The answer is NO. Massage therapists do not need to hire nor employ a receptionist for their clients, especially when working with other established businesses who can assist.
Back around 2003, I opened up a 3rd location to my Massage Works Inc. establishment at Gold’s gym. We simply had one treatment room at the gym for regular massage services, with a massage therapist who had appointments on-site and waited on-site in-between. These therapists who were sent to our third location at the gym were used to having between one to three reception staff on-site and always at our main location on Washington Street, where we operated 10 simultaneous treatment rooms of massage, chiropractic services, thermal therapies, acupuncture, endermologie, esthetics care, and various forms of bodywork, 12 hours a day, 7 days a week. So, some found it weird to be all by themselves with a single treatment room at the gym after working in such a busy clinic for the same employer, but it was doable. Often the massage therapist was available to greet their next massage client at the gym’s single treatment room establishment, and when they were not available to greet them, the gym staff would greet the client and ask them to sit and wait until the massage therapist was available.
Now some would see that gym scenario fairly typical or even low brow for operating standards. So when I just had a tremendous massage and spa experience at one of the top establishments in the world that also did not employ a dedicated receptionist, I decided it was time to write about it and share this acceptable business standard. This is when I sought service at the House of Guerlain which is one of the oldest and well known beauty brands in the world, originally established in 1828 in Paris, France.
Far from stand alone establishments like most spa, bodywork or massage therapy practices, Gurlain 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.
Sometimes when you have a smaller practice that’s relegated to a basement or single treatment room, there is not enough staff or income being generated to pay a receptionist, nevermind the lack of work they might have only receiving one customer per hour, etc. So it wouldn’t make sense to employ a receptionist for this type of operation both sensibly and financially. That brings me to the epic Gurlain spa at Relais Christine, where there are only two treatment rooms in a dedicated 1,500 square foot spa space in the hotel basement. They have one single treatment room and one couples treatment room, and sometimes only one practitioner total is working at the spa at a time. Yet it still manages to achieve jaw dropping greatness through its ambience with excellent high-end products and services. Below are pictures of the two treatment rooms available at Hotel Relais Christine's Guerlain Spa.
In the gym or "wellness" and high-end spa establishment mentioned above, both had staff that were designated for other operations filling in to help with reception duties for their respective clients. At Relais Christine, you have to walk past the front desk and hotel staff before getting to the stairs of the spa, and of course they will inquire if you need assistance if you do not ask for it yourself. At the Calmer Clinic in London, England, I encountered a receptionist on the first day I visited and no receptionist when I returned for my reflexology and Ayurvedic treatments. I simply entered and sat in the waiting area until my therapist received me. The world did not end because of an absent receptionist.
Now with massage, especially when working with the unknown public, it is considered safer to have a second person on-site (such as a receptionist) for obvious reasons. The client will know someone else is there, and that will hopefully help them behave properly. Having no receptionist or other visible person on-site where massage therapy is publicly offered could potentially leave a therapist in a higher vulnerable position for solicitation of sexual services which still occurs to this day. We want to note that most spas and establishments today require their clients to sign a no-harassment policy prior to the start of service, so if you work independently or without a receptionist, we suggest you set up practices that help ensure your safety and make better sense for you.
If you’re going to operate an establishment with a waiting area and no reception staff, set it up in a way that would be user friendly for both you and your clients. That would include having chairs that have arms where a physically disabled client would be able to easier lower or raise themselves out of a chair. Providing reading materials and client health history intake forms to complete in your absence, so that they can make a better use of their time. Make sure there’s signage to the bathroom which they can also use before treatment, which could expedite your service once available as well. If you sell retail, have valuables or simply want to be smart about you and your property’s safety, install security cameras that record to a cloud or off-site location of the common areas. Be sure to publicly post that security cameras are in use in visible spaces, and do not include security cameras in private areas such as treatment rooms or bathrooms. While security cameras can be used in hydrotherapy areas such as pools, plunges, salt areas and more when properly posted, they should not be used where a client may be recorded exposed in various stages of nudity where others cannot see them, so a camera should not either.
When setting up your own spa services or massage practice, while it’s always nice to have a receptionist tend to your every need, do not think that is a prerequisite to a successful business. The examples above should effectively show that receptionists are not an essential requirement. Although it would be good to find work space in a shared environment such as the hotel or gym whether other staff are present and could momentarily help you receive your clients if you are not available to do so upon their arrival. Think about WeWork, where you pay for a single office but then have access to large conference rooms, kitchens, reception staff and the like. While it is more than acceptable to go it alone, there are also shared staff opportunities in like businesses that may make sense for you too.
To learn more about better business practices for both the spa and massage industry, please enroll in training at our school at: https://ceinstitute.com/
Gommage, gommage, gommage, oh my! I couldn’t find a single place that offered massage in Paris without having gommage aka known as a body scrub. Almost any Parisian massage establishment has gommage on their service menu. Providing body scrub service by a spa or massage establishment’s massage therapist or cosmetologist is just good business. It provides additional income for both establishment and practitioner through services, plus a possible product sale if a take-home version of the scrub is sold. It also offers a new experience for customers who may want something different and it breaks up the monotony of other services that the service provider may be practicing all day long too. Spa body scrubs are a win win win situation for all, that is unless you do not know how to properly provide one.
Some think that if they’re a massage therapist, they can simply do a body scrub too? How hard could it be? The answer is - it’s not hard, when you have the proper customized training, know how to properly adjust and use the various ablatives. If a massage therapist tries to apply a scrub like a massage medium - then you’ll encounter problems. Those two products are VERY different, not only in texture but also in how you apply or use them too. Scrubs are not massage mediums, and most feel terrible if you try to use it like a massage oil or lotion too.
Our feeling is body scrub manufacturers are sending sales reps without proper training to sell and train establishments on how to execute a body scrub in a dry or wet room. Obviously a sales rep that is unlicensed with no hands-on experience demonstrating spa products would be a poor choice for training, although we’ve seen this before and we suspect that type of practice is increasing too. If you would like to learn a new service with a new product, ask the sales rep to demonstrate the service ON you first, prior to investing in whatever they are selling. This helps practitioners/decision makers learn what it should feel like with good execution, and can also help identify bad products and poorly provided services too.
