In more than 20 years that I've been a licensed massage therapist I've realized there is still much confusion over what to expect at your first massage session: how far to undress, do you tip, is it going to hurt? Whether you've received a gift certificate, rehabbing an injury, or incorporating massage therapy into your wellness program, there's still a first time for everyone.

Although no two massage session are ever exactly the same, understanding what to expect can ease nerves and anxiety.

Even if you receive weekly therapeutic massage, some of these guidelines may surprise you.
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What's the difference between a massage therapist and a masseuse/masseur? One has about 1000 hours of education and keeps their clothes on. In the US, there is definitely a sexual connotation to the title masseuse/masseur. Generally speaking, massage therapists have had nearly a thousand hours of anatomy, physiology, and kinesiology education. They are state licensed, and/or nationally board certified and won't refer to themselves as a masseuse/masseur.
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How do I know if they're a qualified massage therapist? Ask how many hours of training they've had: NYS requires more than 1000 hours. How long they've been working as a MT will also give an indication of how many hours of continuing education they've had (NYS requires 12 CE hours per year). You can verify someone’s NYS license at: http://www.op.nysed.gov/opsearches.htm

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Do I really have to get naked? No. The client may undress to THEIR comfort level. You may undress completely or you may leave your underwear on. Massage therapists abide by strict draping laws, at no time will breasts or private areas be uncovered or touched. The massage therapist will leave the room for the client to undress to their comfort level and lie on the table under the top sheet. When the session is over, the massage therapist will leave the room again to give privacy to redress.
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What if I get cold? As the parasympathetic nervous system kicks in, the heart rate typically slows, and body temperature may lower. I usually carry a professional massage table heater. Also, feel free to prepare a blanket to use during your session.
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Should I talk during the session? Conversation is led by the client. While some small talk may occur at the beginning of a massage session, once the client is quiet, the massage therapist typically doesn't engage in conversation except to occasionally ensure pressure and temperature are okay. If for any reason something feels uncomfortable, the technique or session can be altered based on your feedback. On the other hand, if something feels wonderful, just tell the therapist and they can work in that area longer.
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What if I fall asleep? It is a common response as the sympathetic nervous system (stressed, "fight/flight") quiets and the body relaxes. The massage therapist will gently wake you when it is time to turn over or the session has ended.
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Will the massage be painful? At certain points during the massage, most people find there is usually some discomfort and pain. It is important to communicate to the therapist when things hurt and if any soreness or pain you experience is outside your comfort range. A qualified massage therapist is trained in a variety of modalities/techniques and is able to address deep muscle tissue without causing pain (or bruising!) for the client.
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Do I tip? My philosophy is that gratuities should never be demanded nor refused. A gratuity should be given because you were thrilled with your session and not as a requirement. Please give at your own discretion and never feel obligated.
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Should I cancel my massage if I'm sick? When muscles and joints ache from a cold or flu, a massage sounds great, but isn't the best idea. If experiencing a fever, massage may increase symptoms as circulation is improved. If symptoms are contagious, it's best to reschedule the appointment to protect the massage therapist and other clients.
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How often should I get a therapeutic massage? Frequency of massage sessions is unique to every client. For those rehabbing injuries, recovering from surgery, or incorporating therapeutic massage into an athletic training program, sessions tend to be more frequent: weekly/bi-weekly. If the goal is general relaxation and health maintenance, frequency is determined by how long beneficial effects last based on the client's lifestyle and daily stress patterns: monthly/bi-weekly is fairly common.

Should I eat before the massage session? Please try not to have eaten within 2 hours of your session. Massage improves your digestion. So, if you’re getting a session and hear some grumbling noises and yes, even flatulence, don’t freak. It’s easy to be embarrassed, but there’s absolutely no need to be: It’s not uncommon for people to pass gas during a massage session, it’s completely normal. If you're worried, avoid any high-fiber foods before your appointment.
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How long should the session last? Most people prefer a 75- to 90-minute session for optimal relaxation. An hour appointment is best for a Swedish relaxation massage or for a deep tissue session in the specific region (e.g. neck and shoulders or arms, etc). Always allow relaxation time prior to and after the session. Hot tubs, steam baths and saunas can assist in the relaxation process.
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What is the best time to have a massage session? Schedule smartly. While getting a massage can be a great way to spend a lunch hour, sometimes the beneficial effects of a midday massage are instantly erased by a hectic workday. Try to schedule your massage at the end of the day or just before going to bed so you could roll from a massage table to your bed.
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What should I do before the session? For the best experience, it’s important to take care of yourself before your massage. The easiest and most relaxing way to prep? A long, hot shower. Showering washes off sweat, particulates and chlorine which otherwise would be rubbed against or into your skin and possibly trapped there, at least temporarily, by massage oil. The relaxation effect of a warm shower on both the mind and the muscles will help you be less tense during the session. Plus, it's easier to feel confident and relaxed about the massage when you know you're squeaky-clean! Exercise. Definitely pump the weights or take the run before, not after, your massage. The muscles you work may be a little tired from the exercise itself, but should be nicely warmed up for the massage.
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What should I do during my massage session? Prior to the massage, feel free to ask the practitioner any questions about the technique or the upcoming session. During the massage, make yourself comfortable. The practitioner will either gently move you or tell you what is needed throughout the session (such as lifting your arm or let). Many people just close their eyes and completely relax, communicating if/when they need more or less pressure, or anything else relevant to the session. Remember to Breathe! Especially when your massage therapist is working out a particularly bad knot, it can be tempting to tense up a little bit and hold your breath. Don't do this, or you may miss out on one of the major benefits of your session. It’s crucial that you breathe fully and deeply when difficult areas are being worked on so as to oxygenate your blood supply and aid tense muscles. If you have any questions regarding the session or about the particular technique you are receiving, feel free to ask the practitioner.
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What should I do after the session?

