This Is What a Massage Therapist First Notices About You

Your overall hygiene

Your massage therapist is about to get up close and personal with you, so if you show up smelling like you just ran a marathon, they notice (and probably cringe a bit). On the flip side, they’ll also know (and appreciate!) if you have showered or freshened up before a massage. “Not only does this contribute to a more enjoyable experience for both the therapist and the client, but having clean skin also sets the stage for a more effective massage because it allows the therapist to apply oils and lotions smoothly,” says Barcelona.

No time to shower right before a massage? No problem. “If you are coming straight from the office, you probably won’t be able to stop home to bathe,” says Erin Copelan. “[But] showering at some point on the day of your massage is preferable.”

On a similar note, you may want to consider going easy on the perfume. A little spritz will likely be fine, but wearing fragrance may interfere with the calming scents used in a spa—not to mention, it could be overwhelming for your therapist since you’ll be in a small, enclosed space together.

Your posture

Whether you walk into the room like a robot or you’re loose and agile, know that your massage therapist is paying attention. The same goes for how you sit in the chair in the waiting room. Don’t stress, they’re not judging you—they’re just collecting info on your body language so they can do their job better. They’ll see where you hold your tension, if you have an injury, how stressed you are and your overall mood.

Interestingly, they may even be able to tell what kind of job you do based on these things. “For example, if a person has a profession that requires them to sit for long periods of time in front of a computer, they will often present with a chronic forward head posture,” says Barcelona. “It’s a fascinating aspect of my work to notice how the body can reflect the demands and habits of a person’s daily activities.” These little tells can be helpful because they can give your therapist a clue regarding what parts of your body need special attention.

Your breathing pattern

Well before you get on their table, a massage therapist will notice whether your breaths are deep or shallow. Yes, we’re talking even before the treatment has officially started. Here’s why: Breathing is important and can reveal whether or not you are holding tension in your body.

“Our observation begins as soon as the client enters the space, continues during the assessment and persists while they are on the massage table,” explains Barcelona. “This helps me assess their emotional and physical state, providing insights into their tension levels. Typically, slow and deep breaths indicate relaxation, while shallow or irregular breathing may suggest tension.”

Your level of detail

Many massage therapists ask you to fill out a form before a massage. On it, you’ll generally find questions about preferred pressure, areas of your body that may be aggravating you and any medical issues you have. All this information can help therapists do their job better and let them know exactly what you’re looking for. “By combining my assessment with the client’s feedback,” says Barcelona, “I can customize the massage techniques to precisely target and address areas of tension, ensuring a tailored and effective massage experience.”

So when filling out this form, be as detailed as possible. Note where you’ve been feeling tight—even if it doesn’t seem like a place a massage can help. For example, maybe your face is feeling tense. Your therapist may have face massage tools to use on you. And always be clear about the level of pressure you like.

Not sure about that last part? Write that down so the therapist knows to try different pressures to determine what will be both effective and comfortable.

Your reactions

Speaking of pressure, if it is too intense and you start holding your breath or trying not to wiggle against the pain, your therapist will pick up on that. “It’s a clear signal that the deep pressure may be too intense for your body to handle comfortably,” says Barcelona.

You may think that deeper is better, even if it hurts. But that’s not necessarily true, says Copelan. “In my practice, I prioritize technique over pressure,” she explains. “An effective massage can be administered and received without beating you up. If a client feels pain, is flinching or yelps from the pressure, it likely means their muscles are on guard in protection mode, and it will be more challenging for the therapist to access deeper layers of tissue.”

Just like it’s a big mistake not to speak up about a haircut you don’t like at the salon, it’s a faux pas not to mention if the massage pressure isn’t working for you. This is all to say, if it’s too much, speak up! You can even note where it’s OK to use deep pressure (like your shoulders) and where it may be too much (your lower back, for example).

Your real-time feedback

Pressure-related feedback isn’t the only kind of feedback that is appreciated during a massage. Rather than waiting till the end to tell your therapist how the experience is, give them an idea of what you think within the first 10 minutes. This will allow them to change tactics or do more of what you like so that you get the best massage possible.

Not sure what to say? Tell them if something doesn’t feel good—or if it does, so they know to keep doing that, says Barcelona. Or maybe you want them to use more massage oil or to know that the smell of the scented candle burning in the corner is bothering you. These are all valid things to note.

