My general approach regarding massage is to start with the client lying face down on the table and turn them onto their back during the session so that they finish lying face up. Occasionally this may change (eg for athletes with lower limb issues I may begin by working on their quadriceps/hip flexors) but for most of the normal issues that clients present then I start with them face down.

For me there are a number of advantages and reasons for doing this.

Firstly, it’s the industry norm. Now, I know some day spas type massage prefer to start with working the client’s face and head but most remedial therapists will ask you to lie face down.

Secondly, for a new client then it may be confronting to be face up having, for example, abdominal or chest work when they have come in for a lower back or neck complaint. “Hi I’m Richard your therapist for today – do you mind if I massage your stomach?” just sounds an unusual way to start a remedial massage.

Thirdly, many people sinus’ block during a massage. It’s a nicer way of finishing with you lying on your back so that there is a chance that your nose may unblock and you can finish the massage being able to relax rather than worrying how you are going to take your next breath.

However, there is a school of thought within the massage industry that, for most effective remedial massage, you need to release tight facilitated muscles before you begin to work on weak inhibited muscles. Now these terms are massage language, but if you can imagine an elastic band being stretched then it will feel tight but it will feel tight because it is being stretched too much not because it needs to be stretched more. This is the situation with a weak inhibited muscle.

Many people present with tightness between the shoulder blades. Releasing the muscles that work in the opposite manner to these muscles namely the muscles of the chest, will be more effective at reducing the tightness compared with trying to stretch them. Similarly with other muscle groups that affect, say, the lower back and the hips.

And so there is a good case for actually beginning a massage lying face up so that tight, facilitated muscles can be relaxed before you begin to provide the pain relief at the specific location the client feels that they need the work.

If you are interested in testing whether a face-up first massage may provide more effective remedial massage for you then please feel free to contact me on 0434 631 987 to discuss.

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