We’re providing a list of Do’s and Don’ts for Spa Body Scrubs after receiving several of these treatments that were less than satisfactory. In the following steamed scrub video, you’ll see the fast, brisk fairly light movements with water application used to scrub the skin and gently dissolve the scrub to keep the product lose, less scratchy, more tolerable and make it easier for washing off in a dry room setting:
Here are some tips and points about a recent spa body scrub service I received in Paris, with focus on what not to do, with most of these pics below depicting non-ideal service:
The practitioner provided paper panties to wear for the scrub and asked me to lie face down in the pronated position at the start of the session. She did not provide any draping to cover myself with (don’t). She left me full exposed during the entire full body scrub session on both my posterior and anterior body (don’t).
OnceI was lying in pronated position on the massage table, she entered the treatment room and started the service with quick brisk scrub strokes on the soles of my feet which was very ticklish (don’t). Most people would experience a ticklish feeling in the feet when lightly rubbing back and forth on them with something slightly scratchy. Unfortunately this is where the practitioner's light pressure stopped. It’s almost as if the practitioner was prepared for the client to not tolerate starting on the feet, but despite her apprehension, she did it anyway (don’t). If something’s repeatedly feeling wrong to you, or you’re repeatedly getting negative feedback or consequences from the client, you should perhaps rethink your work, and in this case, starting a different area other than the feet would have been more appropriate at the pressure and speed.
The practitioner kept scrubbing my calves with excessive pressure (don’t). She just kept going back to calves over and over again with excessive amounts of pressure. It might have been okay with one or two passes, but twelve or more very heavy pressure passes of scrub into my skin (instead of over it) became too much, and I finally had to tell her to lighten her pressure. I told her this so she wouldn’t draw blood! When it comes to scrubbing in large fleshy areas, a full hand with heavy palm contact isn’t the most appropriate to repeat over and over again when jagged sharp sugar and salt crystals are on the client’s skin.
After I told her that her pressure was too much, she lightened it for a few seconds and then immediately went back into her heavy handed pressure (don’t) I probably asked her to lighten her pressure at least 8 times in 20ish minute full body scrub. That’s not relaxing folks. That’s a poorly executed nuisance.
What the practitioner should have done knowing there was an issue with her pressure, was check in after applying scrub to each new area, such as the second leg, or when she moved to the back, etc. (Do). No client should have to ask for the same less pressure eight times in 20 minutes. That’s unacceptable.
After she completed both posterior legs, she moved on to my low back (don’t). The low is the most sensitive area of the back, so when starting bodywork such as scrubbing, hot stones, cupping, graston or much of anything that might be initially slightly shocking to a client, we recommend starting in the upper back area where the body is less sensitive. Her back scrub was okay, minus the unacceptable amount of pressure that continued, even when I asked her for less pressure, which were the words she offered when I told her the pressure was too much, so I do not believe there was a language barrier. I simply believe this massage therapist works with one pressure for all regardless of what she’s doing, and that’s after experiencing a full body scrub, massage and facial with her. All three services were the same exact pressure regardless of the service.
In the picture below, you can see the practitioner's hands have the palms in firm contact with the client's skin. This would be an example of an erroneous application and pressure. It's okay to use a flat hand to fly back and forth over the skin lightly with a scrub, but you should never try pressing or pushing a scrub into the client's soft tissue such as their back, which would be too abrasive and an inappropriate application:
She had me turn over and she started on the feet again. She did some really nice work, or scrubbing around the ankles and heels, then moved up the legs with a venous return approach (do). She also avoided the inner thigh which is generally too sensitive for body scrubbing (great job). She moved onto my arms but the pressure just didn’t let up. It’s like she only had one gear and doesn’t shift it for anyone. She did a great job making sure the hands, feet, fingers and toes were scrubbed (do), but unfortunately while scrubbing my fingers she pulled the scrub interiorly towards my fingertips (don’t), instead of keep her venous return approach of working towards the heart to help continually increase circulation.
Pictured below shows how the palm is firmly planted on the client’s skin which is a repeated misapplication of scrub treatment again. Scrubs should primarily be moved about the client’s body with your fingerpads, and acceptable full hand scrubbing should only be applied when flying lightly over the skin as demonstrated in our youtube video. The only places it might be acceptable to increase scrub pressure with a palm, etc., would be when working on thicker skinned areas. Examples of thicker skinned areas are the heels of the feet which are also less sensitive to pressures and scrub.
She then moved onto my abdominal area which was very interesting. Normally we skip the anterior thoracic and abdominal cavities when it comes to spa scrubs, due to how sensitive these areas can be, and of course you would never scrub a woman’s breast. Luckily she was very gentle with her abdominal scrub (do), and it felt great too. That was wonderful. When applying body scrub to the abdomen, practitioners should work in the same clockwise direction as they would normally apply in abdominal massage. Different mechanical maneuvers and pressure would be applied to the abdominal area with body scrub product.
She continued her scrub up through the sternum and then over my right pectoralis minor to my shoulder; however, she only did this on the right side, and didn’t do the same on the left. Then she just finished and started to setup for a shower leaving me feeling a little off balanced by not completing the left side with the same (don’t).
She did not remove the scrub from my feet before asking me to dismount the table (don’t). I slipped not realizing how oily the scrub was. With the excessive pressure all I felt was scratchiness and raw, so finding there was a decent amount of oil on my feet was a shocking surprise. She also did not put a towel and there was no matt on the floor to dismount (don’t), so I slipped on a smooth vinylish floor.
This was a wetroom 3-step spa scrub where she performed the scrub, then I was to shower the scrub off while she changed the table, then I was to get back onto a clean table for a massage. She walked into the shower with my while I was only wearing paper panties (don’t) and did so with her shoes on (don’t), then showed me how to partially operate the shower and did not mention the knob she told me to turn the shower off would also poor water on me from a waterfall above if I turned it too far - massive don’t. Now my hair that I just styled the other day is unsalvageable - frown face.
