TS

Ch. 7 Massage Business Environment, Equipment, and Products

Massage Business Environment, Equipment, and Products

Learning Objectives (LOs)

  • LO 1 List important considerations when preparing a space for massage.
  • LO 2 Prepare a checklist of supplies and equipment needed for therapeutic massage.
  • LO 3 Check and adjust lighting for the massage room.
  • LO 4 Select a massage table.
  • LO 5 Name and describe various lubricants used for body massage.

Why Study Equipment and Products?

  • Tools of the Trade: Equipment and products are essential tools for massage practitioners.
  • Proper Use and Care: Understanding how to correctly use and care for these tools and products is crucial to:
    • Prevent injury to both client and practitioner.
    • Reduce wear and tear on equipment.
  • Overall Success and Safety: The effectiveness and safety of a massage session depend entirely on the appropriate use of the correct products and equipment.

Introduction to Professionalism and Client Experience

  • Professionalism: Therapeutic massage is part of the healthcare profession, requiring practitioners to maintain a professional and friendly demeanor.
    • Manifestation: Professionalism is an attitude demonstrated through therapists and their business practices.
    • Client Expectation: Clients anticipate a professional image, conveyed through:
      • Speech and appearance.
      • Good manners.
      • Quality of equipment used.
      • Presentation of the place of business.
      • Technical competence and confidence during practice.
  • Creating a Relaxing Experience: To provide a relaxing and rejuvenating experience, several conditions are desired or necessary:
    • Practitioner Demeanor: A professional and friendly approach instills client confidence.
    • Facility Aesthetics: The appearance and atmosphere of the massage facility significantly impact the client's overall response.
    • Essential Factors: Cleanliness and a sense of order are paramount.
    • Furnishings: Comfortable yet professional furnishings enhance client confidence.
    • Environment: Privacy and the absence of distractions or interruptions are critical.
    • Physical Comforts: Adequate heat, ventilation, and indirect lighting are important for client comfort.
    • Ambiance: Relaxing music is an optional, but often employed, enhancement.
  • Practitioner Awareness: Understanding these factors enables practitioners to integrate them into the planning of their massage facilities.

Business Location Considerations (LO 1)

  • Importance: The location of a massage business is a significant factor, as its image influences clients.
  • Industry Trends (AMTA 2014 Survey):
    • Approximately 60 percent of practicing massage therapists are sole practitioners.
    • More than two-thirds work part-time, with some practicing in multiple settings.
    • Places of Employment (Figure 7-1):
      • Work out of a client's home/business/corporate setting: 59
      • Therapist's office: 36
      • Therapist's home: 37
      • Healthcare setting: 25
      • Spa setting: 28
  • Internal Environment: Regardless of the external location, the internal environment of the facility directly reflects on the client's impression of the therapist and services.
  • Client Experience Factors:
    • Decor: Should be professional yet comfortable, clean yet not sterile, relaxed, and free of distractions and safety hazards.
    • Dedicated Space: In a massage establishment, space should be exclusively allotted for massage practice to ensure client privacy, comfort, and a professional image.
    • On-site/In-home Massage: For practitioners working in clients' homes or other facilities, the equipment, therapist's appearance, and actions directly affect client perception.
  • Universal Standards: Standards of cleanliness, safety, and professionalism must be observed in all massage settings (home, client's home, or separate office).

Infection Control and Safety in the Workplace

  • Cleanliness: Space and equipment must be kept clean and neat in any work setting (home office, salon, studio, spa).
  • Regular Checks: The facility and equipment should be regularly inspected to prevent injuries to therapist or client.
  • Safety Measures:
    • Passageways must be kept clear.
    • Surfaces and linens must be cleaned and disinfected.
    • Equipment must be checked against failure.
  • Primary Concern: Protecting client health and comfort (further detailed in Chapter 8).

Equipment and Supplies (LO 2)

  • Variability: Specific equipment and supplies vary based on the scale and nature of the massage business.
  • Essentials: Several items are essential for smooth and efficient operation.
  • Influencing Factors:
    • Massage Service: The act of giving massage requires specific tools.
    • Business Operations: Consultations, record-keeping, and other business activities dictate related equipment and materials.
    • Ancillary Services: Availability of hydrotherapy and bathing influences equipment selection.
    • Setting: A home-based business differs from a cruise ship concession or a professional sports team's facility.
  • Chapter Focus: This chapter focuses on an independent massage practitioner operating from home or a small private office.

