“Do no harm” is a core principle in all health-care professions. The discussion around this part of the Hippocratic oath in the context of massage therapy, however, sometimes focuses more on the application of hands-on technique and less on the precautions that need to be taken before the client gets on the table.
Let me ask you a few questions. When is the last time you deep-cleaned your office space? Do you routinely wipe down and sanitize equipment, products, and fixtures you might touch during a massage session? When is the last time you checked the bolts, hinges, and cable support system on your massage table? Have you assessed the parking lot, sidewalks, and entryway to your office building to ensure there are no hazardous conditions that might cause your client injury? Keeping our clients safe is our primary responsibility, so let’s be sure you are covering all your bases.

Disinfection Isn’t Just for Hospitals

You would never touch a client without first washing your hands or have a client lie on a table with dirty linens. Because of the emphasis on, and repetitive practice of, these tasks in school, handwashing and changing linens between clients become automatic actions. Can you say the same about cleaning the equipment and supplies in your room? Their cleanliness is just as important!
In order to provide a safe environment with low risk of germ spreading, the following tasks should be routinely performed.

Between Clients
Wipe down the following with a disinfectant:
• Any part of the table the client may have come in contact with, including the face cradle and bolster
• Countertops, door handles, and the lubricant container
• Tools, such as hot stones, T-bars, percussive devices, or other massage tools used during the session
At the End of the Work Day    
• Wash massage sheets, blankets, robes, towels, and other cloth items used during the day in hot water
• Clean and disinfect the bathroom
• Clean the beverage service area (water coolers, hot water carafes, and/or tea selection boxes)
• Empty and disinfect trash bins
Weekly
• Clean window frames, ledges, and blinds or other window treatments
• Deep clean treatment room and bathroom, including vacuuming floors and chairs; dusting shelves, light fixtures, picture frames, and other decorations; and scrubbing the toilet, sink, shower, and mirror

A Stable Table Shouldn’t Be a Fable

I was receiving a massage last week when the therapist applied a technique that required heavy pressure and force. The table made a loud creaking noise. I said, “You might want to check the table bolts after we’re done,” to which the therapist replied, “Nah, it’s fine. This just isn’t one of our heavy-duty massage tables. No need to be alarmed.” This is not a wise approach.
Most modern massage equipment is built to last, but as you apply pressure and techniques such as rocking, vibration, compression, friction, and tapotement, the table has to support the weight of the client along with the movement. Even a client getting on and off the table can place frictional forces on the bolts of table legs and shake them loose. It takes less than a minute to check all bolts and tighten them, and it avoids table collapse, which could significantly harm your client. Check the hinges and cables of the table to be sure they are taut and providing stability. Again, if anything is loose or damaged, tighten and repair immediately.
Face cradles must support the weight of a human head, which generally weighs around 10 pounds, plus the pressure applied when massaging the head and neck in prone position. If the locking lever is even a little bit loose, it could give way and cause injury.
Routinely check these mechanisms. Daily is recommended, and immediately if the table squeaks, creaks, or wobbles even a little.

There’s a Lot to a Lot (and an Entryway)

Many massage therapists don’t realize that if a client is injured from tripping and falling due to damaged, uneven surfaces in the parking lot or along the sidewalk on the premises of their office, they can be held liable. Take a walk around the site of your office building, clinic, or home office with a keen eye for cracks or surfaces that aren’t smooth and flat, and ask for repairs to be made. Ensure the lighting in and around the building is working properly so clients aren’t walking in the dark.
Stairs also need to be stable and steady, and a handrail should be provided for stairs and ramps leading to your office. Area rugs in reception areas, hallways, or your office can be tripped over, so avoid using them.

Covering All Your Bases

While these suggestions might seem common sense, the safety of our clients must be at the forefront of our minds. It’s always good to be reminded of the many tasks we must complete in order to ensure it. It is also essential to have a current, comprehensive liability insurance policy that includes general liability coverage should you ever need it. Hopefully with diligence and awareness, you won’t have to use it.

Since 2000, Cindy Williams, LMT, has been actively involved in the massage profession as a practitioner, school administrator, instructor, curriculum developer, and mentor. She maintains a private practice as a massage and yoga instructor. Contact her at cynthialynn@massagetherapy.com.