• Stay hydrated. Drinking water after massage recommended. One reason is that water will help the kidneys and other organs process the various substances which move through the body on a regular basis and after a massage treatment, a lot of toxins have been released, so you need to flush them out. And at least for those first few hours after a massage, avoid caffeine and alcohol, which are dehydrating.
• Unless you received a pre-event sports massage session, working out immediately after a massage is not a good idea as you are likely to stress and strain the muscles that were just relaxed. Also, if you plan your workout for after, you’ll run the risk of being too tired and injuring yourself, or just plain losing motivation after being so relaxed. So what about the gym session on your calendar tomorrow? If you receive deeper work, we advise clients that it’s best to wait 12 – 24 hours before working out to allow for healing time from the massage itself. With deep work, micro-tearing of the fibers can occur, in the same way as a hard workout, and the muscles need to recover.
• Have a bath. What could be better than that feeling of sinking into a nice warm bath? I'll tell you - sinking into a nice warm bath after a massage! Adding some Epsom salts (magnesium sulphate) to the bath will also help with easing any aches and pains. The magnesium in the Epsom salts will absorb through skin, while the warm water helps to open your blood vessels, therefore helping to increase circulation. You can find Epson salts in most super markets and chemists, and they tend to be reasonably priced. If you haven't got any, a warm bath on its own will still work wonders - and if you don't have a bath, a warm shower can be just as good. Keep in mind the word warm is important here - a scorching hot bath will increase inflammation, which isn't a good idea after a massage.
• Notice your body's reaction. Have you ever left a massage feeling a little sore in your muscles? Or perhaps you've noticed it the next day? This is also normal - it's most common after a deep tissue massage, but can happen after a more gentle massage as well. Remember that through massage we are working the muscles, so it's like a passive form of exercise. As well as this, when muscles get overly tight, they can constrict the blood vessels in the area. Over time, this stops the circulatory system from effectively flushing out the waste in that area and you can get a build-up, which causes soreness. When releasing this tension, the blood can start flushing out those toxins, but it can leave you feeling a bit tender, like you've just had a workout (which, in essence, you have). If you have regular massage, you might find this decreases over time, however it does depend on what you do between visits or how often you get a massage. This soreness should not be too severe - more like the ache after a big exercise session. And it shouldn't last more than a day or two. It is important to tell your massage therapist at your next session if anything was particularly painful so that the treatment can be modified next time. Remember that massage therapists aren't mind readers - but with adequate feedback from you, your therapist should be able to tailor the massage to your needs.

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How will I feel after the massage session? Most people feel very relaxed. Some experience freedom from long-term aches and pains developed from tension or repetitive activity. After an initial period of feeling slowed down, people often experience increased energy, heightened awareness, and greater productivity which can last for days.
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Will I be sore the next day? Since therapeutic massage increases circulation and eliminates cellular waste from muscular tissue, it is possible to feel a little sore the next day or two. However, it is suggested to increase water intake post session to reduce any soreness. It is also possible to feel subtle shifts in the body in the 24 hours following a massage session as compensation patterns are changing.
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What are the benefits of massage? Massage and bodywork can help release chronic muscular tension and pain, improve circulation, increase joint flexibility, reduce mental and physical fatigue and stress, promote faster healing of injured muscular tissue, improve posture, and reduce blood pressure. Massage is also known to promote better sleep, improve concentration, improve digestion, reduce anxiety and create an overall sense of well-being. Visit http://www.massagetherapy.com/learnmore/benefits.php for more details on the benefits of massage.

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What if I get an erection? This is also a natural, common response when the parasympathetic nervous system is activated. If noticed by the massage therapist, it will be ignored. If the client draws attention to the matter in a suggestive manner, the massage therapist may end the session.
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Can I joke about a "happy ending"? Your massage therapist has heard the jokes a thousand times....they're never funny. If the client is looking for a "happy ending," they're probably looking for a prostitute...not therapeutic massage. Movie and TV industries - it'd be great if you understood that too.
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Which lotion do you use? I primarily use the following professional massage gels. Let me know if you might have any special request or would like me to use your own oil for your session.

• Massage FX Massage Gel has the glide of an oil with the control of a lotion. A little goes a long way for maximum workability. Perfect for full body massage on especially dry areas. Ingredients such as ivy, arnica, aloe and jojoba provide essential moisture and nourishment to the skin. Unscented. Paraben Free. Ingredients: Sunflower Seed Oil (Helianthus Annuus), Soybean Oil (Glycine Soja), Octyl Palmitate, PEG-20 Glyceryl Stearate, Synthetic Wax, Natural Beeswax, Arnica montana (Arnica) Flower Extract, Vitamin E (Tocopherol Acetate), BHT
• Massage FX Massage Lotion is a light formula that provides extended glide. Absorbs better than most creams and oils. Perfect for facial massage or other areas where less oil is preferred. Ideal for deep tissue work. You will love the healthy glow of moisturized skin. Massage FX® Lotion is a non-staining formula that can be customized by adding a few drops of your favorite essential oils. Unscented. Paraben Free. Ingredients: Water, Octyl Palmitate, Isopropyl Palmitate, Sunflower Seed Oil (Helianthus Annuus), Safflower Oil (Carthamus Tinctorius), Soybean Oil (Glycine Soja), Steareth 2, Glycerol Stearate SE, Polysorbate 80, Steareth 21, Dimethicone, Propylene Glycol (and) Diazolidinyl Urea (and) Iodopropynyl Butylcarbamate, Phenoxyethanol, Carbomer, Tetrasodium EDTA, Arnica montana (Arnica) Flower Extract, Vitamin E (Tocopherol Acetate), Triethanolamine, BHT