Areas of Activity

  • A massage business generally has three distinct areas:
    1. The Massage Area: Where the client receives treatment.
      • Function: Often doubles as a disrobing/dressing area in smaller operations.
      • Size: Minimum of 10 feet wide and 12 feet long to accommodate equipment and allow practitioner comfortable movement.
      • Furnishings: Space for a desk, chair, supply table/cabinet, and a stool (for practitioner rest during certain techniques like neck, face, feet, or hand work) (Figure 7-3).
    2. The Business Area: For administrative tasks.
      • Activities: Record-keeping, consultations, telephone, other business operations.
      • Location: Can be within the massage room, an adjacent room, or divided with client-related activities near the massage area and bookkeeping elsewhere.
    3. The Bathroom or Hydrotherapy Area: Essential for hygiene and client needs.
      • Restroom Access: Every massage area must have access to a clean restroom, as massage can stimulate urinary and digestive systems.
      • Showering Facilities: Ideally, a place for clients to shower or bathe before/after massage.
      • Practitioner Hygiene: Provides facilities for the practitioner to wash hands before and after each massage.
  • Ancillary Services: Services like steam baths, showers, exercise facilities, hot packs, or hot baths affect pre/post-massage procedures and dictate specific equipment/supplies.
  • Maintenance: Equipment and supplies should be checked frequently for proper condition and sufficient quantity. Furnishings and equipment must be appropriate for treatments. All equipment safety-checked regularly. Supplies kept clean. Implements/linens contacting clients cleaned before reuse. Oils, linens, paper products prepared before client arrival.

Equipment and Supplies Checklist (Figure 7-2)

  • The Massage Area:
    • Massage table
    • Stool or Fitball
    • Blankets, wraps, and/or robes
    • Lubricants (oils, creams, powders, liniments)
    • Supply storage cabinet
    • Facial tissues
    • Cotton-tipped swabs
    • Alcohol or other sterilizing agents
    • Hand sanitizer
    • Analgesic oil or gel
    • Dressing area (private space with chair, hangers, mirror, and wraps)
    • Indirect lighting
    • Desk or table and chair
    • Client intake and SOAP forms
    • Clock
    • Bolsters or pillows (face cushion)
    • Linens (adequate supply, including sheets, towels for draping, pillow, and bolster covers)
    • Device to play music and a music selection
    • Table warmer
    • Covered wastebasket
  • The Business Operation Area:
    • Desk and chairs
    • Business telephone with an answering machine
    • Appointment book (can be electronic)
    • Reference books (medical dictionary, drug reference, pathology/massage reference)
    • A secure filing system
    • Stationery and stamps
    • First-aid kit
    • Pencils, pens, stapler, tape, and other office supplies
  • Bathroom/Bathing Area:
    • Liquid soap in a pump container
    • Disposable paper towels
    • Clean bath towels for each client
    • Robes or wraps
    • Shampoo and bath soap
    • Disposable water cups
  • Hydrotherapy Area:
    • Hydrotherapy equipment and related supplies
    • Cleaning and disinfectant supplies
    • Towels and robes

Prepare the Massage Room Environment

  • Room Size: A minimum of 10 feet wide and 12 feet long is recommended to accommodate equipment and allow freedom of movement.
  • Temperature: Should be comfortable, warm enough to prevent client chill, which hinders relaxation.
    • Optimal Range: Approximately 72 to 75^ ext{o}F (22.2^ ext{o} to 23.9^ ext{o}C) is typically comfortable for clients and practitioners.
    • Pre-warming: Room should be warmed in advance, especially since clients can become chilled after oil/lotion application.
    • Heating/Cooling: Small electric heaters or other heating devices can ensure warmth. Air conditioning or fans are needed in hot/humid weather.
  • Ventilation: The massage room must be well-ventilated.
    • Reasoning: Massage requires considerable practitioner exertion. Clients need a good supply of fresh air for proper relaxation.
    • Consequences of Poor Ventilation: Stuffy room and offensive odors. Proper ventilation ensures fresh air supply.

Lighting (LO 3)

  • Avoid Harsh Lighting: Harsh and glaring lighting makes both practitioner and client uncomfortable.
  • Preferred Lighting: Indirect lighting, reflective light, or soft, natural light is preferred in the treatment area (Figure 7-4).
  • Adjustability: Dimmer switches allow for easy light adjustments.
  • Direction: Avoid direct overhead lighting or any light that could shine directly into the client's eyes.

