CE INSTITUTE LLC BLOG

By Selena Belisle, Founder and Instructor, CE Institute LLC

I experience a LOT of massage therapy and bodywork from others. The number of massages I’ve received over my almost 40-year massage therapy career would be in the thousands. Any good massage instructor would seek constant massage from others as part of an experiential learning process to continually share with others.

In this article, we’re going to discuss what an appropriate amount of massage oil, cream, lotion or gel would be appropriate for a massage therapy appointment. I will refer to these substances as massage mediums or mediums, which are common lingo in the massage therapy industry.  Mediums can be oils, lotions, powders, cream or gels used for bodywork or massage therapy services.

I recently went to a Vermont massage school student clinic for a massage therapy appointment and shared a unique experience with the student’s massage medium application.  That was, whenever the student therapist applied their massage medium to a new work area, it always felt like they were not using or applying enough.  A lack of massage medium during Swedish massage in particular can cause an undesirable drag or skin friction, which is usually contrary to a Swedish relaxation appointment.

At first, it was easy and erroneous to discount the lack of appropriate massage medium to the situation where I was receiving massage from a student; however, once the medium was applied to the new work area with longer effleurage application, it never felt like there was a lack of an appropriate medium.  In fact, their massage therapy strokes which included ringing, petrissage, bone tracing and more felt really wonderful! So, in the end, it created this puzzling feeling of what is an appropriate amount of massage medium?

Usually in massage appointments, the amount of massage medium feels less and less as appointment time continues, which requires reapplication of the massage medium to avoid drag and friction.  So how could a massage medium feel like it’s not enough at the beginning and more appropriate during later strokes, such as what happened with this student’s massage? The answer is there was not enough massage medium applied for a longer effleurage stroke, but there was an appropriate amount of massage medium applied for the remaining shorter strokes like ringing and petrissage.

So, this partly answers the question about whether you’re using enough massage medium in your bodywork or massage appointments. Enough massage medium should be used to avoid undesirable skin friction or drag.  Contrarily, less medium should be used when friction or drag are essential to the treatment.

We do not recommend using excessive amounts of massage mediums, unless you’re using massage tools such as hot stones which require quick glide over the skip and  cups where you want to reduce skin friction while working the deeper levels of soft tissue. In examples such as Orthopedic Cupping Massage or Hot Stone Massage, we refer to the phrase “make it shine”, because we want the client’s skin to shine with enough massage medium for proper modality engagement.

The correct answer as to whether you are using enough massage medium in your bodywork or massage appointments also depends on your client.  As long as you are able to execute your massage or bodywork skills with ease, any amount of massage medium the client wishes for would be appropriate, as long as it’s not excessive or causing physical harm.

The massage therapy and bodywork goal for proper medium application is to use enough but never too much. Using too much massage medium becomes expensive, can unnecessarily soil sheets, towels and clothing, make other massage equipment or floors sticky and unsanitary, can cause laborious cleaning efforts amongst other problems. Not using enough massage medium can hurt or in a worst-case scenario, cause injury such as skin friction burns.  Your massage medium application should allow the massage therapist to practice their hands-on skills with ease, feel good to the client and provide a therapeutic result from the hands-on work as well.

After almost 40-years of practice, I’ve seen all types of massage medium monitoring application by employers, most of which is unpractical.  The worst I saw was a lightweight cream provided in a 2-ounce cup per appointment, and the therapist was not allowed to use more than 2 ounces of massage medium per client which was beyond impractical. Anyone who assigns a specific number of ounces of massage medium to be used with any particular client is likely inexperience and uneducated.  That’s because:

• Massage clients can be of various sizes. A 90-pound female client will almost always require less massage medium than a 400-pound client with a larger surface area to cover. As such, providing a 2-ounce ratio per client is likely wasteful with some clients and painfully short with others.

• Massage recipients can have skin hydration differences, with anything between skin dryness and dehydration to oiliness or any other combination.  Some massage clients can have such oily skin that you might not need to use much massage medium at all.  While others can have such dry skin, that massage medium reapplication may be constant, especially if you’re using a highly absorbent product.

• The massage medium’s absorbency rate can also change the amount of massage medium required for the specific task at hand, whether it’s to glide over the underlying soft tissue, compress the underlying soft tissue, cause friction or other purposes.  Changing the massage medium being used on the same exact client can change the amount of massage medium required depending on the product’s absorbency.  Some massage mediums sit on the skin and are not very absorbent, such as Vaseline.  While other massage mediums might instantly absorb, requiring more frequent re-application.

• Some clients may have excessive body hair requiring greater massage medium application too.  Massage therapists should be prepared to use extra massage medium on a hairy client to reduce or painful pulling of the client’s body hair.

In general terms, massage oils and creams would provide the greatest amount of slip or glide with the least amount of absorption while gels, lotions and powders provide the greatest amount of friction and fastest absorption rates.  While every product is different, those generalities amongst massage mediums apply to most but not all.   Relaxation appointments usually require massage mediums with greater while deep tissue and focal bodywork such as myofascial release or trigger point therapy would generally use massage mediums with less slip, such as gels, powders, lotions or perhaps no massage medium at all.

In conclusion, there is no exact amount of massage medium that should be used for clients because this is an individual situation that is based upon client size, modality type, body hair, absorption rate and other factors which require customized amounts.  The right amount will be what feels best to you and your client with an effective result.

By Selena Belisle, Founder/Instructor, CE Institute LLC

Have you had days where you were not paid in full despite being fully booked? Why does that happen?  Sometimes massage therapists and establishments are not properly prepared to avoid last-minute cancellations or non-payment for scheduled services.

