Clothing & Draping
"If you leave any clothing on, areas that remain covered will be areas we won't work on today. Does that make sense?" What exactly do I mean by that? How dressed down should you get for your massage?
I get this question all the time- even from clients who've been seeing massage therapists for years! The ultimate answer- the politically correct one that they taught us in massage school is, "you should remove as much clothing as you're comfortable removing". And while of course, that is the right answer, there is also more nuance and information that should go into your decision making to ensure you get the most from your massage.
The Gold Standard of Touch
I've said it before, and I'll say it again; Skin-To-Skin is the Gold Standard of Touch. It is even written into Arkansas Massage Therapy Rules, that "schools must instruct students to work on unclothed clients for a minimum of 20 hours unless documented religious or medical objections are made by the student". Unobstructed skin-to-skin touch is going to provide the therapist with the most accurate palpation assessment. So if you start off with an inaccurate assessment of soft tissue dysfunction, any treatment is going to yield less than the best results.
There are two major aspects of dress that hinder the massage process; jewelry and clothing.
The risk with leaving jewelry on for you massage is that it can get greasy/smudged from the massage medium (lotion, oil, gel, cream). Even worse, jewelry restricts the flow of your therapist's strokes. Jewelry includes earrings(hinders scalp & neck work), necklaces (hinders neck work), rings, and bracelets/wrist watches (hindering wrist/ankle, arm/leg work). By far, my personal least favorite piece of jewelry to try and work around is necklaces- it always feels like I'm tightening the chain and feels like I'm strangling clients. Not a good experience for either of us. I understand that jewelry can have sentimental, cultural, and religious significance- but for the most part, I would highly recommend the removal of jewelry- it keeps your effects safe and provides you a better massage experience.
The essential function of clothing is to create a physical protective barrier to the outside world. In massage, clothing becomes a nonverbal boundary. A boundary that I will always respect. The rule of thumb I give to client's is that any body regions that remain covered are areas that will NOT be worked on. Clothing could be worked through (and some therapists do that for areas that are clothed), but I've moved away from that practice; when I say that something is considered a boundary, it needs to remain a boundary instead of trying to work through the cloths. If you want to remain clothed for a massage, I would recommend a Chair Massage. The most common pieces of clothing that remain on for clients are brassieres (hinders back/shoulder/arm work), undergarment bottoms (hinders low back/gluteal/leg work), and socks (hinders ankle/foot work). All of these are valid boundaries that client's should feel respected- and empowered- to set for themselves. But keep in mind the goals you have for your massage session and where you might be hindering the greatest benefits from happening. I personally don't adjust or move waistbands or hemlines- bottom line; you set the boundaries, you can readjust them if necessary. I will respect your autonomy and the boundaries you set.
These days, when I get a massage, I remove everything. Jewelry and clothes. Pro-tip: I fold my clothes neatly and leave a portion of the waistband of my undergarment sticking out. This lets my therapist know how much clothing I've removed (without starting to undrape) and nonverbally sets my expectations that I need unrestricted full-body work.
And we're not talking interior design! The purpose of draping is to ensure the comfort and modesty of client's who are in various states of undress while on a massage table. Draping commonly refers to table linens (flat sheets & blankets) that are maneuvered to expose body regions for massage. Draping can also include the use of pillowcases, towels, or other coverings with sheets. I should make it clear that (at least in Arkansas) it is illegal to engage in massage of specific regions, namely, then genital and anal/rectum areas. Breast tissue is also illegal to work on except in very specific circumstances; for therapeutic/medical purposes (scar tissue, myofascial binding, and lymphatic flow), with a physician's recommendation, and with the therapist having a minimum of 48 hours of continuing education in lymphatic/myofascial/oncology massage. Breast tissue is breast tissue regardless of sex or gender of the client.
Draping is the responsibility of the therapist. Unless otherwise asked, the client needn't assist in draping except to communicate that the drape feels uncomfortable or unsecure. Your therapist may readjust the drape throughout the session and only one body region should be undraped at a time. The most common style of draping is known as "Diaper Draping" - I once knew this therapist who could drape so quickly and exquisitely. Honest to goodness, he could have taught a CE course on draping alone. His philosophy on draping is one I share with colleagues and clients, "as much as the client doesn't want themself exposed, I don't want to see it even more".
So there are my basic guidelines for draping and clothing for massage. Hopefully it has helped provide you with more insight to making your own personal decisions for your massage care.
Peace and Healing,
Kirby Clark, MMT, BCTMB