A Reader's Question: Are Massage Therapists Fat Friendly?

A reader asks:

Are most massage therapists fat-friendly? Is it more difficult to do work on a fat person, and is it as effective for the client?

Thanks, Alice!

That's a good question and I'm glad you asked. I'm going to ask some massage therapists and see what they have to say about it. I can't speak for "most" massage therapists. Strangely, I don't recall it coming up in conversation so I don't know what other massage therapists would say. However, speaking for myself, I welcome anyone and everyone that I'm capable of accommodating. It pains me when I occasionally hear someone say that they'd like to get a massage but they are reluctant because of their weight. I want people to feel that my office is one place where they can feel good about themselves and accepted just at they are.

Please note: This article was written in January, 2009. Since that time I have learned some things about how massage works and about how the nervous system works that I didn't know then. My answer would be different now. I am keeping the article as it was originally written. However, I now know that we don't need to be able to palpate the muscles in order to treat pain. In fact, massage works through the nervous system. Receptors in the skin respond to our touch, send impulses to the brain, and it is the brain that makes the muscles relax or turns down the volume on pain. It is not direct pressure on the muscle. Therefore, it doesn't matter how much adipose tissue lies between our hand on the surface of the skin and the muscles below. This is good news.


I still welcome clients of all shapes and sizes and if I am unable to accommodate them for any reason, I am happy to help them find a therapist who can.  - Updated 8/17/13 by Alice


It can present some challenges for the massage therapist and some of this depends on the type of massage that you are doing. If you are focusing on relaxation, there should not really be a problem since the work is more general rather than specific. However, if you are trying to work with a specific pain problem, can be more difficult for the therapist to palpate bony landmarks and to directly affect the muscles below. If the therapist knows their anatomy well, they can compensate for this diminished ability to feel the tissues by their understanding of anatomy. Further, since the nerves that serve the muscles also serve the skin directly over the muscles, we can have an effect on deeper tissues even if we cannot touch them directly. My personal experience is that if I focus, I can sometimes eventually palpate more than than I initially realized. So yes, can be more challenging but it is certainly possible.

As for the effectiveness, this is going to vary with the individual client and is hard to predict. My suggestion would be for a person to try it and see if they find it effective.

As long as my table can safely support a person, they are always welcome in my office. If my table could not support an interested client, I would find a therapist whose table could support them. I would hope that other therapists would feel the same. If they do not, then perhaps they should seek another profession.

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Massage For Couples Class at Forest Park

Have you ever wanted to do massage at home with your partner but didn't know where to start? Do you try doing massage but get tired quickly? Are you wondering how to please your partner, who keeps asking for "harder," without hurting yourself? If so, you need to take the Massage for Couples class I'll be teaching at Forest Park Community College on Feb. 21 and Feb. 28.

This one day, 5 1/2 hour class is meant to give nonprofessionals the basic skills to do massage for relaxation on each other at home. While we can't teach you to be a massage therapist in one day, you should leave the class feeling confident that you and your partner can begin to enjoy sharing massage with each other at home. "Couples" can be any two individuals, not just spouses, but you must register for the class in pairs. Friends, roommates, teammates, and family members are welcome to participate.

The class begins with some introductory information on massage theory so that participants can understand the "why" behind what they are doing. Precautions are covered so that it is clearly understood how to work in a manner that does no harm to either the giver or the recipient. Most of the class is "hands-on." Particular attention is paid to making sure the "giver" works in a way that will not hurt them. A variety of strokes are taught that allow for maximum flexibility. Participants learn strokes that are light but still effective and also more vigorous strokes that can affect deeper tissues.

Class size is limited so that participants get plenty of individual attention and many personal concerns and interests can be addressed. The class is relaxed and friendly. Participants have ranged in age from their early 20s to their 70s and come from many walks of life. It's a lot of fun.

Cost of the class is very modest. To register, go to the website for Forest Park Community College and look for Continuing Education. The class is listed as "Massage for Couples" in the catalog and is in the Health section. Participants should bring a bag lunch, since we only have a half hour lunch break and there is no fast food easily available. Participants also need to bring a set of sheets and a pillow or bolster. Oil will be provided. Sometimes the room is cold so a blanket is highly recommended. Also highly recommended is a yoga mat or heavy bath towel. Since we have to use hard top regular classroom tables, something to make the surface a little more comfortable is desirable. Wear comfortable, loose fitting clothing. You should wear a bathing suit or other clothing that allows maximum access to your skin under your street clothes.

This semester, the class will be offered on Feb. 21 and Feb. 28. If you're interested but can't make it this time, don't despair. The class is offered twice each semester, including the summer semester.

If you've got any questions, please don't hesitate to contact me. If you have questions about registration, call the Continuing Education department at Forest Park Community College.

Hope to see you there! And tell your friends!

Unexpected Results

After a bit of a holiday break, we're back on the blog. Hope everyone is getting off to a good new year.

Life often brings the unexpected and a reader writes about some unexpected results from her massage therapy session.

"Two years ago, I began experiencing considerable, constant pain in my right hip. I was going to be at an event across the country that a friend who is an advanced massage therapist was also going to be at. I scheduled an appointment with him, knowing it was likely to bring me temporary relief and, wow, did I want and need some relief by then!

As it turned out, the single massage gave me a lot more than temporary relief. While he was working, the massage therapist told me what he was noticing in the tightness of my hip and leg muscles suggested that I was probably turning my right foot inward while walking. I'd never noticed myself doing that, but, sure enough, he was right.

Not only did the massage leave me walking pain-free for the first time in more than a month, ever since, whenever I'm walking along and feeling a twinge in my hip, I make a point of pointing my foot out slightly outward...well, making sure it's straight, actually, but it feels like I'm pointing it outward.

Doing that always makes the hip pain go away within moments and the constant pain I was feeling for at least 4-6 weeks before that massage has not returned in the two years since I received it.

I believe it's rare for a single massage to make such a difference, but that one certainly did. It was all thanks to what the massage therapist knew, observed, and mentioned to me as being a possible source of the problem."

I'm always pleased when someone finds relief through massage therapy, but what particularly caught my attention from this reader's story is the unexpected results. We can usually expect to feel relaxed and to get at least temporary relief from sore, tight muscles. However, massage can be a catalyst for other, less expected results.

In this particular reader's case, the therapist was knowledgeable and experienced enough to understand what might be triggering the client's hip pain in the first place. Besides offering some immediate, short-term relief, he was looking at ways to solve an ongoing problem. By making a suggestion as to possible corrective actions, the client herself was able to remedy the source of the pain and prevent future problems.

An experienced and knowledgeable therapist will look for ways to educate the client so that the client can continue to get well and stay well outside of the massage room. By carefully listening to and observing the client, the therapist can help the client discover aggravating factors that may not have been obvious.

Have you had an unexpected result from massage therapy? If so, we'd like to hear about it.