Once I started rinsing the scrub off, I realized it was extremely dry. After applying the product and scrubbing a bit, the provider could have added some water to help make the scrub feel less scratchy and raw, and to help loosen the scrub so that it would be easier to remove. It usually feels best to start with a full salt or sugar scrub with a few strokes, and then start adding water to help the scrub dissolve so it’s easier to remove (do) regardless of who’s doing the removal.
I slipped again in the shower which wasn’t set up very well for someone who just had an oily scrub without removing the product from the feet first before entering this wet area. The most appropriate business practice here would be to provide some type of resusable/sanitizable wetroom footwear such as flip flops with a gripping sole so that the client can safely shower without slipping. Reusable flips flops might cost around $30 per pair but it could save you a $300,000+ lawsuit when a client slips and breaks a hip.
Once I finished showering, I dried myself off with a really nice large bath sheet that was provided, and walked back into the adjoining treatment room where it felt like my bare feet were sticking to the uncovered/dirty floor (don’t). The therapist then tossed the new one-size fits no one paper panties away before I had a chance to put them back on and told me to get back onto the table pronated/face down again fully naked. She then covered me with a dry towel but completely exposed my buttocks for the massage (don’t). There was no need for the excessive nudity other than to give her a real nice shine!
Her back massage was beautiful with alternating effleurages, friction, circular and other complex massage strokes (do). The pressure was fairly perfect and she finally checked in with me to make sure that was (do). When she had me turn over she then lifted the sheet in the air in a way that left me excessively nude again (don’t). This was totally unnecessary, unprofessional and unethical.
She finished with cervical and facial massage with continued skilled complexity (do), and it’s fairly obvious the therapist likely provides esthetic facial services with how wonderful her face, scalp and neck massage was. The creamed used with my facial massage had a faint hint of aromatherapy, which made the massage feel even more luxurious than the incredible contact, fullness and intricacy of the facial massage itself.
Overall the finishing body moisturizer/finishing massage was very good with a couple notable exceptions:
Always use cream or lotion to provide moisturizing massage after an oil based scrub. Applying an oil massage after applying the thick oil that’s traditionally used in a scrub is excessive, and can leave a client feeling sticky and sweaty. In this establishment, they used more oil for the finishing body massage application which was excessive, and would have been a better experience with cream or lotion.
Most gals love a good manicure and beautiful nails, however, I could repeatedly feel this massage therapist’s nails during her massage which was slightly distracting from her gorgeous strokes and soft tissue manipulation. Thankfully despite their length, they were well filed so it didn’t feel like she was cutting my skin, but it was a very unwelcome feeling.
No knee or ankles bolster was provided for pronated or supinated massage, and the excessive exposure through inappropriate and excessively nude draping techniques kind of spoiled her beautiful massage.
From a business, operational, liability standpoint, this spa scrub service is not worth the risk it is posing to the establishment due to poor practical standards. I noticed once I put my shoes on that the sound of them on the sticky floor was unacceptable. While the floor visibility appeared clean, it was likely no longer safe nor cleanable due to the oil buildup over time. The floor is not being protected from the excessive amounts of oil exposure, which could easily be solved by:
Not allowing practitioners to walk in the same area of product (treatment room, shower, etc.) and then continue their footwear into other parts of the spa, i.e. treatment room, hallway, stairs.
Provide appropriate boundaries and protections for flooring, such as using bath matts, towels, etc., which were not used nor provided to protect the floor of this establishment.
In the end, this wasn’t the worst spa scrub in the world, but it wasn’t great either. By adjusting the service with these minimal points, it might have been absolutely incredible, especially when the practitioner was brave enough to scrub the belly and finish her massage with her magnificent facial massage.
If you practice spa body scrubs, then you should receive one of these annually, hopefully from someone who’s using the same type of scrub as you are, so you can feel what it feels like when you’re using that product. Ask them to work in the same direction as you, with similar pressure and strokes, etc. Hopefully feeling this will allow you to understand what the service feels like to inspire continued excellence when you’re providing the same.
I experienced a 30-minute Kobido facial massage with shiatsu at the Assa Japanese Wellness Salon on rue Christine in Paris. Kobido facial massage is provided for anti-aging purposes, to help temporarily diminish fine lines and wrinkles with a natural lifting with rejuvenating effect. This was my experience of it:
It does not appear that there are any hair or nail services provided in this wellness establishment, so I would describe it as a wellness clinic or maybe even a medi-spa given they do have medical devices and equipment for certain services, although they are not used with the Kobido facial massage. Below is a picture of the establishment on rue Christine:
Upon arrival for my appointment, I was asked to remove my shoes for vinyl flip flops which I gladly obliged. This shows respect within the establishment and also keeps the floors more sanitary.
Despite only booking a facial massage, I was asked to remove my dress and lie supine on the treatment table. The table was covered with a paper roll, and I was provided a small blanket to cover myself with. Below are pictures of the treatment room after my facial service was provided, which show the paper covered table and the natural stone surroundings of being within an ancient building in Paris on rue Christine. The pictures are a little blury because it was low light in the dark treatment room.
The therapist reentered the treatment room once I was on the table, and covered me with another towel. I wasn’t provided a knee bolster and I did not ask one for one either. Please note that when a client is lying supine on a flat treatment table, it is best practiced to place a knee bolster underneath their knees to support their spine, unless the client refuses the bolster after they learn how it will help them.
She then used a headband to further pull back my hair from my face with a gentle beautiful touch. The hands-on session then began with make-up removal which was a little odd given I wasn’t wearing any, and haven’t worn make-up for 5-years.
Eye make-up removal was wiped from the medial corner or the eye to lateral, especially when working the undereye area. We recommend wiping in the opposite direction (as shown in the picture below). Lip make-up removal was wiped from the lateral corners to the middle, starting on the left side then the right.