Let’s review how we can ensure better practice and more stable income with proper massage therapy preparation:

ADVANCED CLIENT INTAKE PROCESS

Why would you wait for a client to arrive at your office to determine if they are contraindicated for the appointment?  You should not.  Unlike doctor’s offices that commonly double book appointments every 20 minutes, massage therapists generally book one client per hour.  Massage therapists usually do not work on more than 5 clients per day, while doctors might see dozens of patients in the same time span.  If a doctor misses a client or two for any reason, they’ll still see dozens of others while a massage therapist could lose 20% to 40% of their income in one day if they lost one or two client appointments. This is why it is important to make sure your client is not medically contraindicated prior to arriving to your workspace.

There are different health intake processes that can now be provided online, before your client every steps foot into your practice.  This can help rule out contraindications if the client cannot receive the appointment they have scheduled.  Now you will have time to provide informed consent with the client, mention the contraindication and provide other treatment options. If the client does not want to proceed with an alternative appointment option, it can also provide a massage therapist or bodyworker the time to schedule another client for that appointment in advance with this effective type of pre-screening.

If you do not want to use an online or computerized client health take, you could also call your client and rule out contraindications over the phone, before they come to your office. This is particularly important for pregnant women and clients in pain.  While no one appreciates being inconvenienced due to lack of preparedness, having someone trek to your office while in pain or pregnant only to be turned away is unacceptable and often avoidable when appropriate prescreening is performed.

ALTERNATIVE MASSAGE & BODYWORK APPOINTMENTS OPTIONS

How many types of styles of massage and bodywork have you learned or practiced? Some health contraindications for massage are caused by cardiovascular issues, where an increase of full body circulation would be inappropriate. But that same client might still qualify for other forms of bodywork.  Clients who are contraindicated for massage due to circulation issues may still be able to receive the following massage or bodywork appointment:

• Foot, Hand or Ear Reflexology
• Sweet Session™
• Reiki
• Craniosacral Therapy
• Indian Head or Foot Massage
• Energy Sessions
• Other Bodywork That Does NOT Increase Circulation

Determining how to proceed with each individual client is a decision to be made between the therapist and client, based on their individual needs, goals, contraindications and more.

To avoid burning out and remain diversified, we recommend massage therapists become proficient in at least five different massage and/or bodywork modalities. Diversified training allows a massage therapist to keep their practice interesting and provide alternative treatments for clients who might want to try something different, or for when they’re contraindicated for their originally scheduled service.

MASSAGE SUPPLIES, SUPPLIES, SUPPLIES!

It is always good business to have plentiful supplies on hand. This ensures quality of service is maintained.  How would you like to start your day knowing that you only have 8 ounces of massage medium remaining for 5 clients. Could you stretch 8 ounces of oil to perform 5 full body massages? Or would you have to cancel someone? Or suggest a different appointment that does not use massage medium?

The same goes for linens. Have you worked in a practice where they’ve flipped the sheets?  Perhaps a massage therapist is turning the sheets over between clients because they do not have enough freshly laundered linens for all of their scheduled clients on that day. Flipping sheets is unethical and unsanitary.

It is simple good business to keep extra supplies on-hand. An extra gallon of unscented (nut-free) oil at a massage establishment should always be stored as a sacrosanct back-up massage medium, because:

It can be used to help disperse an unknown aromatherapy or essential oil allergy,

You will always have a back-up on hand for clients who are allergic to nuts,

You will never run out of massage medium that could create appointment cancellations.

Once the gallon of back-up oil is opened, it must be replaced and labelled as the sacrosanct back-up.  Syphoning off just a small portion of oil your back-up gallon and then returning it as your back-up option is not appropriate.  This could:

Allow someone to continue syphoning from it until it is also gone.

Allow the oil to spoil faster or become rancid at a speedier pace once it’s opened.

Can be mixed in with other open products and now your back-up gallon is missing or gone.

Try to create redundancies in the practice, where massage and bodywork appointments can continue even if something breaks or goes missing.  Make a list of all the assets and supplies  you require to practice and then create a duplicate or back-up plan for everything. This way your practice is less likely to be interrupted or stop due to a lack of supplies.

WAITLIST

• Find a way to keep one.
• Collect a waiting potential client’s name, email address and phone #. Request all contact methods to reach them if you can squeeze them in.
• Ask what type of appointment they could accept and document it. This plants a seed in allowing the client to digest that even if their desired service is not available, it might be possible to receive something different.
• Payment method and plan: we recommend collecting a payment method for waiting clients with a plan if it’s acceptable to book and deposit any new openings. This will help ensure their commitment on the wait list to actual show for an appointment if or when you’re able to add them to the schedule.

OLD SCHOOL BACK UP OF THE DIGITAL AGE

Most bodywork, health and massage establishments now allow online scheduling.  But what would happen if you lost internet service?  Or, how would you know who’s showing for what type of service at what time if your online software company used went offline?  We recommend daily closing tasks to include taking a screenshot of the next day’s appointments.  While this screenshot may become outdated as time goes on, it’s better than having no idea of what your workday will look like without! Be sure to copy or save the screenshot to your desktop instead of another place online, because you still want to be able to access it is you lose your internet connection.

The following two pictures are of back-up traffic lights in London England.  I've never seen these in the United States before.  They are mobile traffic lights that can be rolled to any area needed.  Wouldn't it be wonderful if we all had back-up items we could use at anytime to replace our initial need or requirement like these traffic lights?

MASSAGE THERAPY PREPAREDNESS CONCLUSION

There are many things you can do to better prepare your practice for quality service. If you have to cancel an appointment for any reason, look at the reason why. Was it avoidable? If it was avoidable, how could you better prepare yourself to prevent the cancellation from reoccurring.  There are many back-up plans that can be made in advance with a little time, preparedness and thought.

