1. How do I build my practice?
2. What is the best treatment for my client’s headaches?
3. What is the cause of my client’s low back pain?
4. How much money should I charge my clients?
5. Should I barter with my clients?
6. My client has high blood pressure. Is it safe to treat him/her?
7. What are the pros and cons when comparing oils, creams, and lotions?
8. How do handle a client who is chronically late or missing appointments?
9. Should I charge for massaging friends, family, or coworkers?
10. Which professional organization should I join?
1. How do I build my practice?
It has often been said that “Being the greatest therapist is useless if you have no one to work on”. Being a skilled practitioner is only one component of developing a successful massage therapy practice. Some of the most important (and often overlooked) elements for a thriving business include calculated planning, a business model, realistic goals, start-up capital, and a marketing strategy.
The first step is to develop your “brand” of massage. Focus on an identity that characterizes your business in order to reach a target demographic. Next, list off all possible expenses for initial start-up plus monthly or annual fees for the first year; weigh that information against realistic gross income. This will let you know if your business is even economically viable.
If you choose to pursue your endeavor, develop a cost-effective advertising and marketing campaign to solicit business. This may include complimentary chair or table massages in the inception just to attract new clients.
Finally, establish an official company for liability and tax implications. An LLC (Limited Liability Company) is relatively inexpensive to set up and can assisted for you through legalzoom.com.
2. What is the best treatment for my client’s headaches?
Headaches are one of the most common reasons clients seek out massage therapists. Unfortunately clients often self-diagnose the type of headache they actually have. The most common forms of headaches people suffer from are fibrocitic “tension” headaches; these are caused by hypertonicity, trigger points, lack of blood flow, or any other dysfunction to cervical and/or occipital muscles (SCM, suboccipitals, upper trapezius, splenius capitis). They usually are described by the clients as “dull, achy”. These particular headaches are ideal for relief through massage therapy.
Sinus headaches can also be treated with bodywork techniques, specifically acupressure over specific points on the face and head.
Unfortunately, other forms of headaches (migraine, cluster, allergy) can become even more debilitating with massage therapy techniques. Be sure to perform a proper assessment prior to treatment and consult a physician when you are unsure of the client’s current state of health.
3. What is the cause of my client’s low back pain?
Low back pain presents itself in over 80% of the population at least at some point in a person’s life. There are multiple causes for LBP because of several structures located in that area of the body. One of the more common (and serious) causes of LBP is dysfunction of the kidneys or large intestine; asking about any abnormalities to your client’s bowel or bladder function is appropriate.
The erector spinae muscles are responsible for keeping the human body upright. For most people these muscles are overworked to constantly prevent gravity from pulling us forward. The erector muscles are attached to spinous and transverse processes of the lumbar vertebrae. The contraction of these muscles coupled with gravity and body weight can cause injuries to tissues other than muscle and tendon. Facet joint irritation is caused by compression of the vertebral facets (articulation points between each vertebra). Dysfunction at the facets is usually reported as “sharp/local”. The compression can also lead to a herniation of the discs that act as shock absorbers of the spine. A herniated disc will often impinge peripheral nerves exiting the spine- causing “numbness/tingling” to the extremities.
The constant for every client is gravity causing compression. Therefore, a safe approach for treatment is to relax fascia, tendons, ligaments, and muscles attaching to the pelvis or the spine and then traction the lumbar spine.
4. How much money should I charge my clients?
The almighty dollar. Cost per massage should be calibrated by taking into account several different factors. The best approach is to gather information from several other therapists or spas in the general vicinity of where you plan to practice. Most median massage therapy prices will be reflective of the local economy and cost of living. For example: The average 1 hour massage in rural Ohio may cost $45 while the same massage would fetch $95 in San Francisco.
When traveling to a client’s home to perform a massage treatment, additional charges are applicable based on time and distance. The use of products other than standard sheets and a massage table should be factored in to the final cost. Here is a breakdown of a general price list for a treatment session:
- Massage: $1/minute (minimum of 1 hour)
- Travel: $10-$30 based on distance and parking fees
- Essential oils: $5-$10
- Hot stones: $10-$20
- Cupping: $5-$10
- Salt scrub: $5-$10
It is customary to offer your client’s discounts for referrals, purchasing multiple massages, or for treatments lasting at least 90 minutes. The most important rule when charging clients is to be consistent. Do not charge on a fluctuating scale, do not accept checks (unless you so desire) or IOU’s, and do not wait until the massage is completed to receive your compensation. Some clients have a tendency to “forget” their purse or wallet after the session is over.
5. Should I barter with my clients?
Bartering in the service industry is nothing new but when analyzed there are some drawbacks. First, bartering does not allow you to declare all received income and therefore defrauds the federal government on tax implications. Another drawback is a lack of documentation for personal protection. If you were to barter massage sessions for the services of a painter to paint your house and either he damaged your property or you injured him, it is hard to recoup an actual payment if money never changed hands.
