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When Your Table Doesn't Accommodate Larger Clients (Video and Full Transcript)

Oh no! You realize your treatment table is too narrow to fit your client's arms. How can you help them be comfortable?

Chances are your schooling didn't really cover how to work with larger bodies but don't worry. I'm Jesse Martel, a licensed massage therapist here in Seattle, and I'm going to show you four solutions for getting your clients comfortable on the table.

First, a word of caution: when you see your client like this (arms falling off the table) of course we want to ask, "Are your arms comfortable like that?"

But the problem is they're almost always going to answer "Yeah, I guess."

At the end of the day, anytime you ask a client of any size a yes or no check-in question, once they're on the treatment table, they're naked, they're prone, you're standing over them... there's all this power differential between the two of you... They are likely going to answer "it's fine" even if it's not fine because in that moment, it's so much easier for them to just affirm whatever's currently happening.

This is true when you're checking in about pressure and asking "is this pressure okay?" They'll answer yes even if it's painful because you're the expert and, I don't know, they're just gonna go with it. Same when you ask "are your arms comfortable like that," they don't want to be a bother they don't know how to fix it, so they're going to say yeah, it's fine, it's comfortable enough.

Instead I encourage you to say hmm, let me try this real quick, and just move their arms or add the bolster, do whatever you think would really help to make them more comfortable, and then ask "is that more comfortable for you?" after they know what it feels like. That way they have two things they can compare, and they can choose the most comfortable option.

You'll have a lot more success communicating with your clients like that.

And by the way, if your client ever says "no, that's not more comfortable," that doesn't mean that you failed! You noticed, you cared, you communicated with your client, and now you're collaborating on what would be the most comfortable outcome for them. So that is an absolute success.

So I encourage you to ask a different question, give them a couple options to choose between, and let them know that you really care and truly do want to make them comfortable.

That brings us to option one, which is a simple verbal cue.

You can ask your client to rest their hands on their belly or chest, or to tuck their hand under their side. This is actually a pretty decent option. It's really comfortable for most people and it keeps the shoulder comfortably internally rotated as opposed to falling out an external rotation.

Your client might not recognize that these positions are okay unless you explicitly tell them. I want you to think back to your first massage, when you didn't know the rules... we put a lot of pressure on ourselves to lie perfectly still with our arms by our sides. So tell your clients it doesn't have to be that way. If they'd be more comfortable with their arms resting on their chest or belly, or hands tucked under their waist, go ahead and do that.

Anyway we have three more solutions to explore, each more clever than the last.

Solution number two is to get a wider table. The standard treatment table is usually 32 inches wide they go up to 40 inches. But let's be real, most of us aren't looking to invest in another treatment table today, and if you're in a group practice this might not even be an option for you at all.

So let's move on to option number three: table extenders!

Transform any regular 32 inches wide table into a 40 inch wide table just by adding this belt thing situation. I was so excited to get these table extenders and start trying them out with clients, but a couple years later I have to be honest, I had to dig them out of deep storage to make this video. I just don't use them anymore. Here's why:

#1: My experience with these table extenders revealed a problem with extra wide tables in general which is that I am a short fat person. I only have so much range that I'm working with here and when the table is wider that means I have to lean more to reach my client, which puts more stress on my back.

The second problem with table extenders is that you have to strip off all the sheets to belt them around the table to put them on, so there's no way to add them once your client is already on the table, which means you have to know your client's size in advance to prepare the table for them, and sometimes that works but sometimes you just don't know until they're here.

But even if you can find solutions for all that, such as being tall and using the table extenders all the time, there's still a third problem with the table extenders which is really the fatal flaw in my opinion.

They can't hold weight.

When you're turning over, if you put your hand on these, you will shift the whole thing and fall off the side of the table. It feels precarious and even a little bit mean when it's time to turn over so for that reason I decided to retire my table extenders.

So this is actually why I wanted to make this video... Solution #4 is something I came up with like a year or two ago. I've been using it regularly with clients and it's a hit so I wanted to share it and see if it works for other people.

The solution is simple, easy, and you don't have to buy anything.

All right, here's my trick: we use the fitted sheet to create a hammock for our clients arms. You're just going to roll up the corner over their shoulder and then their arm can hang in the sling and be totally relaxed while still being held in a supported, semi-flexed position.

You can see that some of the (table) vinyl is exposed when I flip the fitted sheet up and there might be some contact with the vinyl from me or from my client, but it's starting fresh and clean for this session and I'll clean it again when my client leaves.

So these options are great for when the arm is at rest, but what about when you're actually trying to massage the arm?

In that case you'll either want to support the arm with one hand while you massage with the other, or you can sit down and support the arm with your knee while you massage with both hands.

Okay, we're wrapping up here, I'm going to cover some prone options but thanks for watching this far. I'm really trying to grow this channel so please like comment and subscribe if you haven't already thank you!

When your client is lying face down on their belly, the most comfortable thing is probably going to be having them hang their arms off the sides or front of the table.

It's even better if you provide an arm rest, or in a pinch you can use your rolling stool and adjust the height and placement to be perfect for your clients arms. Just don't trip over it...

Okay, so I hope these ideas give you the confidence to take the initiative and get your fat clients comfortable on your table! I encourage you to think creatively and communicate openly. At the end of the day your best teacher will always be your clients, if you can just help them to advocate for themselves.

I'm Jesse Martel, thanks for watching.


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