Did you know that the design on the exterior of this bathtub was used to exfoliate an athlete’s skin in ancient times?  Or that caring for and improving an athlete’s skin could likely increase their performance? Pictured below is a fine example of a bathtub from the 3rd century with scales on the outside that can be used to exfoliate an athlete's skin.

The tautness of work class athlete skin could make the difference between speed and stretch. 

Exfoliating dead skin cells which are automatically shed at around 1,000,000+ dead skin cells per hour can also provide micro reductions in a client’s body weight as well. Shedding dead skin can also help us feel fresh and anew, especially when an athlete may feel tired, fatigued and worn out.  Any competitive advantage you can legally provide your client is always a blessing, and exfoliating a client’s skin is one of those simple yet effective practices.

Body scrubs feel better and are more effected when they are executed properly. Adding a facial steamer to a body scrub service can also stimulate circulation which can also assist in an athlete’s healing and recovery.  To perform a steamed body scrub:

1. Add steam to the area that’s being scrubbed with a facial steamer (those are the spa machines that stand about 3 to 5 feet high on wheels).
2. Keep the steamer arm about 14 to 18 inches from skin/scrub area. 
3. Watch for skin redness and adjust accordingly.
4. If the skin becomes red or feels a little too hot to the client, the steamer may be too close to the skin or the scrubbing is too hard (especially with sensitive skins). 
5. Move the steamer around to the different areas of the body being scrubbed.
6. Facial steamer equipment may provide more steam than 10 to 20 minutes, so turn the steamer off while not scrubbing to ensure there is enough steam for the full body.
7. Some steamers allow aromatherapy or essential oils to be added. If you can add aromatherapy to your steamer, I suggest using something “minty” to refresh your athlete and energize the overall air.
8. After all scrub product is removed, massage the skin with moisturizer to keep it hydrated, healthy and flexible.

Spa type oriented services are not just for a posh clientele. Get your spa game on for athletes to give them a competitive advantage too!

It's interesting that CNN published an article today title ‘Haute Couture’ facials and re-energizing mattresses: Inside Dior’s first permanent spa in the US, because I just had a massage at a Dior spa in Paris, and it was definitely something to write about!

If you’d like to enjoy massage therapy at its finest, then look no further than Dior Spa Cheval Blanc in Paris, France. Dior is a major luxury lifestyle brand which is deeply rooted in its fragrance and cosmetic lines. Those lines have been transferred into professional spa services at the upscale Cheval Blanc Hotel in Paris, amongst other high-end destinations, which now include New York!

The spa is decorated in a light colored modern interior with extra thick and impressively esthetic doors for soundproofing.  Upon entering the spa for your massage appointment, you will be greeted by a smiling attendant who will invite you to sit in a decent sized reception area where they will serve you a light peach refreshment and cool fragranced hand towel.  

The receptionist is the one who will review any medical conditions or contraindications with you prior to your service, so that the therapist is prepared before they even meet you.  Once you’ve completed some brief questions, your massage therapist will then greet you, and invite you to one of their private massage suites.  The suites contain two separate rooms:

A shower/changing area:

Joining the treatment room and changing room/shower into one suite/entrance has both benefits and disadvantages.  The benefits are, high profile clients can easily relax in this extremely private environment which they do not have to share with anyone, or worry about a common locker area picture being taken while they’re in various states of undress, etc.  The downside for the business is, you’ll have to schedule additional non-revenue time for the suite for changing, showering, etc.  My 30-minute massage reserved the suite for 60-minutes, so that I would have time to change and shower, etc.  Spas with common area showers and changing rooms would easily be able to more efficiently schedule a 30-minute massage in 45-minutes, and then all the client to shower and/or change in the common/shared locker room instead of massage suite where you would no longer have access to the treatment table while the client is doing things that they could probably do elsewhere, with less privacy.  

At the Cheval Blanc, the spa was SOLD OUT the day I sought services, so charging $330+ euros for a 90-minute treatment isn’t an issue. They’re sold out at that price which means they could likely increase their prices during peak times, and maintain a healthy clientele. However, if they wanted to maximize their income, then relegating the changing/shower area to a common area to allow maximum revenue use of the treatment room would be advised.  It’s possible they could have less clientele if they chose that type of standard operation, because some clients might be scheduling here for those private suites and exclusivity; although, the celebrities and royalty legitimately seeking that type of privacy out of necessity is probably not enough to offset the increased income the establishment would achieve if they separate their shower/changing rooms from the treatment stations.  Usually celebrities and royalty that are highly photographed and at risk of having their privacy invaded in public would have their spa services provided in their hotel suites, or they might rent a second hotel room to receive massage and spa services.  Rarely would we ever encounter what Dior has offered which is a fairly exclusive and unique setup.

The service and massage treatment room:

Both are elegantly appointed with the finest touches, including bottled water, slippers, robe, toiletries, spa products and of course, more fragrance.

Everything between the two rooms of the massage suite, reception area, bathroom and beyond is branded.  Dior and Cheval Blanc are never out of sight. The brand’s constant presence reminds you of where you are which is in their lap of luxury.

The therapist invited me to change into a robe and slippers in the changing room, and then had me enter the massage treatment room where she provided three different scents to choose from for the massage medium. I chose the scent that was the strongest and most exotice.  The scents were contained on patterned fabric in three different glass jars with lids.  She removed the lid of each, one at a time, and had me smell them to choose.

