The MT’s 10

In this guide you’ll learn the 10 basics of how to build an online practice for relaxation and self-massage, various platforms for scheduling and taking payment, your office set up, ideas about how to work online and a sample session.

We also present a full sample session of self-massage that you can teach online.

We are living in exciting technological times where massage therapists, craniosacral therapists, Reiki practitioners, Rolfers, bodyworkers, and bodywork training programs are meeting the new demands of clients and students.

If you have the appropriate training and experience, and in some cases an additional certification, online sessions that massage therapists can provide* include:

• Breathing techniques

• Self-massage with hands

• Self-massage with tools

• Couples massage

• Infant massage

• Stretching

• Meditation

• Relaxation

• Energy work

*Before offering a new session or class, check your state and local regulations to make sure you are working within your scope of practice.

We’ll say it again: Don't offer anything outside your scope of practice. In some states, for example, a massage therapist can't provide stretching or instruct in it until they are certified in assisted stretching or have earned certification as an athletic trainer. You might want to pursue advanced education to offer new types of sessions online. If not, double-check your legal scope of practice before launching online sessions.

There are good reasons for providing online sessions beyond the demands of the here-to-stay digital community: some people have faced financial hardship and are looking for a less-expensive option for self-care (group sessions!), some are seeking preventive care, others aren't ready to return to the world for various, often health-driven, reasons, and some may need you more often in between their in-person sessions to support their results.

Some classes are drawing in people all over the world, and word-of-mouth is spreading across social media. Some find themselves interacting primarily now on Facebook groups, live social media presentations, and Instagram channels.

Massage therapists are creating YouTube libraries of relaxation and self-massage techniques and are earning passive income by selling packages and memberships. Some are finding success by creating TikTok channels to make stress reduction and instant relief techniques fun and accessible.

Digital, even in the massage profession, is becoming a way of the future. To help you meet that future, we’ll look at the elements you’ll need to get in place to offer online sessions.

It's a good idea to create a simple website to link to your scheduling page. This is an online hub for your clients to find you with one click. Wix and Squarespace are website builders that offer clean, easy-to-use templates.

Four pages are all you need: your homepage with your mission statement; your services page, where you describe what you offer; your about-you page with bio and contact information; and your scheduling page.

Keep it simple. Before looking for your website, some will look for you on social media. Create an Instagram, Facebook or TikTok page separate from your personal page. Check the availability of your name across social media platforms before committing that name to your domain page, to create synergy. The digital community is vast and far-reaching.

Scheduling and payment software is the heart of your website. Along with a place for clients to schedule, you can send out reminders, intake forms, disclaimers, and make mailing lists for newsletters and group classes. Acuity Scheduling and Calendly (which offers a free version) are both easy to use.

You can choose different-length sessions to offer, from 20 to 90 minutes. For payment, Calendly integrates with Stripe and PayPal, and Acuity with Stripe, PayPal, or Square. Othere scheduling and payment software includes Mindbody, MassageBook, ClinicSense—and others you can find with a quick Google search. This type of software can also send out invoices and generate annual reports, helpful for tax season.

Payment through systems such as PayPal, Square, Zelle, Wise, Stripe or Venmo is convenient whether you use online scheduling or set up appointments by phone or email. They are simply linked to your email. Although fading fast, a check in the mail is still a good option if you prefer to skip the internet altogether. Payment platforms do have transaction fees, some more than others, so read the fine print before you decide which one to use.

Some massage therapists charge by the minute. Some create online session packages to offer savings for those who want to buy sessions in bulk. Without travel time to and from an office, your client can schedule a 30-minute session during their lunch break. Some practitioners offer monthly memberships that provide access to libraries of videos, thereby generating passive income with prerecorded videos.

You’ll need to choose an online video platform. Zoom is the most popular for sessions and teaching. You can even use it on your smartphone. Other options include Skype or Google Hangouts.