Use of Music

  • Relaxation Aid: Soothing music can add another dimension to a relaxing massage.
  • Client Preference: Always ask the client about their music preference, as some prefer absolute quiet.
  • Noise Masking: Music can mask distracting outside noise.
  • Music Selection: Avoid up-tempo beats, music with lyrics, some classical music, and nature sounds, as these can inhibit relaxation.
  • Rhythm: Generally, do not attempt to match the rhythm of massage movements to the music tempo.

The Massage Table (LO 4)

  • Importance: The massage table is one of the most important possessions for a therapist, serving as the main piece of equipment after the practitioner's hands.
  • Key Qualities: Must be stable, firm, and comfortable.
  • Types:
    • Stationary Table: Best choice for an office or studio setting.
    • Portable Table: Suitable for temporary setups or practitioners who travel to clients. Must be foldable and light for transport.
  • Construction: Inspect construction carefully, considering its durability over hundreds of treatments.
  • Practitioner Movement: A well-chosen table allows the practitioner to move and change positions easily without disrupting the massage rhythm.
  • Optimal Height: Depends on several factors:
    • The height of the practitioner.
    • The specific kind or style of massage being performed.
    • The size of the client.
    • The personal preferences of the practitioner.
  • Height Adjustment and Ergonomics: Proper table height prevents fatigue in the practitioner's back, neck, arms, and shoulders, providing proper leverage.
    • Measurement Method 1: Stand erect yet relaxed, and measure the distance from the floor to the middle of the palm of the hand; this is approximately the optimal height (Figure 7-5).
    • Measurement Method 2: Stand next to the table, place the palm flat on the table, and hold the arm straight at the side.
    • Discomfort Indicators: Lower back discomfort suggests the table is too low; upper back, shoulders, or arms discomfort indicates it's too high.
  • Adjustable Tables: Many stationary and portable tables have adjustable legs (using wing nuts or thumbscrews), beneficial for multiple practitioners or techniques requiring different heights (e.g., deep tissue or Asian bodywork may prefer a slightly lower table). Hydraulic or electric stationary tables are costly but useful for elderly or disabled clients and multi-practitioner settings.
  • Table Width:
    • Approximately 28 inches wide, with an additional 1 inch for padding, totaling around 29 inches.
    • Narrow Tables: Less than 27 inches may not support larger clients adequately.
    • Wide Tables: Wider than 30 inches can be awkward for the practitioner to reach across.
    • Practitioner Height: Taller practitioners might find wider tables easier to reach across and carry when folded.
  • Table Length: A good length is about 76 inches. Portable tables are often 68 to 72 inches, which can be too short for taller clients.
  • Padding: Should be firm (1 to 2 inches of high-density foam) so that pressure is absorbed by the client's body, not the table. Padding should extend approximately 0.5 inch beyond the framework for client comfort.
  • Covering: Good-quality vinyl is the best covering due to durability and ease of cleaning.
    • Care: Clean regularly with water and mild detergent.
    • Avoid: Extended contact with massage oils, body oils, alcohol, or chlorine bleach, as these can make vinyl brittle and crack. Avoid extreme temperatures.
  • Design Considerations and Accessories:
    • Table Designs: Some studio tables have surfaces that fold up or down for specific therapies, though less useful for general practitioners.
    • Headpiece/Face Cradle: A valuable accessory that adjusts up or down to alleviate cervical strain. Allows clients to lie face down with the cervical spine straight, reducing neck and upper back strain. Adjustable positions ensure comfort.
    • Side Extensions: For supporting the arms of larger clients.
    • Carrying Case: Essential for portable tables, providing protection during transport and easier carrying with extra handles, straps, or wheels (Figure 7-6). Often includes pockets for linens and supplies.
  • Choosing a Table: A professionally designed massage table is recommended.
    • First Table: Many students and new practitioners opt for a good-quality portable table.
    • Manufacturers: Several reputable U.S. manufacturers offer a range of tables at different price points (depending on accessories like adjustable face rests, special coverings, or extra foam padding).
    • Sources: Publications (e.g., Massage Magazine, Massage Therapy Journal), catalogues, specialty stores, massage convention exhibits, websites (e.g., craigslist.org for used tables).
    • Selection Factors (Figure 7-7):
      • Adjustable legs
      • Appropriate dimensions
      • Face rest (adjustability is a benefit)
      • Vinyl covering (for easy cleaning)
      • Easy setup and take-down
      • Stability and durability
      • Maximum weight capacity
      • Carrying case (for easy carrying and protection)
      • Good warranty