I only had a 30-minute massage appointment because that is all they had - the spa was fully booked. So I was lucky to even get that! I had tried to book online and call but there was nothing available. So to get the appointment, I actually went to the spa, and told the receptionist that I am massage therapist myself, and I’m trying all the various high-end spas in Paris, and I’d like to try theirs, so she squeezed me in.  I’m not sure they even offer 30-minute massage appointments to the public.  That might just be an add-on service to their other body treatment specialities and services.

When she asked me what type of pressure I wished for and where to focus, I shared again that I’m a massage therapist and was just there to try it all out, so to do whatever she wanted.  She said the receptionist had already told her and it made her very happy.  She asked me if there was any area I wanted to avoid (there wasn’t), and then asked if it was okay to massage my face, scalp, abdomen, etc. - and I told her it was all good with medium pressure.

Once we determined the style, pressure and fragrance of the massage, she then asked me for my choice of music.  I told her to play whatever she liked best because I knew the happier she was, the better my massage was likely to be, which allowed us to share a little laughter together. Then she left the room so I could disrobe and lie on the table in the pronated position. I took this picture of the massage tools in the treatment room shown below - they're quite impress and on display for sale in the retail area too!

As typical of high end European spas, they offer a 40” extra wide spa table with a hole in it instead of a face cradle.  This hole was different though. It was extra small.  My entire face did not fit in it. My eyes were closed and on the table itself because the hole was only large enough for my mouth and nose and nothing more. There was an elegant setup where a branded Dior towel was visible through the table hold but you couldn’t view this with your eyes being closed and lying on the table itself.

The massage started typically as all other high end spas, with hot towels to the feet and compressions through the sheet, and then the real luxury began.  The massage.  She undraped my back from the head of the table, and then covered me with fragranced lubricant. Then a fusion of lomi lomi magic began. Her massage strokes were long and continuous to the point that they felt neverending.  She started at the upper trapezius with a full hand and firm palm and worked inferiorly, introducing her forearms as she continued towards the ileums and beyond into the upper gluteus muscles. She then kept contact with her forearms in the reverse direction superiorly back towards my upper trapezius and repeated different variations of this.  She moved to the side of the table and performed more lomi fusion strokes in the shape of boxes over my back. The massage on the back alone was complete, engulfing and superior.  She worked both arms while pronated and she finished the back massage with repeated massage strokes that started around my sacrum and continued superior up my back, neck and over my scalp to the crown of my head.

She then worked both posterior legs individually, appropriately undraping each area as she worked on it, and redraping it when she finished.  The posterior leg work included knee flexion range of motion (ROM), where she flexed my knee and placed a fabric barrier between my lower leg and her shoulder to work my hamstrings and more. It was an experienced, detailed and wholesome extremity massage, similar to how we teach some of our posterior leg work in our lomi lomi massage training here at the school.

I then rolled over into supinated position where she worked my anterior legs and arms individually, not missing a square inch of the extremities.  Almost every massage stroke was repeated at least twice, with every toe, finger and joint in between caressed with skilled therapy.

The massage therapist then draped my chest to perform an abdominal massage.  After the abdominal massage was complete, which included strokes through the obliques to the low back, she then turned her forearm parallel to my sternum, and stroked inferiorly to superiorly over my sternum to my cervical area back to my abdomen. It was expertly executed and divine.

She finished her thirty minute full body massage with facial and scalp work. The work over my head was brief due to the limited time we had, but perfect. She used extraordinary pressure to trace my mandible and zygomatic bones and it felt wonderful.  It was fairly extreme pressure but not too much at the same time. The contact of her hands was always full, similar to how lomi lomi massage should be executed. Lomi is rarely about digging or pointing.  Lomi lomi massage is more about long strokes that feel like they never end which was terrifically mastered by this Dior massage therapist.  I never expected her to attempt a full body massage in just 30-minutes, but she did it, and it didn’t feel rushed either.  It was perfect. 

After I got up and got dressed, the massage therapist led me back to the reception area where she had a jasmine infusion tea with cookie waiting and a small gift in a canvas bag as well.  It was a really nice ending to such an incredible massage experience.

The reception area has an impressive array of retail items, that range from massage crystals to cosmetics to clothing and fragrances. There’s plenty of eye candy shopping to view before or after your spa appointment.  I especially loved the baby Dior retail line (pictured above) which allows mommy and baby to share her favorite brand with products that are formulated without alcohol and other harmful ingredients. The crystals used in the Dior body treatment and massage services were also in the retail area for sale too (pictured below). 

Far from stand alone establishments like most spa, bodywork or massage therapy practices, Guerlain spa services are primarily offered in the world’s most prestigious locations, such as the Michelin Star Relais Christine Hotel in Paris, France. Like many other top resorts, hotels or destinations, spa treatment areas are often relegated to highly modified basements given this type of treatment of business is usually an add-on operation long after the business was established.  Spa and massage services became more prevalent, popular and in demand around the 1980s. Today, a top hotel or destination would be considered incomplete without these services.

I scheduled my spa massage therapy appointment in-person at the Relais Christine because I wanted to see it first, and I was having problems scheduling certain services as well. Upon entering the spa service area in the basement, I knew I wanted to experience my Gurlain service there.

The carpet itself is extremely busy, however, it wonderfully compliments the interior design of the basement, providing an exotic warm special. Wholly together it creates a combined elegance once would hope to see of the House of Gurlain. They have wonderful welcome beverages such as homemade ginger lemonade, spa snacks and more. In fact their spa sessions end with an individually wrapped Angelina chocolate which is a sure treat!