Offering your clients the option of recording a session adds value. They can re-watch the session when they like, between sessions with you. If you’re not interested in recording or adding music or video, you can use a simple platform like Signal, WhatsApp, Telegram or Facetime, all free apps that link to your cellphone number.

Zoom offers free and paid subscriptions. With the free version, you can schedule and record with unlimited time for two people. For more than two people, there's a 40-minute time limit. If you are teaching classes, upgrade to the paid version so you have enough time for full-length classes.

A note on recording: If you give your client the option to record the session, have the client record it themselves. They can download it to their computer from Zoom. Zoom offers limited cloud storage, so it's easier if the client handles the recording rather than you storing recordings for several clients. Some clients will be less computer savvy, and in that case, you can record the session for them and then send them a link with an expiration date for download.

You can also set up a YouTube video library and direct clients to your public and private videos by sending a link to watch them. When clients leave comments and subscribe to your work on your YouTube channel, it strengthens professional connections.

If you want to set up a multifaceted business or one that includes teaching classes, video libraries, pre-recorded class series, memberships, sessions and more, there are integrated platforms such as Teachable. The possibilities are endless.

Consider having clients digitally sign a disclaimer form that online session privacy is important, and recordings will not be shared by either party. HIPAA rules and privacy policies are still going to be recognized online; however, in most locations massage therapists aren't governed by HIPAA rules unless they work for someone who is considered a health care provider, such as a physician or chiropractor. However, massage therapists in some states might be considered health care providers— contact your state board of massage or an attorney for the answer where you live.

Also, remind clients that online sessions are a wellness experience and are not a replacement for an in-person massage therapy session. During group classes on Zoom, you need to be the one to press record, and this will prompt a request for each person in the class to give their consent to be recorded.

You may ask the class for those who wish not to be recorded to take a few minutes to change their online screen name and picture or to turn off their video before you begin reminding them that they can give their consent by pressing the ok-to-record button. Remind the class that this is for their use only and that they are not allowed to share links with others or put them on social media.

Your online office reflects your professionalism. The feel, lighting and background are all important. Keep your space neat and uncluttered. Choose neutral-colored walls as the background.

Although things like altars and salt lamps may be important to your practice, they can create visual distractions during online sessions. Be yourself. To add warmth, set up a plant to the side of where you’ll be sitting. Wear light-colored clothes like beige, blue, lilac or white, and keep jewelry and makeup to a minimum.

If you’re going to demonstrate stretches or do floor work, wear modest, form-fitting clothes to demonstrate anatomical references and adjustments, and remind your client to have their props ready as yours will be visible.

The second most important thing is good lighting. The soft, sphere lamps are the best choice as they provide soft, even lighting for your face. The ones with a tall stand are more versatile as they provide a desk or floor option. If you wear glasses, set up lights to minimize glare from the computer. Don't sit with the window behind you, as the client will only see your silhouette. Take time to get your lighting right.

Mark where the camera is on your computer with a sticky note. People like eye contact. When you are speaking, look into the camera. When the client is speaking, look at them on screen. This takes practice but makes the world of difference in creating a comfortable online experience for the client.

Be mindful of how often you are checking in, as you don't want to be intrusive. Your eyes should be at the same level as the camera, and make sure your forehead is not cut off. From left to right, make sure you are in the center of the screen and show more of your body than the ceiling. A swivel stool is helpful for gliding turns when you demonstrate how-to self-massage of the back, neck, and shoulders.

On Zoom, don't use a blurred background, photo background or self-promoting advertisement wallpaper, as they can make the presenter appear blotchy or even disappear, which can be distracting for your clients.

The Gallery view option on Zoom is nice when working one-on-one. In a group, it's ideal to pin yourself as the speaker and make it your responsibility to mute all the microphones versus asking the participants to mute their own. Zoom also offers breakout rooms for group sessions where the people can share their experience with one another in small groups.