Immediately after make-up removal the practitioner then provided a facial cleanse. She cleansed my face, neck and decolote, and removed the cleanser with sponges and a hot towel. Next she applied a lightly scented floral toner, wiping away any leftover cleanser or impurities.
Facial shiatsu was applied next. She started with fairly heavy pressure from the middle of my forehead with the sides of two thumbs, working her way out laterally with pressure points approximately one inch apart. The pressure was around three pounds or greater. She repeated this horizontal line from the middle to lateral forehead bilaterally before moving superiorly towards the hairline and repeating. Shiatus with pressure points continued on the face from superior to inferior. This was a curious direction to work given most anti-aging facial treatments would work inferiorly to superiorly to lift away or against gravity.
After facial shiatsu was applied, the therapist then applied a massage of high viscosity with sweeping strokes for full coverage. She turned my head to one side and fairly vigorously worked the soft tissue between my mandible and zygomatic bones. When she finished, she turned my head to the other side and repeated the routine.
After she performed lower face work bilaterally, she then started massage or manual mechanical maneuvers directly over aging lines or wrinkles, commonly known as the marionette lines, crows feet, nasolabial folds and the eleven between my eyebrows. Once the massage strokes and kneading were concluded, she then performed fingerpad grasping and tapotement over the entire face.All of the massage was wonderful, and when she completed it, she then wiped the massage medium from my face with the same slightly scented floral toner and cotton.
I have extremely dry and dehydrated skin, so I was a little surprised after wiping my face with toner that she then placed a tissue over the skin to dry it. The make-up removal for nonexistent make-up as well as the tissue to dry dehydrated and dry skin are all steps that should have been skipped for better treatment proficiency.
Once the massage medium was removed, the therapist then placed toner soaked cotton pieces over my face as seen in the picture below. She then continued with shitsu pressure points over my scalp while the toner packs remained stationary over my face. The treatment ended with bilateral simultaneous and alternating compressions over my chest and decolote area.
The treatment was very nice and cost $55 euros for 30 minutes. They did not expect a tip and offered no way to provide one when I was paying, but when I asked to add a tip to my charge she gladly obliged. I was provided tea at the end of the session in a disposable cup and led back to where I could change back to my regular shoes (pictured below).
Even though this wellness clinic or medispa is a short walk from my hotel in Paris, I decided to take an uber because it was heavily raining and I was running a little behind to walk, and I didn’t want to be late. Rue Christine is a very short street in Paris, and was named after King Henri IV’s 2nd daughter Christine. When I got into the uber at my hotel, it was so interesting because my uber driver asked me if I was going to go have a massage. He probably guessed this based upon requesting a ride to this very short street where there appear to be two similar Japanese wellness clinics offering massage, plus the Gurlain Spa is in the Relais Christine Michelin Star Hotel across the street. Needless to say, I found one of the places that could be called the heart of massage in Paris on rue Christine.The picture below shows the exterior of the businesses Assa and Calma on rue Christine in Paris:
Before the COVID and especially now post-pandemic, it's more important than ever to use online tools for day-to-day business operations. Online operations allow spas and massage therapy establishments to reach a greater population and streamline business operations too.
ONLINE SCHEDULING
Customer convenience may improve if/when online scheduling is offered, especially for spa or massage establishments that do not have a large admin staff to expediently answer every inquiry. The keyword here is “easy”. Online scheduling should be clear, have minimal steps with essential information, including prices of available services with cancellation or business policies clearly defined prior to payment.
Ensure Online Scheduling is Secured and Functional
Even at the most prestigious spa establishments in the world, including the spas at George V in Paris and Claridge’s in London, I found security site errors when trying to use their online services. In fact Claridge’s REQUIRED online reservation deposits to secure an appointment; however, I received a secure/connection error when trying to pay it. It can be offputing, annoying or even concerning to receive the following error messages in the screenshots below while providing personal details and credit card information online. When setting up your online scheduling and payment options at your spa or massage establishment, try to find compliant software that’s properly programmed and up-to-date to avoid customers encountering these types of errors:
Online Scheduling is A Great Time to Offer Add-ons
When programming online scheduling for your spa or massage therapy establishment, we recommend offering add-on services too. Add-on services can:
Enhance the appointment and make a greater or more enjoyable experience for the client
Add income to the establishment and practitioners
Diversify the practitioner’s work to help avoid burnout
Turn over supplies to help keep them from expiring on your shelves
Maximize of fill your calendar space/time that might not fit a longer or regular service time
Add-on services make great business, and should always be offered whenever available. Here are some screenshots of add-on services that I was brilliantly offered for spa and massage appointments in London and Paris:
Improve Your Customer’s Experience with Virtual Outreach
Requesting client preferences during virtual online scheduling or the customer intake process is a brilliant approach to enhance their experience. Here are some examples of appropriate questions to ask your client online during these processes for better business practices, which includes scents and music choices:
Please make sure that the information sought to enhance your client’s visit is appropriate for their appointment; otherwise, this could lead to disappointment. Those are questions that were asked of me for a manual lymphatic drainage (MLD) appointment; however, MLD is applied dry, without oils, so asking which scent of oil I would prefer is irrelevant, and could create a customer expectation that can sorely lead to disappointment when they learn that they will not receive any aromatherapy during their MLD. Offering choices or enhancements that cannot be provided is bad operations that could be avoided with appropriate choices/disclaimers or better online programming.
Failure to Accommodate with Online Appointment Scheduling
I tried visiting this Tibetan spa in Paris (pictured below) on FOUR separate dates. It semed whenever I arrived they were closed, including one Sunday there were gates over windows. Due to language barriers, I only tried for a walk-in appointment given it was only 15 minutes from my hotel, and across the street from Notre Dame and the Seine river which is always a nice walk. On my FORTH attempt to visit, I went during normal daytime/weekday business hours only to find their door locked, again! The business didn’t have its metal cage over the windows so I knew they were open for business versus how I had seen the business closed during other nonoperational times, so I rang the doorbell twice and waited about 10 minutes at the door, but no one answered. Then I saw the option to book appointments online, and I thought, if this spa is so busy that they can operate in such a prime location for such minimal hours, then I MUST see and experience their services! So I tried to use their QR code to schedule an appointment online rather than attempt to schedule with walk-in service, and would you believe that in the heart of Paris I received an error message that said it could not accommodate customers from my area (I was using a cell phone from the United States).