The service provider helped me choose a Sunday service special that included brunch with a 90 minute massage therapy appointment.  I had told her I was interested in scheduling the 90 minute massage that spent 30 minutes on the face and 60 minutes on the body which didn’t seem to available at her location on the website, and she expediently offered to provide some additional facial service during the Sunday 90-minute special which was a welcomed offer and customization.

The massage appointment itself started in the supinated position. After I had mounted the table and covered myself with the sheets, the massage therapist re-entered and covered my eyes with a cloth. Then she said she was going to provide 4 different scents for me to choose from, to use for my massage medium. While I’ve rarely ever seen Guerlain promote itself in the overly crowded Aromatherapy industry, they are using plant extracts to formulate their fragrances, so their products are considered to be aromatherapy practices by definition. 

She explained the ingredients of every aromatic concoction which included a variety of scents to inspire warming, refreshing, relaxing, energizing, comforting sensations. The scents were gently and slightly provided next to my nose so that I could smell each with the various explanations of their ingredients and purpose.  I chose the fourth and final scent offered which she said was considered their strongest aroma with neroli and other fragrance, although I did not find it strong in the least.  She also used a hot towel to cleanse and compress my feet prior to hands-on massage.

The hands-on application then began with warm oil, so oil warmers were in use which separates some of the higher-end establishments with this type of premium equipment and service.  The therapist started with enveloping strokes of the decollate and back being worked together simultaneously while standing on the sides of the treatment table, which was the extra large 40” wide version.  

After opening the massage with some beautiful anterior and posterior upper torso massage, the therapist then had me roll over into pronated position, and I had to place my face in the hole of the table instead of a face crest.  The therapist then appropriately placed a bolster under my ankles to support my low back while in pronated position.  One superior touch that Gurlain spa provided was a floral bouquet in a bowl placed on the floor, underneath the top of the table where I could view the flowers instead of the floor when/if I opened my eyes.  Below is a picture of what the flowers looked like in relation to the massage therapy table:

The therapist continued her massage with confident firm strokes and was excellent at using both the heel of her hand and forearms to apply pressure without pain. Her massage was engulfing as she worked opposing areas that included working the back and hamstrings simultaneously or the hip and opposing shoulder simultaneously. She also massaged my arms while I was lying in pronated position.  She moved my arms off the table to coordinate the range of motion (ROM) of my shoulder joint with more coordinated massage strokes of the back.

Her massage strokes were expertly coordinated as she whisked about, without ever breaking contact, even as she continually applied oils to new areas.  She traced bony landmarks such as the vertebral border of the scapula and did not miss other areas like working directly over the gluteus minimus.

When she finished with the back, she did not skip a beat by covering the back with one hand while the other continued contact down my right leg. After she covered the back with one hand she used that same hand to further expose that right leg and then continued contact and massage while dispersing additional oil to this new area.  She worked the posterior legs one at a time and then had me roll over into supinated position.

As promised, she customized my 90-minute massage by adding a few mini facial steps, which included cleansing, toning, eye and facial serum applications, facial massage plus moisturizer. Adding esthetic facial steps in place of massage time is a wonderful opportunity to showcase products and hopefully make a sale at the conclusion of service.  I would also say that aesthetic facial steps are less physically challenging that providing massage, and anytime a practitioner can do easier work they should!  Massage therapy practice is mentally and physically stressful work, so anytime a therapist can provide easier work at the client’s request or enjoyment, they should! It’s a win-win for all! Please keep in mind that most European massage therapists are dually trained to practice esthetic and massage services if they work in a spa environment.  Practicing massage therapy in other countries beyond the US usually requires much more extensive training than what individual states require in America.  Massage therapists should not practice esthetics or any other service unless properly trained and licensed to stay within their scope of practice.  

The facial massage itself was complex as expected of any experienced facialist working with an upscale retail line, which in this case was Gurlain.  She included bone tracing, finger pad tapotement, grasping, kneading, sweeping effleurage with those opposing area strokes again, such as pulling up the side of the face while simultaneously massaging and depressing the shoulder on the same side. She did not include scalp massage nor offered it, which was acceptable given my hair was clearly professionally blown out and styled, and scalp massage would likely leave my hair in disarray. Furthermore, they did not have salon services on-site which could remedy any type of hairstyle.  However, we feel it is always best business practices to offer services such as scalp massage and allow a client to decide if they want it, instead of deciding for them, regardless of your reason why you think it shouldn’t be provided.  As long as a service can be reasonably provided and is not contraindicated, it should be offered to clients.

After the facial service, the massage continued to both arms and legs, one at a time.  The therapist regularly provided compressive strokes through the top cover prior to exposing the underlying extremity. Each extremity was thoroughly addressed in both supinated and pronated table positions.  She even found an old ankle injury that most therapists do not recognize, and provided specific/extra therapeutic work on it too. Foot massage was provided on one foot at a time with focal work on the dorsal side.  The plantar side of the foot was avoided, likely to not make it too greasy or slippery, given the spa is in the basement with a long set of stairs to exit. 

When finishing the massage, she undraped both lower extremities and performed long sweeping and bony tracing strokes of the tibia simultaneously. She then washed her hands (after working the leg and foot area), and proceeded with similar strokes to the opening of her massage on both my anterior and posterior upper torso with a new aromatic massage medium that felt like lemongrass gel.  It had a refreshing scent that was both awakening and enjoyable. The therapist then told me the service was finished and she would step out of the room so I could get up. I exited the room to find a refreshing beverage and Angelina chocolate to conclude the service.

The spa is equipped with a whirlpool, sauna and shower facilities.  I brought my bathing suit and hopped in the whirlpool; however, it was a little cool for my preference, so I moved on to the shower area where I got to experience the Guirlain shower gel and body lotion which was divine. The spa establishment itself is intricately laced with retail product testers for personal use which helps promote those extra retail sales which are a real financial bonus to the service appointments!