The Massage Chair

  • Function: An auxiliary piece of equipment allowing clients to sit, fully supported and clothed, for massage to the back, neck, head, shoulders, and arms (Figure 7-8).
  • Marketing Tool: Excellent for offering relaxing massages in public areas or businesses, serving as many clients' first massage experience.
  • Availability: Sold by most massage table manufacturers (more details in Chapter 19).

Bolsters and Pillows

  • Purpose: Essential supportive devices for comfortably positioning clients on the massage table (Figure 7-9).
  • Bolsters:
    • Variety: Come in various sizes and shapes (round, half-round, rectangular, custom-shaped).
    • Specialized: Body support systems and bolsters designed for pregnant clients (prenatal massage) are available.
    • Common Type: 6 or 8-inch round bolsters, made of foam and vinyl-covered, nearly table-width.
    • Placement: Placed under the client's knees when face up, or under the ankles when face down, to reduce strain in the lower back.
    • Usage: Can be slipped under the sheet or into a pillowcase; the vinyl should not directly contact the client's skin.
    • Cleaning: Cleaned with the same mild detergent used for the massage table.
  • Bed Pillows: Keep three or four firm bed pillows on hand for special positioning, such as side-lying or extra support under the abdomen or head.
  • Hygiene: Pillowcases on pillows and bolsters that come into contact with the client's skin must be changed between clients.

Massage Linens

  • Usage: Linens cover the massage table, client, face cradle, bolsters, and pillows.
  • Selection: Type and style depend on services offered and draping techniques.
  • Types of Linens:
    • Table Coverings: Single-sized (twin) fitted or flat sheets.
    • Drapes: Single-sized (twin) flat sheets, bath sheets, beach towels, large or regular-sized bath towels.
    • Pillowcases: For pillows and potentially bolsters.
    • Face Cradles: Washcloths, hand towels, pillowcases, or specially made covers.
    • Linen Sets: Available from massage supply businesses, often including a fitted table cover, top sheet, and face cradle cover.
  • Hygiene: Clean linens must be used for every client.
  • Quantity: Depends on the number of clients per day and laundry frequency.
    • Daily laundry: Enough linens for two days.
    • Weekly laundry: Enough linens for one and a half to two weeks.
  • Fabrics: Popular choices include percale, cotton, cotton blends, bamboo blends, and flannel.
  • Colors: White, light pastels, and pale floral prints are preferred as they launder well and tolerate bleach. Darker colors tend to fade and show oil stains.
  • Replacement: Linens should be replaced when stained or threadbare. Specialized products are available to remove oil stains and odors.
  • Towels for Draping: Some practitioners prefer towels or a combination of towels and sheets.
    • Sizes: Variety of towel sizes can be used.
    • Top Cover: A bath sheet or large beach towel.
    • Partial Drape: A large bath towel, possibly in combination with a top sheet.
    • Upper Torso Drape: A small bath towel for breast draping.
    • Bathing Facilities: Extra towels required for drying if bathing services are offered.
  • Blankets: Two light flannel, cotton, or wool blankets should be kept on hand for clients who might become chilled. Used on top of usual draping for extra warmth, security, and comfort. Although they don't directly contact the client, they should be made of easy-to-launder material for occasional cleaning.

Massage Lubricants (LO 5)

  • Importance: Good-quality lubricants are crucial products for a practitioner.
  • Primary Purpose: To reduce friction between the practitioner's hands and the client's skin.
  • Selection Factors: Choice depends on massage style, client needs, and practitioner preference.
  • Types: Lotions, creams, gels, and massage oils. Massage oils and creams are the most commonly used.
  • Unsuitable Lubricants: Mineral oil and Vaseline (petroleum-based) are not recommended as they tend to dry the skin, deplete nutrients, and clog pores.
  • Preferred Lubricants: Vegetable-based oils such as coconut, sweet almond, apricot, olive, peanut, sesame, grape seed, or sunflower oils.
    • Benefits: Mild, easy to work with, and provide natural nutrients to the skin.
    • Allergies: Be aware that some clients or practitioners may be allergic to nut products (e.g., almond or peanut oil).
  • Freshness: It is vital to use fresh oil, as rancid oil has a strong, offensive odor and potential health considerations.
  • Linen Care: Oil remaining on sheets can saturate fibers, leading to stains and offensive odors. Some distributors offer special laundry products for oil removal from linens.