To create the best online experience without interruptions, it's best to have a dedicated Ethernet cable plugged into your computer for reliable connection. Turn off notifications from apps that ding on your phone and computer.

Keep your furry animal companions out of the room.

Let the people in your household know you will be in session and not to disturb asking them to stay off the Wi-Fi, so your signal won't break up. If your internet connection is jumpy, it may be the client's signal, and you can ask them to turn off their video for easier streaming.

Keep the volume low if you are playing background music. Nature sounds are relaxing if natural and non-repetitive. Sound machines simply do not translate. Streaming services like Spotify and Amazon offer calming and relaxing spa stations.

And, of course you can always make your own: individualizing is fun! Wholetones, which offers music with healing frequencies, is another subscription-based music service. With Zoom, you can share music from your desktop. (The music and video sharing aspect of online work does take some practice.)

Bring out your inner teacher. People love to learn about their bodies. Savvy navigation of the online experience you are orchestrating will instill confidence in your client.

Some therapists working online offer mini-slideshow presentations with pictures of the muscles they are focusing on. Showing how the trapezius muscle inserts all the way down into the lower back and spans up into the base of the head is very interesting to people, and knowledge gives them a sense of control of their bodies.

If you want to use an image you’ve found online, do contact its owner to request permission to use the image, so as to not violate copyright law. Wikipedia is a great basic resource that allows you to use its pictures. (When you right click on the images you’ve opened, it will indicate if the author requires you to cite them or not.) Unsplash.com is a site that allows free photo use.

In their slide shows, massage therapists and teachers may sometimes provide a step-by-step instruction review list on how to perform self-massage or stretching at home. The trick here is to have the presentation already open before sharing your screen and to become fluent on how to use the multiscreen button on the function strip of your computer keyboard so that you can jump back and forth from screen to screen while you continue your session.

With Zoom, if you’re doing more advanced work, you can easily work with two different cameras, switching between the desktop camera and an action camera like the Bluetooth connected GoPro or webcam. The GoPro can be placed on a floor stand, which is great for showing floor work and means you don't have to lie on the floor in front of the computer when teaching. It even works from the GoPro app on most smart phones.

For those teaching classes online where you demonstrate techniques, stopping and starting the recording to record the technique video separately can offer a major convenience because the technique videos can be broken out to watch separately later.

The greatest feedback from teaching online is having access to those technique videos that students can watch on their own again and again. If techniques are recorded with the GoPro on the forehead, it shows the perspective from the therapist's point of view, which creates a very interactive experience.

And, yes, paying the price for a GoPro, although costly, is worth it. Make sure you get a model that can serve as a webcam and has Bluetooth, as not all of them do.

When in session with your clients, coach them that it's not important that they worry about their camera angle. Often clients get distracted making sure you see that they are doing something correctly on screen. If they are working gently within their limits, they are usually gaining benefit. Always remind them never to push through pain.

Your hands set the rhythm for an in-person session, and online your voice will guide your client through the session. Most people tend to yell or talk quickly when they are online. Slow down, speak clearly, create pauses and check in. Be mindful of transitions and keep them smooth, connected and relaxed.

You’ll want to create the sense of working together with your client, so they don't feel like they’re on stage. If you are interrupted by unexpected construction noise outside, just calmly mute yourself while they work. The shared music will also turn off, so be aware that mute means mute.

One of the big no-nos that almost everyone does while running an online session or class is to talk to themselves while running things. Like, "OK, now I’m going to share sound" and "Now I’m going to share screen." The professional way is to keep talking with the client while you are running the show. Perhaps ask them a question on how they did after their last session; mention how exciting the times are that we can now reach people virtually. Don't be afraid to sell the experience. The world is just getting used to it. Friends and family love to be the test run before going live.

In terms of body language, be mindful of your posture, but stay comfortable. Don't slouch or lean your hands or elbows on the table, and don't rest your chin on your hand. Resting your hands gently on the table is acceptable, and relaxing your body will help your client relax theirs. Don't cross your arms, close your hands, or get too close to the camera.