No matter who the client is or the relationship you share with that person, keeping the professional relationship professional protects all parties and avoids both conflicts of interest and a dual relationship.
6. My client has high blood pressure. Is it safe to treat him/her?
There are several common medical conditions your clients will present to you that are outside of your scope of practice but must be monitored to prevent injury. Massage therapists are not licensed physicians and can not perform diagnoses but should engage in pre-treatment screenings and assessments to search for “red flags” or contraindications. With the myriad of medical conditions and prescription medications it is impossible to predict all possible effects from massage but the most important approach to health concerns is to make sure the client’s conditions are monitored by a physician and are being treated (medications). As long as the illness, disease, or condition is being addressed, most will not have a detrimental effect from massage. However, it is safe to use the approach of: When in doubt, refer out. Ask your client to provide written consent prior to their massage therapy treatment.
7. What are the pros and cons when comparing oils, creams, and lotions?
Choosing the best lubricant to use during the massage is not as easy as one would think. The different lubricants provide pros and cons for each selection. This is how the “Big 3” stack up side-by-side:
- Lotion: Lotions are the most commonly used and readily available lubricants for massage. They are light, cheap, readily available, and mostly hypoallergenic. However, there are a few drawbacks. First, lotions are not natural products despite what their labels read. They are a combination of synthesized and processed ingredients. Once applied to the skin they are absorbed into the body… if you wouldn’t put it in your body, you shouldn’t put it on your body. Lotions also absorb easily so reapplication is common and out of the 3 options, you will probably use the most on your client by using lotion.
- Cream: Like lotions, creams are mostly hypoallergenic and relatively inexpensive. They have a smoother consistency than lotions which provides more fluid effluerage strokes. Again, the drawback is that cream is not a natural product and because of their consistency, some creams won’t dispense from a bottle and require therapists to repeatedly place their fingers into the receptacle which is unsanitary.
- Oil: Massage oils are usually the most expensive lubricants available. They are also problematic because they can stain sheets and if not removed with a warm towel after the treatment, can leave the client feeling “greasy” once they redress. The benefits of oils are plentiful. Oils are natural products and absorb providing some healthcare benefits (depending on the oils used). Oils have a great consistency for long, flowing strokes and require very little volume limiting the need for reapplication. Oils also conduct temperature effectively so the will provide warmth for the client once used repeatedly on the skin.
8. How do handle a client who is chronically late or missing appointments?
MASSAGE IS A BUSINESS! The stigma of the flighty masseuse is still a black eye on this industry. For too long society has viewed massage therapy as a luxury for themselves and a hobby for the practitioners. When a client shows up late, they do not receive extra time. If they choose to leave early, they do not get a partial refund. If you were to show up 10 minutes late for a play, you wouldn’t expect the performers to wait for you or have them restart the performance. If you were in a movie theater and left early, the box office won’t give you $2 back as a reimbursement.
When a client cancels within 24 hours of the massage or fails to attend for any reason other than a legitimate emergency, charge an additional 50% to their next appointment. If they never return, you are better off not having them as a long-term client anyway. If they pay, you are at least partially compensated for your time. Your time as a professional massage therapist is valuable. Do not let any client take advantage of your career.
9. Should I charge for massaging friends, family, or coworkers?
As a student of massage, it is wise to accrue as many hours of practice as possible. Depending on the state you are practicing in you may be unable to receive any compensation without a license or certificate of completion from a program. Legality aside, the recommendation is that you do not charge anyone for massage services while you are not a professional.
Once you have completed your training and you are a professional, it is recommended that you do not treat friends and family to avoid dual relationships. It is important to establish boundaries. At home you are a husband, wife, aunt, uncle, friend, or whatever title that is appropriate for you. Your responsibilities as a massage therapist should specifically be designated to situations when you are “on the clock”.
10. Which professional organization should I join?
The largest and most powerful professional organizations in the U.S. today are the American Massage Therapy Association (AMTA) and the Associated Bodywork and Massage Professionals (ABMP). The AMTA has a larger member base than the ABMP but other than the number of members, the two organizations are remarkably similar. The AMTA and ABMP offer near identical liability insurance plans and both offer free educational resources. A subtle difference is that the ABMP is more inviting of all forms of bodywork including Eastern modalities (AMTA’s insurance will bot cover fire cupping). The AMTA does however offer more courses in continuing education.
The AMTA professional membership is $235/year plus a state chapter fee. The ABMP has multiple professional plans which range from $199-$239 so the price for each is comparable. You can also find cheaper liability insurance without all of the additional educational resources and benefits through companies like the American Massage Council ($99) or the Hands-On Trade Association ($165).
The owners of this website are members of the ABMP. It is our opinion that the online resources offered (including listings, web-page, various modalities) outweigh the benefits of the AMTA.