My spa day started with Relais Christine Hotel’s Breakfast Buffet which was separated into 3 different stations of pastries, fresh fruit and a hot section. All of it was included and I certainly tried it all too. The hot dauphine potatoes, fresh fruit and strawberry flavored madelines were wonderful and better than I could have hoped for. They also had fresh pressed orange juice and made-to-order specialty coffees included with the brunch as part of their special spa package.

Overall, this half day spa service experience with breakfast and hydrotherapy was well worth the $250 euros. I thoroughly enjoyed the splendid surroundings, treatment and incredible staff of Relais Christine.

One of the only critical feedbacks I could provide for this appointment was the treatment table was a little high to mount and dismount.  I forgot to look to see if this was a stationary table, but there would be an expectation for high-end adjustable electric tables at a Michelin Star hotel spa, that should be adjusted in height for table mount and dismount. Other than that, this spa service truly matches the hotel's Michelin star. 

I went to the Institut Baim Siam on Saint-Germain Boulevard in Paris, France for a traditional Thai massage.  Paris is covered with Thai massage establishments similar to this one, and this one had fairly good reviews, so I was able to do a walk-in on my second visit. On my first visit the door was locked. The therapist work dully as a receptionist, so everyone must have been in appointments. A busy establishment can usually be a sign of good services.

I asked for a 30-minute Thai massage and 30-minute foot massage for a total one hour service.  She kept asking me if I wanted an oil massage, and I repeatedly said no, that I wanted Thai.  She seemed very surprised that someone would walk off the street and ask for a Thai massage, but that’s what I did.  I was then asked to change my shoes for their natural material flip flops and gladly obliged.

She brought me downstairs and asked to change into pants that were the exact same draw string that I was already wearing, because I knew I was going for a Thai massage.  When I lifted my shirt and showed her I was wearing the exact same pants in a very similar color to what she was holding, she burst out laughing and we had a nice bonding moment.

She then asked me to remove my top, and had lied on the table in pronated position. After I laid down, another massage therapist entered and asked me to remove my bra as well.  I was lying on table paper on a 40” wide table and then most of my posterior body was covered with some type of towel that didn’t really feel like a towel. I’ve never felt anything like what I was covered with before.  The image below shows one of two massage treatment rooms in the basement which are separated by curtains.

The Thai massage started with pressure points up the feet, then she hopped onto the table between my legs and continued applying alternative pressure on my posterior legs from inferior to superior.  The pressure was too much and she did not respond to French or English requesting less, so I asked her in English, what language do you speak, and she said Thai. So I grabbed my phone and googled an English to Thai translation for less pressure and played the audio for it, and she laughed and used less pressure.

The alternating pressure with her palms continued into my hips, and then when she got to my back, she performed circular friction with her thumbs on my erector spinae from inferior to superior.  She pulled on and kneaded my upper trapezius and it all felt divine.  

Once she finished kneading my back, she then applied oil and performed a Swedish style back massage which was a surprise.  I was only expecting a Thai massage until she got to my feet, but I went along with it because it felt really good and she had beautiful hands and good training.  

After she finished my oil back massage she then went back to the inferior end of the table and started legs stretches, following by placing one leg at a time in various positions for more kneading of the leg with her palm. This felt wonderful as she stretched my adductors and other muscles with simultaneous kneading through the draw string pants.

Once she had me roll-over from prone to supinated position, I realized we were doing an hour long table massage without the 30-minute foot appointment I had requested, which was fine by me because the massage was extremely interesting and enjoyable.  The massage therapist continued to place my legs in various positions as she continued her experienced compression which all felt good and non-invasive.

Then she undraped my chest to expose my abdomen and performed an oil massage over my tummy. She reached through obliques, used appropriate pressure and it was another wonderful experience to receive this with my Thai massage appointment.  The abdomen is usually included with traditional Thai massage bodywork.

She then left the room and thoroughly washed her hands. She returned with herbal cottons which she then applied to my face. The first herbal cotton was placed over my eyes, then she placed another over my jowl area, and then started chest compressions using her palms again.  Another herbal cotton was then placed over my lower face and she started squeezing my mandible under the cotton. She then moved to my forehead and did some pressure point work. After she removed all the cotton which was now cool, she started a facial massage without lubricant, which was fine, because my skin was still wet from the herbal cotton. 

The facial massage felt wonderful and she finished with an incredible mind-blowing scalp massage before finishing the treatment.  The scalp massage wasn’t sophisticated but she kept rhythmically repeating the same incredible engulfing stroke over and over again.  She had both hands over my entire head with her fingertips reaching all the way down to my ears and would pull up with the stroke, and relax back down in the same starting position and repeated it over and over again.  It was really wonderful. The picture at the top of this article is one of their treatment rooms upstairs which looks a little bit better than what I occupied in the basement.

When I came upstairs, I was presented with a snack, bottle of water and paper cup which was a really nice way to finish the Thai massage appointment.  The snack was some form of delicious, airy, salty wafer from Thailand.

I asked if I could get a 30-minute foot massage at this Thai spa and they obliged.  It appeared they had all the equipment they needed to perform the foot massage in their lobby/reception area. She had me sick back and placed both feet on the ottoman which she had just placed a towel over.  She started with one foot by oiling it, then adding cream and what seemed like a menthol gel (pictured below) together. So there were three massage mediums used all at once.  The oil provides the high viscosity slip, the cream provides a moisturizing effect and the menthol provides an additional cooling and energizing effect. She worked one foot at a time while leaving the other covered with a towel, similar to how we would work in Reflexology treatments. She was methodical in stretching the foot and using her knuckles for foot massage as well.