If you are using your hands to explain something dynamically, hold them at shoulder height for an uplifting affect.

Articulate your words clearly, and smile. This will help to regulate any nervousness. You can always give your client the option to turn off their camera so they don't feel like they are on stage.

Make sure to send your client the link for the online session 24 to 48 hours ahead of time with a cancellation policy note. You may want to offer a free tutorial video to clients who are less computer savvy or add an extra 10 minutes to your session to help them get set up. You can prerecord your tutorial video on Zoom. Create a meeting on your own, record it, and save the recording.

Before your first session:

• Send your client an intake form to fill out and return digitally. This can help you prepare their program.

• Be clear with your client as to when you want payment, either before or after the session.

• Consider having them digitally sign a disclaimer form that privacy is important, and recordings will not be shared by either party.

• Let your client know to wear loose comfortable clothing and to come regularly hydrated.

• Make sure they have their props, which may be a firm chair, a tennis ball, a mat for the floor, a roller, or essential oils, nearby.

• Ask them to use a blanket in case as they tend to cool down with relaxation. (Floor heaters are noisy.)

• Recommend that they have a water bottle or tea nearby.

Online trends show booming numbers of clicks on nature videos and autonomous sensory meridian response (ASMR) stimulating—otherwise known as "brain massage"—videos to help people relax and unwind. Combining self-massage with a virtual reality visual experience is the magic carpet ride people are looking for to let their tensions go.

Most everyone can apply small, circular motions softly with their fingertips on tension points, trigger points and acupressure points, while breathing and visually exploring a walk in the forest or swimming along a coral reef.

Additionally,studies show that being in nature influences regulating the immune and nervous systems. Offering a virtual reality experience takes the pressure off the client and creates even more relaxation.

You can also find something in nature that reflects the anatomy. Compare the wings of a bird to the movement of the breathing diaphragm and the ribs. Or a stream of water as cooling off the heat or discomfort in the body. Guide the client to bring the waves of the beach into the shoulders or the walk in the woods to the bottom of the feet. Bring the video of a waterfall to imagine it running down the spine.

The massage therapist's role is also to create relaxing space, and the frontal lobe enjoys a moment of rest with these exercises.

If you’re using nature videos, choose and watch them ahead of time. Again, contact the creator to request permission and not run afoul of copyright law. Videos should be 10 minutes or longer so that they don't stop mid-technique. Always watch your videos before using them (truth be told, you may stumble upon hunter or prey videos, a big oops!)

Set up your videos (advertisement-free) beforehand and have them ready to go for Zoom's share-screen option. Have all your tabs set up on your browser ready to go and have open only what you need for your session. Be sure not to have your personal email or social media open when you start your share screen.

This is a 60-minute sample session. It could also be two 30-minute sessions, one focusing on the upper body and the other focusing on the lower body. First, here are some basic concepts for guiding clients in online self-massage:

• Brush up on your anatomy. Think fascia! You’ll be giving them the how-tos and whys! Teach them that fascia is a network of tissue that runs through the entire body. Use examples like, "massaging your feet might help your lower back." You can address deeper layers without necessarily using deep pressure.

• Use your words. Decide what words you’ll use like kneading, lengthening, stretching, etc.

• Think about purpose. Massage can help improve circulation and provides relaxation.

• Visualization. Guiding visualization is a powerful tool for relaxation and connection. Bringing in images from nature can help to deepen the experience. You can explore your own metaphors. We’re wired to respond well to imagery and storytelling.

• Check in with the client, answer questions, and go over the payment and disclaimer.

• Begin the session seated.

• Anatomy with slides of where you will work: diaphragm, trapezius, scapulae, pectoralis, rhomboids, quadratus lumborum.) Teach that the diaphragm is the biggest muscle in the body and how it attaches to so many places and can influence the back neck, arms and legs. Keep this quick and fun.