Paris has an estimated population of about 2 million people with an estimated annual tourist population of 30 million. So when working in such a highly touristed area, wouldn’t it be wise to use an online app or software that accommodates your largest market which in this case would be out of country tourists? If you’re in a similar, highly touristed area such as LA, New York, Boston, Miami, etc., where you have a lot of international tourists or even students for customers, you should use online software that not only accommodates international customers, but it should also translate into various languages as well.
In the images immediately below, you will see this Tibetan establishment’s app failure where I repeatedly visited without success. Needless to say, I did not go back and they lost a potential customer and services payment too.
Better Business Practices
Treatment contraindications should be discovered BEFORE your client reaches your establishment. Learning the client is contraindicated for their scheduled service after the client has arrived is a waste of both your and the customer’s time. You’re also probably not going to be paid when you cannot provide a service due to an unknown contraindication that prevents you from working. Screening for contraindications prior to the client arriving is essential to good business for both you and your client. Screening for contraindications and precautions can also be achieved online, but make sure you have secure online practices to do so to avoid a HIPAA violation.
Another recommendation would be to provide clear policies and business requirements to patronize the establishment, BEFORE the client pays for service. Many spas, especially those that include massage therapy are including no harassment policies as part of their business practices. I was required to agree to this no-harassment policy to receive my MLD appointment at George V in Paris:
There are many other recommendations that can be made for online operations for both spa and massage therapy businesses. These are just a few. If you haven’t already implemented some of these practices, please think about how or if they would work for you.
by Selena Belisle, Founder/Instructor, CE Institute LLC
Are you sick of hearing the same massage music over and over again? Do you remember when you first heard it though? Wasn't it the most amazing thing you had ever heard?
When I entered the world of massage, I was only a teenager. I had a fairly chaotic life all the way up to winning my first world title in arm wrestling in the Athens Greece Olympic stadium, and then moved to a new state by myself at 19 years old, so I could train with other members of Team USA. I was young, alone, fearless in a world moving very fast, so being in a dark room with ethereal music plus stillness, comfort and care was a great attraction for me. There were some days that I wanted to stay in that massage room and never leave it! While the specifics of my story are different to others, I believe many massage therapists find appeal in the massage industry because of the wonderful peace, calmness and comfort that our work world can provide.
Fast forward after many years of practice, and most of us could probably hum any Enya or Clannad song ever released, without the music playing. That’s because massage therapists usually listen to the same songs repeatedly to no end. The music, our surroundings and the massage itself can become extremely redundant over time, especially if you're practicing the same modality instead of holding a well diversified practice.
So how can we break up the monotony of our massage therapy practice? Especially when facing burnout? One of the answers is to change HOW we hear our music.
I recently went to see the Lion King theatre production at the Lyceum Theatre in London, England. Many songs from the Lion King soundtrack are used in online radio stations for massage or spa practice. And now, whenever I hear one of those songs, I don't think about how boring it is to hear that same sound for about the 5,000th time. I instead reflect on my time in London with a smile, and that wonderful theatre show and the story they sang and told with it.
Now it's important that your focus remains on your client at all times during your massage or bodywork treatment. But it is okay to fondly and momentarily reflect on your positive new experiences with your work music. Allowing yourself to feel something new and different can break up your daily routine and reinspire new feels with your career.
A lot of the music we hear at work was born from movie soundtracks, or later added to them. Being able to add new experiences with any aspect of your work, including exploring the roots of various songs to see and hear them in a new light is a great way to create a new joyful experience out of something old and tired.
So if you're looking for new ways to inspire or reinvigorate your massage therapy career, and you don't want to diversify your hands-on skills, redecorate your workplace or other things that may switch-it-up for you, then try to find new ways to appreciate the music you listen to all day. Take a mental vacation and go enjoy a movie, concert or theatre show where you can might be able to hear that same music - differently - with an alternative and hopefully happy application of it, similar to watching the Lion King theatre production.
While you could try to find new music to play at work which is always advisable, it isn't a bad idea to view the old music in a new light, especially if your clients love the music too.
We know now that COVID-19 was airborne, spread through droplets, aerosol and through contaminated surfaces. So, the best course of action to protect yourself from this airborne contagion was to avoid others who could be infected. We called this social distancing, where the virtual workplace became prevalent, and physical hands-on practices like hands-on medical treatment, massage therapy and spa services were not included. These hands-on client practices were practically abandoned if you wanted to truly keep yourself safe.
There were many things that could be done to create a safe work environment, through improving your air quality at work, where outdoor workspace might be considered the best option of all. The best, safest and most reasonably available overall air quality during an airborne pandemic (that we know of to date in this highly evolving time), can be achieved by practicing your hands-on services, where there is an unlimited amount of air ventilation. Outdoor practice allows infected individuals to exhale their contaminants into unlimited amounts of air, which will disperse the contagions and lessen the viral load exposure to others in the area.
A cabana, rooftop, balcony or working underneath an outdoor trellis could be a better option than most indoor treatment rooms during an airborne viral pandemic. To achieve outdoor workspace for spa, massage and medical practice, you should ensure that your treatment space has privacy and is protected from direct sunlight to avoid sunburn. Use outdoor fans to cool yourself and your client if needed. When setting up fans, you would want to make sure that the air or wind is not blowing directly onto you.
The next picture is an example of an existing trellis at the Michelin Star Relais Christine Hotel in Paris, France. It is unfortunately at the entrance of the hotel in public view of all the hotel guests; however, this is an excellent example of creating outdoor treatment space to use during an airborne contagion concern. Growing additional plant material including vines could help reduce the visible exposure of the spa or massage therapy treatment that could be provided inside of it.
