Why Do I Have To Do Paperwork Before My Massage?

If you go in for a massage, chances are that you will be asked to provide some personal information before the massage begins, and that is usually done by filling out paperwork. Every massage therapist and company is different, and your overall experience with paperwork will be different, but why do we make you fill out that paperwork in the first place?

We know you come in for a massage to relax and escape from the everyday, and filling out paperwork is not something you do for fun. So why do we make you do it? Well, it is for your good as much as ours.

Every therapist is different and prefers/needs different types of information. I actually have different forms with different information for specific types of massages (prenatal vs. regular, etc), but overall, they serve the same purpose. Personally, in my practice, for a new client, I have two pieces of paper that are handed to the client before a massage. The first page is basic information including medical history such as allergies, surgeries, chronic issues, etc. Why does this matter? The short answer is that we don’t want to make anything worse. We need to know allergies so that we don’t use a lotion or oil with an ingredient that will give you a reaction. If you have had any surgeries or other chronic issues, we want to know so that we don’t pull or stretch or work on anything that had previously been repaired. While some surgeries leave an obvious scar such as a knee replacement, others like plates in your neck may not be as easy to see, so we have to adapt our technique accordingly. My second page of paperwork is given at every visit, even if the client sees me every week/month/etc. This page asks the client to specify what specifically brought them in for massage that day, and what they want me to be focusing on or avoiding, as well as any immediate changes in health.

Now every therapist is different, and some may never give you a shred of paper, but may ask you questions, to which they may go and write the info down themselves. Some therapists may not ask you a single thing about your medical history, but I’ve never known a legit massage therapist who doesn’t at least ask about allergies. Also, you don’t need to worry about what information you put on that paperwork. As health care professionals, massage therapists are bound by the same HIPPA laws as your doctor, so we can not share any information with anyone without written consent from you.

In my own experience, I’ve had a range of emotions from my clients about paperwork when they come in for massage. Some just go through the routine without questioning anything, some outright complain about “having to fill out that thing again”, and some have fun with it - I once had a regular older male client check the box marked “pregnant” and then admitted with a laugh that he just wanted to see if I was actually paying attention to the paperwork.

So as much as all of us hate dealing with paperwork, it can be considered a 'necessary evil'. Records need to be kept because massage does deal with a human being’s health, so to help us provide the best care, we need to keep everything in writing. With the digital age, there are many paperless and digital options coming into common practice, but it will still involve you answering questions in some form. Nevertheless be assured that we hate paperwork as much as you do, and we hate giving it to you as much as you hate filling it out, but overall, it is there for the best.

To Tip or Not To Tip Your Massage Therapist?

I recently had a client come in for a massage who admitted that she hasn’t really had many massages before. She asked “Is this like a haircut where there is one price listed and then I’m expected to pay a tip on top of that price?” It was an interesting way to put it, but I do get asked this question frequently by clients. Tipping is often something that many people aren’t sure what exactly the protocol is when it comes to massage because massage exists in so many different forms and is used for so many different reasons. 

According to Wikipedia, “A gratuity (also called a tip) is a sum of money customarily given by a client or customer to a service worker in addition to the basic price.“  Many times when we hear the term ”service worker” or “service industry” we immediately think of restaurant servers, taxi/Uber drivers, or hairdressers. We tend to view massage therapists in mainly one of two ways: spa employees or health care professionals. This creates an odd divide for individuals who do relatively the same thing. You usually wouldn’t think twice about tipping your hairdresser (service industry) but would never dream of tipping your doctor (health care industry). But ultimately, massage therapists can fall into both categories. They provide a service to individuals, so they qualify as members of the service industry, however they are also responsible for improving your health, so they are also members of the health care industry. 

Two big things also help make tipping confusion stronger; Environment and purpose. If someone is an employee in a spa, it seems like a no-brainer that, like a hairdresser, you give them a tip. However, if someone providing the same service in a doctor’s office, tipping may not seem as natural. Likewise, the purpose or reasons a person receives a massage can change the perspective as well. Some people get massage purely as a relaxing treat, while others get massage for therapeutic or medical reasons. This can change their perspectives on if a tip is warranted. This is probably the reason I get this question. I work out of a chiropractors office, but I am self employed and my rate doesn’t include gratuity built in. Plus, I may be in a health care setting, but, (at least in the state of Pennsylvania) every massage therapist, even those that work exclusively in a spa setting, has to have a license to practice just like medical professionals.

So I guess this whole article is a very long-winded roundabout of a very simple question and answer: should you tip your massage therapist? The answer that I give to anyone who asks me is: A gratuity is never required, however it is always appreciated.  Bottom line, massage therapists are members of the service industry. They provide you a service - making you feel good. They also are members of the health care field - so it is their job to make your health and well-being a priority. If you choose to and you feel it is appropriate to tip your therapist (unless their employer or organization specifically forbids it), it is never required but always appreciated. There is no right or wrong answer, it is all in how you view your therapist and the care that you get from them. 

Should You Talk or Not Talk During Your Massage?

Massages are supposed to be a relaxing experience. But does relaxing mean the same thing to everyone? Case in point; one question that I frequently get asked: "Should you talk or be completely silent during a massage?" Well, like many areas of massage, there really isn't one answer because everyone is different, and their needs as well as reasons for coming to massage are different.

