Creating a unique session for each client is achieved through both technique and evaluation. The therapist must have a variety of different techniques that they can use on their client. These may include; Deep Tissue, Neuromuscular Therapy, Lymphatic Drainage, Cranial Sacral, Reflexology, Myofascial Release, Polarity Therapy, Ayurvedic Styles, Energy Work, stretching and more styles- with Swedish massage being the foundation of most work. If the therapist lacks experience in modalities other than Swedish, they can still enhance their work by varying the technique. For example a therapist can use faster strokes for an energizing massage, slower strokes for a sedating massage, or slower strokes and more pressure for a penetrating, muscular massage.

Even with therapists who know many techniques, it is still possible to fall into the trap of performing the same routine on everyone. This is where the ability to assess each client is essential. Assessment is the most important part of giving a unique massage to every client.
Sometimes clients are used to jumping on the table without any evaluation. In this case the therapist will need to educate the client by letting them understand that you can help them more by taking a few minutes to first evaluate them in whatever way you know how. I recommend the evaluation be something that happens before you begin the massage session. In this way you can create a complete treatment plan prior to starting. Additionally, performing the evaluation first communicates to the client that massage can do more than offer simple relaxation or stress relief, and helps to increase the professionalism of our entire industry.

One modality that offers a unique method of assessment is Polarity Therapy. The Polarity practitioner compares the pulses at the ankles and neck. The pulses should be balanced top to bottom and side to side. From this evaluation the practitioner can determine what mode of touch to use- light, penetrating or stimulating, in Sanskrit called Satvic, Tamasic and Rajasic. The entire session would be performed using that specific quality of touch, and at the end of the session the pulses are revaluated for balance.
Ayurvedic Medicine also contains useful evaluation techniques for the massage therapists. Ayurvedic practitioners evaluate clients based on their body type and general nature- called their Dosha. The three Doshas are Vata, Pita and Kapha. Once the client’s Dosha is determined there are a number of techniques that the practitioner can perform to balance that Dosha. Ayurveda is different from western massage modalities in that the primary focus is on using substances such as herbs and oils, to treat the person. In Ayurveda, the practitioner giving a massage would use different oil for each Dosha, as well as a different mode of touch.

Western massage modalities tend to classify what clients need according to their condition. Clients that feel fine and just need to relax receive Swedish massage. Those with injuries receive deep tissue and neuromuscular styles, and those with long-term postural distortion or lingering injuries receive myofascial release. If the client has edema, or a suppressed immune system, lymphatic drainage is the technique of choice. Headaches, injuries to the head and neck, or clients that feel scattered, often receive cranial therapy. Of course these are generalizations and there are many other modalities. The point is that western styles, we use different modalities to treat the client, while eastern styles tend to use the same techniques in a different way on each client.

Consequently, clients that come in with no specific injury can still receive a massage tailored to their needs. If the therapist knows some myofascial release, they could evaluate for fascial restrictions before the client gets on the table. Some structural bodywork styles like deep tissue or Neuro-Muscular Therapy include evaluation techniques based on range-of-motion tests, postural evaluation, or resistance tests in cases of pain. Therapists with this type of training can use these evaluations on every client, not just the ones with injuries or pain. In this way the therapist can better serve their clients.

Another very simple way to give your client a unique session is to ask yourself (or your client) whether they need the massage to be energizing, sedating or penetrating. This follows the three modes of touch from Polarity Therapy. From here you can adjust your work during the session and stay away from giving the same routine to each client.

Listening to your client
The second pitfall is in not asking, hearing, or acting on what the client needs. I have experienced again and again therapists, who after hearing my list of specific aches and pains, proceed to give a general sequence that address everything equally. Listening skills are not often taught at massage schools, but are one of the most important parts of being a successful therapist. The first step is to ask your client if they have any specific needs that they would like addressed. Then the therapist should repeat verbally back to the client what they heard. This is as simple as saying- ”So your lower back is a little sore, your left wrist hurts when you open jars, and your neck feels tight on the right. Is this correct?” Second, as discussed above, evaluation techniques should be performed to get a deeper picture of what is going on. During the session, therapists should address the client’s needs first- i.e. work on the wrist, neck and lower back first before moving to other areas. Many therapists always start in the same area, no matter where the client needs work. By working on the areas that the client has requested, or the evaluation has revealed, the therapist demonstrates that they have heard what is needed and are immediately addressing the client’s needs. This lets the client know that you heard them. General relaxation techniques should be applied only after the client’s specific needs have been addressed.

Maintain a healing presence
The power of massage is a mixture of technical ability, anatomical specificity, and healing presence. Many therapists focus on learning technique, and forget that their peaceful presence is equally important. This explains why some practitioners who have only basic Swedish training, are ‘better’ than some practitioners with thousands of hours of training. The missing link is the healing presence. For example, if you tend to think about other things while giving massage, spend time during a session talking about your life to your client, or find yourself only able to perform vigorous, fast massage, you may need to work on your healing presence. Whenever the massage is more about you than your client, then you know there is room for improvement.

How do you foster a healing presence? The first step is slowing down internally. This can be accomplished by performing yoga, tai chi, meditation, quiet contemplation, or anything that allows you become calm. The second step involves creating a healing space within yourself that the client can resonate with. When the session is in progress, your job is to be totally loving, expansive and gracious- and to hold the possibility of the clients’ highest potential. Presence is a feeling-state. When the therapist enters it the client can feel it and will respond on an unconscious level. This state of being is healing for the therapist as well as the client, and is one of the main reasons why people like giving massage. Healing Presence is a feeling that is hard to describe, but most massage therapists know it when they are in it.

It takes work to maintain a healing presence with every massage. Carrying on conversations during a massage diminishes the amount of healing presence that you can bring to the session. Under these conditions both therapist and client lose out. Make sure that you have people that you can talk with outside of work, so that your clients don’t have to fill this need.

Maintaining a healing presence, listening to your client, and varying your sessions to match each client’s needs are three ways that you can keep your work powerful and effective. These fundamental skills may not be taught in all massage schools, but are the foundation of every great massage. Where can you improve?

About Sean Riehl
Sean Riehl is the author of the videos Deep Tissue and Neuromuscular Therapy, Myofascial Release, Lymphatic Drainage, Heal Your Wrist Pain and Anatomy and Pathology for Bodyworkers. He has been a presenter at the AMTA CA convention, written articles for Massage Magazine, and has been teaching massage since 1993. He is the president of Real Bodywork. Real Bodywork has produced over 20 educational massage videos.

Put this by the video ad next to the article- In order to help therapists break out of their routines, Real Bodywork has created the Integrative Massage series that includes multiple modalities in three different routines.