The trellis in the back of the picture shown below would be a more ideal position for a spa station, medical treatment or massage table to protect yourself and your client from the sun and other natural disruptions such as birds doing their business, etc. Planting natural climbing vines and plants along the trellis will take time to grow, so it would be best to start preparing any available workspace you have for this outdoor practice option.
Massage therapists, occupational therapists, physical therapists and other rehabilitative professions should start preparing plans now. Think about how would you work in another airborne pandemic?
In this video below, we’ll show a trellis that's already setup in England that could support outdoor massage, spa and medical practice where it would likely be safer from airborne contaminants than attempting to practice inside where air quality would likely be poorer. If you have available or similar space to this, it's time to plan on how you would or could use it to create safer practices for all.
The following opinion is from a medical and scientific observation. Anyone seeking spiritual or religious guidance should seek answers from their own religious establishments.
The world's leading public service broadcaster, the BBC has stated that prayer was often used in medieval times for medical purposes. Others suggest prayer was commonly used as a method for healing. Some thought that pain or disease was a test of faith or a result from committing a sin, and prayer could improve their new medical issues through divine intervention.
At the Church of Saint-Sulpice in Paris France, there are painting depicting stories of Jesus comforting and healing crowds of people. Saint-Sulpice has a sign further explaining their paintings with quotes from religious sources that said as depicted below: If you know the disease, here you can entrust your state of health, lay down your burden. Be comforted... Jesus always paying great attention to the sick that He met in Israel. He suffered intensely during his Passion: He is beside you in sickness and suffering."
Prayer is multifaceted process because there’s two distinct elements to it:
Calling from higher above.
Being physically restful, peaceful and meditative.
From a scientific and medical standpoint, prayer was probably very helpful in medieval population centuries for pain, disease and other medical purposes. That's because of its restful, meditative element, which has health benefits on its own. Rest is good for your health, period. Without rest, we succumb to fatigue, exhaustion and other compounding medical deterioration. Here are few recent medical studies which demonstrate the benefits of rest:
Notre Dame Church of Paris' rose window is pictured below. Please imagine what it might have felt like to spend some time under these windows in restful silence or prayer at church.
When examining medieval lower and middle class populations, which ironically made up the majority of populations up to today and remains unchanged, we came to these conclusions:
Prior to advanced machinery development with industrialization, people usually worked from dawn until dusk, seven days per week. Transportation included walking, bicycling, horseback riding and other physical activities, sometimes for prolonged periods of time. Cooking required transporting wood, splitting, then creating and maintaining fire. You might have to pluck your own chicken. Fish for your own supper. Plant and harvest your own vegetables. Daily survival was a much larger process, and that’s before we get to the workplace to pay for everything hundreds of years ago. Work could involve swinging a tool to cut a field of hay, all day long. Think about that repetitive strain that would happen if someone did that, day after day, for up to 12 hours per day.
Below, St. Paul's National Cathedral of London is pictured. Can you imagine what it was like to leave your dirt floor home with a straw roof and open windows to enter this religious establishment:
In prayer, we are often sitting, kneeling or standing with stillness. It can be extremely restful, especially when compared to one’s daily activities in medieval times. Prayer allowed an individual to take a break from their daily physical exertion. And it's more than likely that constant daily exertion either caused or exacerbated certain medical issues.
Today, in modern times, we have an entire industry called occupational therapy, which evaluates an individual’s situation to help prevent injury or correct poor personal mechanics to avoid greater harm. Once injured, occupational therapy will help treat it with thermal therapies, exercises, massage therapy, improved routines and other measures. Occupational therapy can also provide appropriate adjustments for daily life or work if an individual is physically handicapped or unable to perform specific tasks due to physical disabilities. And while we did not have occupational therapy in the medieval centuries, there was prayer.
The gates and entries alone to religious houses or churches could leave someone awestruck by that alone. What would you think someone's focus would be when walking up to an establishment or entering through doors like these ones pictured below? The first picture is of a door that was preserved from the Church of the Virgin in St. Germain Paris from the 12th century. This was the side entrance, where plants were intricately carved in stone material. Prior to modern day medicine, the use of plant material through aromatherapy practices was commonly used for healing. We believe using depictions of plant material carved in stone or marble left subtle hints or suggestions of their healing properties being found inside. This door was preserved through history and is now on display at the Musee de Cluny in Paris France.
The next picture is the Hereford Screen made for the Hereford Church in England. It is adorned with passion flowers and currently sits in the Victoria & Albert Museum, aka known as the V & A in South Kensington, London, England. Passion flowers are another natural herbal botanical inscribed by the church. They are thought to be used to relieve pain and insomnia.
This screen is now considered to be a fairly priceless work of art, so it was removed from the Hereford Church in 2000 to be preserved and was permanently installed at the V & A Museum where you can view it today. While most museums are free in London, most museums charge a fee to show their collection. So, in retrospect, today we pay to view such incredible visual pieces; however, in medieval times, tenants of their lords would marvel at these amazing works of art with great hope for something beyond their grasp, and in many cases it was for wishful healing for themselves and loved ones.
The following are additional gates, entrances and facades of various religious houses which show great opulence if not power:
Prayer in a religious establishment might have included physical contact with a staff member. They might have shaken hands, placed a hand on one’s shoulder or back or even hugged. We now scientific studies that show the power of touch:
In terms of pain relief, spending time with a cognitive distraction such as prayer could help disrupt a pain cycle. While pain might be felt in the back, leg or other place in the human body, pain is perceived in the brain. Pain is a cerebral reaction to issues such as soft tissue strain, overuse problems, physical misalignment, injury and other ailments. So when someone is thinking of something other than their pain, especially if they can find a place of positive feelings with rest, this could help minimize, diminish, reset and refocus an individual away from their pain and into a better mindful place.
Many places of worship for prayer have tremendous art installations for an individual to view or focus upon. While some religious artistic scenes portray demons and violence, the majority depict paths to peace. Viewing beautiful artwork can allow time for the human mind and body to experience meaningful rest. It’s a time to get out of your own head and think about something else. Those restful moments for an individual who's mentally taxed or physically overworked could prove beneficial, regardless of the religious component.