• Move into relaxation with hands on belly and belly breathing (longer exhale) and nature video (synchronize breathing with wings of butterfly), music, feel in and out movement.

Explain and demonstrate on yourself each technique as you move through the session.

• Lymphatic pumping at collar bones.

• Scalp massage in circles to relieve stress. Mini circles at base of head moving out toward ears.

• Massage back of neck, gliding fingertips down, slowly bring chin to chest.

• Take a break with diaphragmatic breathing. Let's not forget that the biggest muscle in the body is the diaphragm. Studies have linked how working with breath has helped many chronic conditions. Studies also show that stimulating the vagus nerve can slow down the heart rate and reduce symptoms of stress.

With a pandemic that has affected some people's ability to breathe and with stress increasing the rate of respiration as an alarm response, massage therapists can use deep-breathing techniques along with self-massage to their diaphragms to help their clients reach a state of rest and relaxation.

To stimulate the vagus nerve, you can coach your client to take deep breaths from the belly, extending the exhalation more than the inhalation. Humming stimulates the vagus nerve as well and can lessen stress. Applying a cold pack to the chest has also been known to calm the central nervous system (which our clients are used to using with sore muscles.)

• Gentle head rolls.

• Pinch and release the trapezius and work around scapulae (tennis ball optional on wall).

• Stretch neck, ear to shoulders.

• Palm of the hand to the sternum, gently move in circular motion.

• Massage pec muscles. Soft knuckles. Start from sternum, stroke outwards as they bring arm up like statue of liberty.

• Massage down each arm through the hand and fingers, mini circles down biceps, glide over forearm and brush out through hands.

• Roll shoulders to integrate, stretch arms tall and then slowly down.

• Nature video or music and breathing, try humming.

• Roll a tennis ball under the bottom of the feet (GoPro to forehead) apply acupressure points to link inner arch of foot to back.

• Break to stand up and move or even dance (while they dance, move GoPro to floor stand, as it pops on and off.)

Explain and demonstrate on yourself each technique as you move through the session

• Massage lower back with fists.

• Massage in circles with finger pads on rib cage.

• Have the client move to floor and lie on their back. Switch camera to GoPro. Lay on back. Tennis ball (optional) to glutes, back of legs, lower back (be careful not to roll kidneys).

• Bring the knees to belly, hold knees and breathe. Rock side to side.

• Stretch lower back, arms to side. Rolls knees fall gently to the right, head to left. Switch.

• Stretch out legs, arms above head. Lengthen and breathe.

• Cue music.

• Relax on the floor.

• Cover up with a blanket.

• Pillow under knees.

• Belly breathing and visualization exercise—imagine you are on a beach basking in the sun … (Experts in neuroplasticity remind us to speak in the present tense and use all five senses.)

End your session with any recommendations, remembering to stay within your scope of practice. Have clients drink some water. You can set up another appointment if appropriate. Wish them well and sign off.

There are endless ways to customize online sessions and classes for your clients and students. What modalities or specializations are you trained in? How can you teach your clients to do this for themselves?

Can you teach them lymph massage, myofascial release, to work with trigger points, or visceral manipulation? What can you teach in a class format? Let your training and creativity guide you.

Set up your office, practice with a friend, and bring your work to the world. You are the next pioneer.

Carey Benenson Taussig, D.O. (IT), LMT has been practicing manual therapy since 2004 and teaches practitioners worldwide how to effectively work with clients online. She is certified in Esalen massage, has a dual degree in osteopathy from the College d’Etudes Osteopathique headquartered in Montreal, Canada,and a B.Sc. from [VP1] Boston University. Online, she teaches practitioners to work with clients to apply self-massage, use imagery and visualization methods to help the body self-adjust, "brain massage" exercises and and vagus nerve stimulation techniques. For more information contact [email protected].

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