Features Patient Care Practice
Being aware of anxious massage therapy clients

For some clients, previous negative outcomes from massage treatments, chronic pain, muscle guarding and unexpected triggers can be the root of anxiousness. Here is how we can professionally and delicately treat a weary client.

Sign up for our once-weekly newsletter to get the latest research, news, and events sent straight to your inbox!

Scenario one:
In the first (admittedly naïve) year that I opened my massage clinic, I had a regular client who simply dropped off. I didn’t follow-up, assuming life had become busy for her, and she would dutifully book again when feasible. What I didn’t know then (and what I would learn a full year later) was that during her last treatment with me, her father died. He died at home while she was on my massage table, enjoying herself. She had finally given herself permission to “take care of the
caregiver.” She had been at her dad’s side for months, providing palliative care in between home-care nurse visits, until that moment.

My client wasn’t necessarily afraid to get a massage again, but there was an undeniable association with her father’s death and massage, knotted into one memory. Certainly, my client isn’t alone in experiencing guilt for self-care and the unfortunate, coincidental outcomes from making such a decision. How many people indulge themselves in a massage, only to learn that something terrible and unforeseen has happened in that one-hour time span?

Of course, there is no preventative measure for this. Instead, an awareness. How do we respond to the aftermath of this type of situation? How do we tailor a treatment application to ensure a positive outcome for an individual whose association with massage has been tainted by a life-changing event?

Scenario two:
I had heartburn, really debilitating heartburn for a year and a half. I tried everything from old wives’ tales that praised licorice and slippery elm tea, to baking soda, chewing gum, and vinegar before giving in to a steady feed of western medicine’s solution: Dexilant. I gave up coffee (but not red wine) and, subsequently, had to give up receiving massages too. I booked my usual 90-minute treatment and had to self-talk and sweat my way to the end. I have never counted the minutes to the end of a massage, but I couldn’t wait. I couldn’t even entertain the thought of another massage for nearly two years because I remembered how I felt that day so vividly. As a massage therapist, I knew it wasn’t fair to end the treatment (even though clients have that right), and I didn’t communicate my struggle to get comfortable. Sound familiar?

So, we must better accommodate clients in a similar situation. For clients who have had a painful outcome from a previous massage, we need to ensure that they communicate their discomfort. For those who may have finally booked a massage in hopes of relieving migraine tension, but walk away with amplified symptoms, we should suggest that this is not the norm.

What can a massage therapist do for clients with pre-existing conditions that can make a session intolerable? What are some temporary alternatives when hands-on care is contraindicated? Or, simply uncomfortable?

Sure, there are shelves of self-help books on mindfulness. There are apps like Woebot that have been designed to nurture anxiousness. (These artificial intelligence therapy chatbots use cognitive behavioral therapy techniques
to understand your thoughts and reactions.) The Headspace app helps track your meditation minutes, while
calm.com monitors mindfulness, meditation and sleep patterns. But, there’s no app for massage therapists who find themselves in these scenarios.

Michelle Simian’s Lemon Water podcast, her “auditory journal of inspiration, empowerment and wellnesss” confirms that “it all starts with a glass of water.” For instant, accessible lessons on intentional therapeutic vibration, Chinese medicine, intuitive eating and the power of manifestation, the podcast is a wealth of intel for therapists and clients alike.

Maybe there are no definitive answers or tidy solutions for these (and other) scenarios. Clients will never present themselves in tidy, uniform packages. Creating even tidier, successful fool-proof treatments, individual alternatives and follow-up is our greatest challenge. While a client may be afraid to seek treatment, it’s easy for therapists to be afraid to step outside of textbook suggestions, too. Just like the ever-changing approach to diet and fitness, adapting and evolving in step with new trends and modalities is paramount. Consider exploring resources that were once foreign to you, like podcasts. Better yet, gather your favourite crew of colleagues, host a meeting and chat about this scenario for continuing education units, and let us know what you come up with.

Jules torti, RMT, has been in practice since 1999 and a freelance writer since age six. In between massage engagements, she travels to Africa to be with chimpanzees and writes about her zany travels for Matador Network.