According to the American Psychological Association today, "chronic stress is linked to six leading causes of death including heart disease, cancer, lung ailments, accidents, cirrhosis of the liver and suicide."
A common trend of art in churches is to show suffering with hope through grand paintings. Below are two paintings hanging at the Saint-Nicolas du Chardonnet Church in Paris, France. Both paintings depict suffering while one is receiving medical care on their death bed, while the other tells a story of how a woman was completely healed in a religious setting.
Please take a moment to look at these images here with this article. What do you feel, think or see when viewing them? Consider that some of these depict physical items that could stand 30+ feet tall. Can you imagine what type of jaw dropping experience that might have brought a working individual who stares at the same stove or field every day?
So when considering the medieval and post-medieval population having disease, disabilities, or needing adjustments in their daily life to continue, think about the benefits of what some restful peace and touch might have provided to their hectic lives Or the amount of restoration or rejuvenation a little bit of rest might provide. It’s no wonder that people returned to their daily activities with better ease after some restful peace at prayer. This is not to suggest spiritual intervention from a higher source did not occur during prayer or create benefit. This is a simple medical evaluation of how some time at prayer could contribute to better health from a scientific standpoint.
The pictures of church examples we provided in this article are some of the most well known in the world, including Westminster Abbey of London. So while local churches amongst working folk would definitely be less grand, most churches do try and would love to emulate their grander counterparts. In Paris, just across the very narrow Seine river is another church in Notre Dame's shadow. When looking at this for yourself in the pic below, you can see that the smaller, lesser known church is still quite grand when compared to Notre Dame Church of Paris in the background.
Now we do not recommend using religious items to bring about prayer or peace in your spa, massage therapy treatment rooms, health establishments or waiting areas. We are merely providing this opinion as a matter of observation, and to show some roots to our therapies today. Experiencing rest in your workspace, and then beyond your workplace can be achieved through other objects such as nature, plants, peaceful animal depictions and other artistic displays of non devotion. Please review our series of using plants and nature to build a spa or massage therapy establishment’s visuals for revitalizing a practice. It might be the key you need to tap into some additional therapy for both yourself and your clients.
It was noted in the press on July 17, 2025 that the US sitting president, Donald Trump was diagnosed with Chronic Venous Insufficiency which is generally referred to as CVI. Chronic venous insufficiency is one type of disease that could cause swelling over a period of time, usually in the lower extremities. When left untreated, severe cases could result in skin infections, ulcers, infection, sepsis and even death; however, this is regularly averted in countries with modern medical practices such as the US.
While CVI is most often seen in the legs, it can also be diagnosed in the upper extremities or arms. While the pictures in this article do not depict Trump, they are a fairly good example of what CVI could look like in a younger male subject. Affected individuals during the initial onset of CVI define symptoms as unknown bilateral extremity swelling, the feeling of heaviness in the affected extremities and fatigue.
The venous stasis which occurs during CVI can also cause the discoloration effect seen in the pictures above and below. The affected areas can appear darker in color, which is a result of the blood pooling in the veins for prolonged periods of time, which causes swelling, discoloration and other symptoms.
Manual lymphatic drainage has been shown to be an effective treatment for chronic venous insufficiency (CVI). Studies of successful manual lymphatic drainage applied to chronic venous insufficiency date back as far as nearly 50 years ago! One randomized control study concluded: Short-term MLD treatment ameliorates CVI severity and related edema, symptoms, and pain HRQOL in patients with CVI.
One of the things that's most important of all is manual lymphatic drainage has not shown to produce any negative side effects to treat CVI, unlike other possible interventions or pharmaceuticals to treat or ameliorate this common disease.
We teach evidence-based MLD practice here at our school, where manual lymphatic drainage can be provided for a variety of medical disorders and diseases, including CVI. Manual lymphatic drainage utilizes specialized hands-on skills to lightly manipulate the underlying soft tissue to promote drainage wherever acute or chronic edema exists. The goal in MLD practice is to create a volume reduction to reduce the swelling. Clients usually feel better plus have greater physical function and range of motion (ROM) with swelling relief. There is no cure for CVI; however, MLD practice can provide temporary benefits to affected individuals.
This is a professional evaluation of a 50-minute lymphatic drainage session at the Four Seasons Hotel, George V in Paris, France. This is one of my favorite spas in the world, which was refurbished during COVID. I will write a separate article about this newly updated establishment at a later date.
Their manual lymphatic drainage aka MLD was offered as either a 50 or 80 minute service. Manual lymphatic drainage is typically applied to reduce swelling which can produce various health benefits. I do not have any swelling or lymphedema, so I simply scheduled a 50-minute service to evaluate their manual application. What I found is their manual lymphatic drainage strokes and techniques are quite different from what is practiced in the United States, whether it's our evidence-based approach, Chikly, Vodder or other "types" of MLD. Just because something's different, doesn't mean it's less effective. Similar results can be achieved with different approaches, and this establishment had a very different approach.
At this spa establishment where MLD is not being offered in a medical setting, they automatically include both facial and body treatment with their lymphatic drainage appointments. In the US, we usually separate MLD application as a facial treatment, body treatment or if a client wants both facial and body MLD treatment, they would have to specify wanting both when scheduling the appointment, so that an appropriate amount of time can be scheduled for the desired services.
The 50-minute lymphatic drainage treatment began with the service provider using hot towels to wipe both the hands and feet in a private treatment room. This is not the customary start for MLD, but it is good for sanitation and a really nice way to open any type of massage or bodywork service. The lymphatic system work then began with repeatedly pumping of the lymphatic terminus. Her pumping of the terminus was faster than what we teach. The pumping was almost as rapid as a heart beat, with on average one pump per second. I have recently seen greater research that shows this faster pumping technique while we like to teach pumping techniques with client's inhaling and exhaling.