Types of Massage Lubricants

  • Massage Lotions:
    • Glide: Provide a more limited glide that decreases as the area is worked.
    • Absorption: Mostly absorbed into the skin, can become sticky.
    • Nutrients: Provide nutrients to the skin.
    • Deep Tissue: Often preferred by deep-tissue practitioners as they allow penetration without irritation.
    • Reapplication: May require frequent reapplication due to rapid absorption.
  • Massage Creams:
    • Popularity: Increasingly offered by specialty manufacturers as an alternative to massage oil.
    • Properties: Often provide special stimulating, soothing, warming, cooling, or nutrient-providing qualities.
    • Composition: Often less oily and can be water-based instead of oil-based.
    • Glide: Have gliding properties similar to oils.
    • Cost: Usually considerably more expensive than oils.

Purchasing Lubricants

  • Experimentation: Therapists should experiment with different products to find those preferred by themselves and their clients.
  • Bulk Buying: Once a preference is established, it is more economical to buy in larger quantities.
  • Storage: Transfer bulk lubricants to smaller bottles. Keep bottles filled to the top, as air space can cause oil to become rancid.
  • Scenting (Caution):
    • If oil has an unpleasant (but not rancid) smell, a few drops of essential oil (e.g., lemon, clove, cinnamon, musk) can be added (a few drops per cup of oil is usually sufficient).
    • Client Sensitivity: Use scented oils cautiously, as clients can be sensitive, allergic, or simply dislike certain fragrances.
    • Aromatherapy: For aromatherapy treatments, oils should be mixed specifically for the client at the time of application.
  • Sources: Oils and concentrated fragrances can be purchased from supply houses, specialty stores, or drugstores.
  • Dispenser Bottles: Practitioners often mix oils and store them in unbreakable, easy-to-handle bottles with dispenser tops to prevent spillage (Figure 7-10).
  • Contamination Control: All lubricants must be kept in and dispersed from containers in a manner that prevents contamination.

Powders

  • Alternative: For clients with oily skin or those who cannot tolerate oil.
  • Cornstarch: A light powder, generally preferred.
  • Talcum Powder: Not recommended due to its potential as a lung irritant.
  • Application Precaution: Avoid inhaling talc or other powders by applying them carefully and potentially wearing a mask.
  • Lubrication: While powder does not provide the same lubrication as oil, massage movements can still be effectively performed, and some clients prefer it.

Product Ingredients and Allergies

  • Label Reading: Always read product labels to understand ingredients and ensure safety for massage use.
  • Resources: A dictionary of cosmetic ingredients is useful for unfamiliar terms. Consult a pharmacist or dermatologist if needed.
  • Regulation: The U.S. Food and Drug Administration (FDA) aims to control the distribution of products with harmful substances.
  • Individual Sensitivity: What is harmless to most can cause an allergic reaction in someone with sensitivity to a particular substance (e.g., natural products, synthetic fragrances, dyes, or other ingredients).
  • Pre-application Check: During consultation or before applying any substance to the face or body, determine if the client has any allergies.
  • Patch Test Procedure:
    • If in doubt, perform a patch test:
      1. Wash the inner bend of the elbow with mild soap and warm water.
      2. Rinse the area.
      3. Apply a small amount of the product to the skin.
      4. Allow 15 to 30 minutes to check for a reaction (e.g., itching, inflammation, sensitivity, stinging). If a reaction occurs, do not use the product.
    • Immediate Reaction: If a client reacts during a massage, immediately remove all lubricant with soap and water. The client can then decide to discontinue or continue with a different lubricant.
    • Delayed Reactions: Most reactions occur several hours after application, often after the client has left the facility.
  • 24-Hour Patch Test: Clients with known allergies to fragrances or other cosmetic substances may require a 24-hour patch test beforehand.
    • Client Awareness: These clients are usually aware of their sensitivities and products to avoid, and may be under a physician's care for guidance.
    • Client-Supplied Lubricants: Some sensitive clients prefer to supply their own lubricants.
  • Hypoallergenic Products: Products labeled