11 Massage Etiquette Questions You May Be Too Embarrassed to Ask

Massage therapist working on patient's legs
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Not knowing the proper etiquette when having a massage can cause moments of confusion. Do you tip a massage therapist? How much clothing should you remove? Whether you're a massage newbie or have a specific question, here are the top questions you may be reluctant to ask.

Do You Tip a Massage Therapist?

Although a tip is never required, if your massage is at a spa or hotel in North America, a 20 percent tip is standard if you were pleased with the service.

(The exception is all-inclusive spas that have a no-tip policy.) If you were given a gift certificate or purchased a deal through a discount site, a tip based on the original price is customary.

If the spa or clinic provides envelopes for tipping, place the money in the envelope and write the therapist's full name on the envelope to avoid confusion. If a spa doesn't provide envelopes, you can either give the therapist cash or add the tip when you are paying for the service.

If your massage is in a medical or clinical environment, tips may not be expected or even accepted. If you're unsure, ask the clinic receptionist or massage therapist whether tipping is customary. If you don't want to ask in person, call ahead to ask.

Should You Feel Soreness or Pain During a Massage?

It's a myth that any form of massage therapy (even deep tissue massage) must be painful to be effective. Pain during a massage isn't a sure sign that the massage is helping.

In fact, pain can cause muscles to seize up, making it harder for the massage therapist to ease tense areas.

Certain techniques, like trigger point therapy, usually cause soreness. Correcting a soft tissue problem (such as adhesions, tight attachments, and trigger points) can also cause some discomfort.

However, if you don't have a soft tissue condition, a massage shouldn't cause soreness or pain.

Open communication with your massage therapist is key to a massage that meets your needs. If you have an injury or chronically tight or painful areas, be sure that your therapist is aware of it before the start of the session. If the pressure is too intense, tell your massage therapist immediately so he or she can ease up.

How Much Clothing Should You Remove for a Massage?

Typically, a massage therapist will ask you to undress to your level of comfort. Many people prefer to keep their underwear on during a massage, while others prefer to be nude. It's up to you. Women usually remove their bras to allow the massage therapist to work on the back and shoulder area without getting massage oil or lotion on the bra.

If your problem area is your low back, hips, buttocks, or groin, tight-fitting or large underwear can sometimes get in the way of massage work. You can ask your massage therapist before getting changed. In North America, if you do remove your underwear, licensed massage therapists must ensure that you are always properly covered by a sheet or towel.

The massage therapist will leave the room so that you can remove your clothing and lie on the massage table (usually face down) under the top sheet.

In North America, you shouldn't worry that the massage therapist will walk in on you; they should knock and ask if you are ready before entering the massage room.

How much clothing you remove also depends on the type of massage you're getting. If you prefer keeping your clothes on, opt for massage styles like shiatsu or Thai massage, which are usually done fully clothed.

What If You Feel Self-Conscious About Your Body?

Being self-conscious shouldn't keep you from seeking health care, whether it's visiting your doctor or seeing a massage therapist. A professional massage therapist will be non-judgmental and focused on your muscles (and other soft tissue).

Still, some common concerns clients have are:

  • Having back acne
  • Believing they are overweight
  • Thinking they have ugly feet
  • Being self-conscious about scars 

You can request that the massage therapist avoid certain areas. Or, you can look for a licensed massage therapist who uses a style of massage that can be done through clothing. No massage oil or lotion is used, so you remain fully clothed during the treatment.

If you didn't have time to shave your legs, not to worry. Whether or not there is hair on your leg is of no concern to your massage therapist.

Should You Make Conversation During the Massage?

Although some people prefer to talk throughout the massage, don't feel like you have to make conversation with the massage therapist. After all, you're having a treatment; you're not at a cocktail party. Many people close their eyes and try to relax. Your massage therapist should take the cue from you.

Deep tissue massage and sports massage are just some of the types of massage that require more feedback. The massage therapist often works on deeper layers of muscle and will want to ensure that the pressure is comfortable.

Be sure to speak up if you:

  • Feel too hot or cold
  • Are in pain
  • Have any questions about the massage
  • Forgot to mention a health issue during the consultation

What If You Fall Asleep and Snore or Drool?

Falling asleep during a massage is very common. Many people go into a massage stressed and sleep-deprived and feel so relaxed that they fall asleep on the massage table. Your therapist won't judge you if you snore during the massage.

When you wake up, you may notice a little drool on your face or on the massage table. It's common and has to do with your positioning on the massage table. You don't have to do anything about it, but you should feel free to ask for a tissue.

What If You Have to Go to the Bathroom During Your Massage?

Going to the bathroom before the massage begins is ideal, but if you need to urinate during the massage, be sure to let the massage therapist know. Holding it for the duration of the massage isn't comfortable or conducive to relaxing.

If it happens at a spa, there is usually a robe that you can slip on to walk out to the restroom. In a medical setting or clinic, you'll likely have to put your clothes on to go.

What If You Get an Erection During Your Massage?

It's normal for men to sometimes get an erection during a non-sexual, therapeutic massage. There's no reason to be embarrassed if it happens to you. Gentle touch anywhere on the body can activate the body's parasympathetic nervous system, resulting in an erection. A professional massage therapist will understand that and simply ignore it.

What If You Are Ticklish?

Let your massage therapist know if you're ticklish before your massage begins. Usually, firm, slow pressure (and avoiding certain spots) can keep you from feeling ticklish during a massage.

What If You Need to Pass Gas?

From a massage therapist's perspective, it is far better to pass gas during the massage (often a sign that you're relaxed) than to clench your gluteal muscles during the massage to hold it in. Passing gas during a massage is normal and nothing to feel embarrassed about. If you're really uncomfortable doing it, you can always excuse yourself to go to the bathroom.

How Do You Determine Whether a Massage Clinic Is Legit?

If you're trying a new clinic or spa, it's a good idea to call first and ask these questions:

  • Do you offer therapeutic massage?
  • Is the massage therapist certified or licensed?
  • Do you require a health questionnaire of your clients?

A licensed massage therapist will not come into contact with your genitals or nipples during the massage.

A Word From Verywell

Whether you're a massage newbie or just have a specific question that you've been reluctant to ask, being observant can give you clues that may help answer certain questions. You can also ask the clinic or spa receptionist your question. He or she likely answers many newbie questions on a regular basis and would be happy to answer yours so you can get the most out of your treatment.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.