The therapist then moved on to some submandibular work. She worked from the midline laterally on the submandibular area, then moved up to the hairline at the forehead. As she moved onto each new area on the face, she alternated lymphatic terminus pumping in between. Then from the forehead she continued inferiorly along the hairline to work anteriorly to the ears and back to the lymphatic terminus for more pumping.
Abdominal lymphatic drainage was immediately provided after facial work and repeated pumping of the lymphatic terminus. My breast area was draped by a towel while a sheet covered my lower body to expose the abdomen. Very light work was started at four corners around my abdomen, as well as some initial sweeping strokes throughout the abdomen. Then, deeper techniques were applied in the same areas where the lighter techniques at the four corners began. The intensity of pressure gradually increased and the work was primarily provided towards the navel as the pressure was increased. All pressure applied was comfortable and tolerable throughout the entire appointment, including the facial and bodywork. The whole session could be described as light to lightly moderate pressure.
After her finishing strokes on the abdomen, she covered my upper body with the sheet, and then moved to undrape one full lower extremity. The service provider worked proximal to distal on the leg, which is a fairly standard MLD approach when starting extremity work. She manually pumped slightly inferior to the inguinal lymph nodes, then continued her MLD manual techniques inferiorly from the hip towards the foot. She only kept me in supinated position for the entire 50-minute appointment. Once the anterior lower extremity work was completed, she flexed my knee with my foot flat on the table, and reached underneath my leg, starting MLD techniques at the hamstring attachments of the ischial tuberosity, working inferiorly under the leg towards the popliteal fossa. She continued pumping techniques in the popliteal fossa and then worked her way down the calf until she reached the foot again. This was repeated on the other leg.
Once she completed identical work on both legs, she moved back up to my head for more lymphatic terminus pumping and what felt like a general and gentle session closure application. She finished her treatment with a repeated hot towel wiping of my hands and feet, despite not using any lubricant during this dry hands-on application. This is very good practice and may be a required business policy to finish every body treatment, so that there's less liability for the client to slip while dismounting the treatment table. The reason why hands would be wiped is because if the hands are oily and you reach out to prevent a fall, your oily hand may slip on any grabbed surface, so that is why it's good business to wipe both the hands and feet during table dismount.
She washed her hands before starting the hands-on bodywork and again, after she completed it. The therapist did not include the upper extremities during this 50-minute treatment. The upper extremities would likely be included if I had scheduled the longer 80-minute MLD session instead.
After washing her hands, the table was inclined electrically at the superior end which is more good practice, to allow a client to reestablish normal blood pressure in a seated upright position instead of attempting to go from fully supinated to standing after an hour of relaxation, which could end in orthostatic hypotension, which would put a client at other risk during table dismount.
While this MLD session was extremely different from anything I've received before, I wouldn't be able to attest to its effectiveness due to the fact that I do not have any swelling. What I can attest to is that it felt wonderful and was very sanitary and relaxing.
Despite the alternative approach to what we practice or teach for MLD in the US, there was one error made with this MLD service. I had asked the therapist to elevate my legs while supinated on the treatment table, and she initially refused saying that would negatively affect drainage. Unfortunately we shared a language barrier where I was unable to explain that elevating the legs would actually improve drainage instead of hurt it as she had implied. When she did eventually use the electrical table to lift my knees, she further showed that the drainage on my lower legs was now opposite of where we needed it to drain. She is correct that lifting the knees during MLD would promote drainage towards the ankles which is undesired. However, this can be EASILY improved by placing a pillow under the ankles which will create extremely desirable postural drainage for the entire leg. So in this establishment , they are not applying postural drainage techniques that should be used with MLD to make the treatment more effective and achieve greater drainage. Lifting the legs while a client is supinated also has the added benefit of relieving stress on the low back as well.
Overall, aside from not providing appropriate positional drainage with the MLD appointment, in addition to the fact that it was quite different from any MLD I have experienced in the past, I still found it to be an excellent application by a highly skilled practitioner which was enjoyable and quite nice.
Would you like to add another dimension of healing to your spa, medical or massage therapy practice? Chances are, you’re already playing enjoyable music which helps set the tone or mood within your business. Providing music can soothe the mind and tension, especially when service providers are running behind or there’s a period of wait time between appointments and for all other reasons that physically host a customer within your establishment.
Our customers are usually pretty busy, and sometimes they’re even in pain while waiting, which is not a great way to start at your medical or massage practice. They do not have extra time to sit around and wait for others. Have you thought about how you can ease a client’s stress or wait time with acoustic pleasures?
Below is a video of an extremely large sculptured waterfall in front of The Church of Saint-Sulpice in the heart of Paris, France. It’s bustling with tourists, children, traffic, dogs, trains and the general noise of a major European city. But what do you hear next to this water feature? Do you hear the city racket or noise? Or is that water fountain something that would provide acoustic pleasure or peace?
Many people are attracted to, sit and stand around this water feature in front of Saint Sulpice's church here in Paris. And while it’s visually spectacular, the sound itself is also soothing and comforting. Ask yourself, what image would you like to project with your business or practice? Would you like to provide something that feels comforting or peaceful to all senses for your client?
On the downside, some may say the sound of running water may make them feel like they have to go to the bathroom, and that is true. So if you have limited bathroom facilities within your practice, then this might not be the right investment for you. However, if that’s not a concern, then set up a water bubble where clients can replenish themselves, then let the amazing soundful natural enjoyment begin.
Many of us play music within our own establishments. However, hopefully now you can consider a waterfall, fountain or some other device that allows for the sound of the flowing of water, that’s if you don’t already have one! There are many different sizes, price points and types of commercial waterfalls and fountains. Some are very small and can sit on a massage reception area desk or coffee table. Some are very thin and can hang on the walls in a treatment room, hallway or office. Some are larger and are made for centerpieces. The choices are fairly endless.
Sometimes at trade shows, you’ll find a booth by a wholesaler who exclusively sells these to your market. Why? Because it’s a great investment to treat your clients to something that’s easily enjoyable with minimal effort.