Your body-hair situation

Didn’t get a chance to shave your legs? Are your underarms a little fuzzy? Sure, your massage therapist may notice—after all, they are running their hands over your body. But they won’t care. The same goes for things like back acne or callused feet.

“I strongly encourage clients not to feel embarrassed about their appearance when coming in for a massage,” says Barcelona. “Body hair, acne, scars and various skin conditions are entirely normal and make no difference in the quality of care and attention you will receive during the massage. Your comfort and well-being are what truly matter.”

That said, if you will feel self-conscious the entire time and it prevents you from being able to relax fully, that’s not ideal either. If this sounds like something that would plague you, consider setting an alert on your phone the night before your massage appointment to remind you to shave or give yourself a quick pedicure at home.

Whether you chit-chat or not

A really good massage therapist wants to make you feel as comfortable as possible, so they pay close attention to your conversation cues. If you make small talk, they’ll engage. If you are silent, a good therapist will follow your lead and speak up only when they need you to move or want to check on you. That said, most pros will prefer not to engage in extensive conversation. “I do attempt to limit my responses,” says Copelan. “My massage is better if 100% of my focus is on the client’s body.”

Another thing to keep in mind is that a spa’s environment mirrors that of a library—it’s quiet. “Sound can travel, and that may disturb other clients,” says Barcelona. If you do want to chat, keep your voice low so as not to bother anyone else.

If you’re wearing underwear

To fully strip or not to strip and instead leave your undies on: That is the question. Whatever decision you make, it’s totally fine. But they will notice because if you’re going commando, they’ll adjust the sheet accordingly.

Not sure what to do? “Always ask,” says Copelan. “Some therapists require underwear. I give the client the option and always use proper draping—a technique used to only expose the body part being worked on.”

If you fall asleep

You’re lying on a table in a dark room with relaxing music. Who could blame you if you doze off? Certainly not your massage therapist, especially if they’re using one of those super calming scalp massagers. Still, just like hair stylists, they notice.

“I can typically discern if someone drifts into slumber during a massage,” says Barcelona. “Often, subtle shifts in their breathing pattern signal a transition into a deeper state of relaxation.”

Ah, and falling asleep may even signal to the therapist that they’re doing their job right. “In massage styles like Swedish massage, sleep is often a positive sign, indicating that the therapist is effectively inducing relaxation and comfort,” explains Barcelona.

That said, not every style of massage is suitable for sleeping. Sessions that concentrate on more intensive, structural techniques like trigger-point release and rolfing can be more challenging if someone is asleep, says Barcelona. If you have one of these types of massage scheduled, try to go in well rested to avoid the potential for snoozing.

FAQs

Can a massage therapist detect underlying health problems during a session?

A massage therapist may detect tension, soreness or unusual changes in your muscles and soft tissues, but it’s important to remember that they aren’t trained to diagnose medical conditions. A study published in the International Journal of Therapeutic Massage and Bodywork notes that clinical reasoning—the process of assessing a client and coming up with treatment strategies—is often underused in the field. Yet when applied, it can help massage therapists recognize patterns and suggest when a client should see a doctor.

If you notice anything unusual, like sharp pain, swelling or a lump, it’s always wise to let your massage therapist know. Even though they can’t provide a medical evaluation, they may be able to give you a helpful heads-up for further treatment options.

Are there signs that indicate you should not get a massage?

Yes! There are times when a massage should wait, according to the National University of Health Sciences. If you’re sick with something contagious, injured or under the influence of drugs or alcohol, a session could do more harm than good. For most people, massage is safe and beneficial, but it’s always smart to share health concerns with your massage therapist. They can adjust or let you know if it’s better to hold off until your body’s ready.

How do massage therapists handle clients who are nervous or anxious?

According to the American Massage Therapy Association, massage therapists support anxious clients by creating a calm, safe space and checking in about comfort levels before and during a session. They may soften their approach, adjust pressure or slow the pace to ease tension, all while respecting boundaries and listening without judgment. This steady, reassuring presence helps nervous clients relax and makes the experience feel supportive rather than stressful.

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Sources:

• Carmen Barcelona, licensed massage therapist and owner of Body Boheme
• Erin Copelan, licensed massage therapist and the owner of Erin Copelan Massage
• International Journal of Therapeutic Massage and Bodywork: “Clinical Reasoning in Massage Therapy”
• National University of Health Sciences: “When It’s Not a Good Idea to Get a Massage”
• American Massage Therapy Association: “Beyond the Physical: Massage Therapy for Emotional Health”