One side of the argument says that you should be relaxing during a massage, so that means be quiet, listen to calm, quiet music, and just mentally let yourself enjoy the quiet to allow yourself to relax. The other side of the argument says some friendly banter allows the person receiving the massage to ask questions and get educated about things going on with their body, and can also be a form of relaxation therapy in itself by allowing the client to expend any pent up energy, frustrations, or just basically having someone to talk to.

Sometimes the technique itself can work better if there is talking versus no talking. Cranial Sacral or Myofascial work is more effective when the therapist can quietly concentrate on the sensitive and intricate things they are working on, while something like stretching or deep tissue work might require communication between therapist and client to make sure that the modality is working and not too much, as well as some conversation about what caused the issue in the first place.

I have seen forums and routine questions throughout the massage industry about what other therapists think of this topic. I've seen answers that range from therapists who find it fine to be sociable and chatty, while others state that they prefer to work in silence and have gone as far as to gently tell chatty clients to be silent 'for their own relaxation benefits'.  There are also factors such as the environment or the rapport of the staff that can influence whether talking is discouraged or encouraged during a massage.

Personally, as a therapist, I believe that it is ultimately up to my client - the person receiving the massage. After all, they are the ones coming to me for relief, healing, relaxation, or whatever their reason. I should allow them to achieve their goals however they need to. Some people do want the silent, quiet relaxation, and it can be a calming, almost meditative session that lets them fall asleep and me to put extreme focus on what I'm doing. Other times, people will ask questions, vent frustrations, relate plans they are excited about, etc. I used to wonder how they were able to relax while being so chatty, but I realized that perhaps they don't have anyone else to talk to so they need an outlet to vent or just enjoy speaking to another adult before they can unwind. In these cases, the talking is therapeutic and relaxing in itself, so I don't discourage it. I do, however, strive to let them lead the conversation or lack of it. The only time I usually try to initiate conversation is when I'm either asking about conditions, giving instructions, or reassuring a fear or concern. I work with many Prenatal clients, and many first-time moms can get concerned with all the strange things that are happening to their bodies, so sometimes I need to reassure them and will sometimes tell them about my own experiences in the same situation to help put their minds at ease and give them a chance to relax.

That being said, I do believe the answer of "to talk or not to talk" is up to the person receiving the massage, and what their goals of receiving the massage are. Sometimes quiet silence is needed and wanted, and sometimes chatting, venting, or letting off steam is just as important to their relaxation and healing. If my client wants to talk, I'll talk, but if they want to be quiet and go to sleep, I'm not going to engage them in deep conversation. I'm there to provide my clients with what they want and need, and everyone's wants and needs are different but no less right or wrong.

Detective vs. Mind Reader

I haven't posted for quite a while, but sometimes it takes taking a step away from something to help you to realize what you actually want to do with it. So I guess from now on the blog will be kind of a fusion of musings, possibly some rants, and any interesting information I've picked up along the way. Bit of a mish-mosh, which kind of describes my life right now, so what better place to let the mish-mosh flow.

When I was young, I read a lot. I mean A LOT - I was that kid who always had her nose in a book, whether it was on my own, or on the playground at recess. One of the things I liked to read at the time was a silly little series of books called "Solve the Crime" where a kind of police report of a crime (nothing too gruesome - it was a young reader's series) was presented, and the reader had to figure out the guilty party, who was lying, etc and how to prove it. I was surprisingly good at solving the mystery, and even speculated at one point about becoming a detective.

Fast forward many many years and several careers later, and Detective never made it onto my resume, but Massage Therapist did. I have discovered that in several ways, Massage Therapy is a little bit like detective work. A Client comes to me and tells me something pretty basic - "It hurts here". From there it is up to me to first ask questions: "How long has it been hurting, did you do anything that you can recall started the pain, does anything in particular aggravate the pain, etc". Next, I find the source of the problem, and implement my knowledge and training to try to repair or resolve the problem, then educate the client on what should happen next whether it is more massage, exercise, or whatever. It's no CSI, but all the same steps are there. So in a way, I guess I get to be a detective after all.

Now, just because I'm not a bad detective (if I do say so myself), that doesn't mean that I am a mind reader. I find this is a big area of client-therapist communication breakdown, especially if the client is either brand new to the therapist or if the client has been seeing the therapist for a long time. New clients can often not know exactly how much to tell the therapist, and established clients can often fall into "oh, she knows this already". Well, like I said, I can use detective skills to find a problem, but if something else is there that a client didn't divulge, I may not be able to find it right away. I can't tell you how many times I've been almost completely finished with a massage and the client will speak up with "Oh, the other day I ... and I think I tweaked ..., so could you work on that?" With 2 minutes left in the session, it is kind of difficult to start working on a new 'project', and it can cause the client to not get their issue fully addressed and the therapist to stress out, trying furiously to get them some sort of relief.

So I guess the moral of the story is, there is no such thing as giving your therapist too much information, but trust them and let them do their job. Give them what they need to find and solve the case, but don't withhold evidence that can keep them from doing their job. Now should I consider adding PI to my title? Nah, too many letters.