Once she finished with one foot and lower leg, she would provide compressions on it through a black towel. Notice how she always has two hands on the client.  While compression is being made with the hand working superiorly, the inferior hand remains with firm contact which makes the massage feel wonderful and wholly engulfing. We call the second hand that remains in constant contact the "mother" hand.

Once she finished both feet, she then provided dual foot stretches and compressions on both.

Pictured below is the gel that was mixed with the cream for the 30-minute foot massage appointment at the Thai spa:

After my foot massage ended, the massage therapist had me sit on the ottoman where she was massaging my feet, and finished with a couple minutes of upper back massage, primarily squeezing, kneading and massaging my upper trapezius.

In the end, I was very happy with this massage therapist's technical skill; however, the work surroundings justified the lower prices of their services.  When we went downstairs to the basement for my massage (pictured above), it was dark, cluttered and just felt a little dirty. I lied on a table partially covered with paper and the towels or blankets I was covered with felt pilled, scratchy and/or gritty. 

If they are laundering their supplies between clients, the cloth type material is far past what should be considered normal use because now they just feel quite soiled.  The same with the towels that were used with my foot massage upstairs.  Aside from the environment and my therapist’s inability to speak in any language other than her own Native tongue while working in another country, it was all good.  Please note that I was not provided the service I had requested in both French and English, which was only a 30-minute Thai massage plus a 30-minute foot. I received a 60-minute full body thai massage instead, then had to add the 30-minute foot after the fact. Regardless, it was still a good experience despite these setbacks. 

I probably would not go back due to sanitation concerns, communication issues and poor quality of the supplies used.  The therapist repeatedly "double" dipped her hand into the cream after massaging my feet with oil, and despite the quality of her massage, that’s unfortuantely not something I would want to be on the receiving end of on a regular basis.

As massage therapy and spa appointments become more prevalent in an overall approach to today’s wellness, we’re finding ourselves carving out spaces for treatment all over the place.  Some establishments are relegated to the basement, yet turn into 5 star establishments. Others might be using the closet space as an add-on service to a pre-existing medical practice.  Some will have the luxury of building their massage or spa establishment from scratch. Regardless of how your practice came to existence, most of us are all seeking the same thing which is EXTRA SPACE.

In the United States, whenever we seek to renovate or build business space, we must do things such as make sure our bathroom facilities are ADA compliant.  Handicap bathrooms can take up a tremendous amount of space, and can leave less room for other needs.  However, once you have your handicap bathroom(s) in place, you’ll likely find yourself in need of additional bathrooms.  Running late because a therapist or client is waiting for a bathroom is preventable when additional bathrooms are available.

In Paris, where there’s extremely limited space beyond comprehension with businesses and living areas piled atop one another, I found a new toilet/sink combination that I have never seen before which is shown in this article. If you’re renovating or building new space, we hope showing this combo toilet/sink combo might inspire space savings ideas to enhance your practice. We would recommend relegating this type of space saving idea for staff use only, but having this available just for staff when compared to nothing at all is a great option!  

Tucked away in the Passage Choisseul in the Heart of Paris lies a tiny 4-story spa called Zen Bar. I found this place because it was highly rated on Trip Advisor.  Zen Bar advertises to “treat yourself in an instant”, so I was excited to try.  Who doesn’t want an instant treat? They appear to offer a lot of automated massage services, so I wanted to see how they were providing this to the public in such a busy city.  

Upon entering the establishment, you’re offered refreshments and a service menu to choose from, and the receptionist explained that there was no massage therapist on duty that day, so my choices would be limited. They have maximized their income opportunities without staff, which includes retail products and paid refreshments.

The spa is made up of four separate floors. There is no elevator. Each floor looks like it could be around 13’ wide by 20’ long, so perhaps around 1,000 square feet for the total establishment's combined four floors. On the main entrance in a small reception area with a couch, chairs, retail, lockers and mechanical foot massagers.  The basement has a bathroom with tanks for a fish foot spa, plus nail polish and service stations for manicures and pedicures.  The second floor (known as the 1st floor in Paris) is equipped with 3 mechanical massage chairs which they also refer to as zero gravity.  And on the 4th floor are three mechanical massage beds which they claim provide shiatsu with heated stones.

Pictured immediately below this paragraph is the foot spa offered with fish to “clean" or exfoliate the feet.  The fish supposedly eat away dead skin; however, we do not advise adding this to your establishment given it can be seen as animal cruelty. Some have claimed that the fish are starved and not fed so that they will nibble on the feet or anything added to the tank. There's also a claim that one fish spa experience caused a woman to amputate her toe. And you could also have problems with PETA or other activists for offering such a service. I was offered the fish spa and refused for anthropomorphism reasons.

All of the offered services are less expensive than the cost of service with a real massage therapist and live, hands-on application.  The lower cost is because Zen Spa’s equipment is providing the massage appointments and services instead of a human being.  

After I chose the shiatsu massage with heated stones which is one of the mechanical appointments I was offered, she then had me remove my shoes and asked that I place all of my personal belongings in a locker which she locked, and then gave me a pair of elastic gritty botties to place over my socks so that I could walk without slipping. I first used the bathroom downstairs in the basement, which was smart of the receptionist to offer given my treatment station was on the 3rd floor, four flights of stairs away from their restroom facility.

After using the bathroom, she then escorted me up the winding staircase to the 3rd floor where there were 3 mechanical beds behind curtains with a corporate massage chair in the middle of the three staged curtain areas.  She had me lie down on the mechanical massage table and gave me headphones for music.  The headphones had disposable covering over them and the table was covered with a disposable cover, so it appeared they had good sanitary measures.  She also offered me a choice of music with the headphones too which is great customization for any massage appointment.

The shiatsu heated stone mechanical massage was poor at best for an experienced massage therapist.  I did not feel individual stones at all, and there was no heat.  Instead, there was this hard roller that slowly moved up and down my body vertically.  It felt like someone who was making pie crust with a rolling pin was rolling up and down my posterior backside instead, from the top of my cervical to my heels.  At one point, multiple rollers lifted my buttocks and heels at the same time which provided extreme hyperextension of my knees, and I couldn’t help but think someone with a previous knee injury might find that really uncomfortable.  I walked away reminded about how important it is to have a human provide manual massage therapy services instead of a machine that could possibly harm someone when they do not appropriately apply pressure or put a client in the wrong position due to some type of timing issue with different client’s body types and sizes. Pictured below are two of the three shiatsua table stations on the third floor. The room was very dark hence better relaxation but poorer photo quality. 

Overall, someone who’s unfamiliar with the wonder of licensed massage therapy services might be satisfied with that mechanical table, especially if they do not like the touch of another human being.  However, if you’re used to regular massages with a professional massage therapist, then this was not a great substitute.  The zero gravity massage chairs might be a better option than the mechanical massage table.

There’s some concern in the massage industry where some businesses are advertising massage or bodywork services without explicitly stating it will be executed by a machine. Pressotherapy is commonly advertised as lymphatic massage, lymphatic drainage or lymphatic drainage massage; but, what it really is are enveloped balloons fitted around extremities that inflate and deflate with air pressure.  Now we have another establishment claiming shiatsu is being practiced by this roller table, which couldn’t be anything further from real shiatsu application by a licensed bodyworker.

The receptionist told me when my session ended, to simply come downstairs to where more mechanical massage would be provided for free.  There are foot massagers on the first floor that are offered complimentary with their other services, where you can enjoy refreshments at the same time.  I ordered a strawberry drink while enjoying my foot massage which was quite good.  The mechanical foot massager compressed, vibrated and rolled the soft tissue of my feed in a wonderful way that felt really good. You put your feet in the foot machine with those gritty booties on which keeps solid sanitation. That part of their mechanical service was unexpected and excellent.

I believe this mechanical spa will be the way of our future, where machines are available when staff are not, although there should be a better balance between the two.  I think machine services are wonderful to supplement regular appointments, and great to use when a therapist is running behind or doesn’t have enough time for longer service when a client wants more.  Using them exclusively is a little impersonal, but can also be highly effective like how this establishment is operating here with just one staff member coordinating clients on four separate floors into machines.  

There was a mother daughter due on the first floor who had other mechanical services prior to enjoying the final mechanical foot massage with refreshments on the first floor.  They stayed there for almost an hour thoroughly enjoying it all.  Minor children may do better in a mechanical service environment where the services are shorter, and there’s no touch from another human involved which alleviates many liability issues too.  While the table massage itself left a lot to be desired, there are definite market opportunities and fun to be had here.

On a final point, I will say that the aqua massage tables might be my favorite mechanical massage, which spray high water pressure through jets onto a canvas that covers you while you lie horizontally inside their machine. They’re more modern, adjustable, sanitizable, look better and more. Unfortunately all mechanical massage tables are extremely heavy with the aqua jets perhaps being the heaviest, which is why they’re likely not used on the 3rd floor of this extremely old Parisian building.  Hoisting a heavy mechanical table to the 3rd floor on a winding staircase with no elevator must be challenging at best, which is too bad because the best of all is probably the heaviest of all which is likely prohibiting its use.

Hydrotherapies have been through an amazing evolution from the ancient Roman baths to today’s most updated practices and experiences. Some cruise ships have cashed-in on that ancient hydrotherapy tradition, and have become the new kings and queens of spa hydrotherapy services.  Many of the newer larger ships provide surreal thermal and hydrotherapy experiences as shown in the video below.

Hydrotherapy stations often allow do-it-yourself (DIY) services, where a customer will continue a massage or spa experience on their own through various uses of thermal and hydrotherapies. 

Hydrotherapy stations usually cost more to install upfront when compared to a massage therapy treatment room. However, their ability to operate without additional staff expense. can also offset the initial expense.  DIY single-use thermal and hydrotherapy stations are also more desirable during a pandemic event such as COVID-19. It is best whenever a client can enjoy therapeutic services without exposing themselves to another who may be infected and vice versa for the massage therapist or spa provider too.

Benefits of thermal and hydrotherapies are innumerous.  They can be relaxing and provide stress relief. Establishments can provide DIY scrub products to a client that can be added to specialty shower services. Hot and cold baths, showers or rooms can also provide circulatory benefits. Clients can use heat or cold therapies alone, or contrast the thermal therapies for detoxification effects. Combined, the therapeutic effects of hydrothermal therapies are extensive. Many clients leave thermal and hydrotherapy areas feeling better with less tension, smoother skin and overall satisfaction.

• Hydrotherapy and thermal therapy suites can be offered to clients in a number of ways:
• Various shower facilities, including waterfalls, jets, handheld hoses, breezes, bucket dumps and more
• Whirlpools and spas
• Saunas
• Steam rooms
• Relaxation areas
• Salt rooms
• Turkish baths
• Cold plunges
• Other various baths
• The various options or endless

Today, it seems like some establishments are turning to hydrotherapies and thermal therapies to replace the decades long practices of massage and bodywork therapies, which is acceptable and has some benefits when the hands-on appointments offered the added hydrothermal benefits.